MAC Postoperative Care & PACU Management 1 — Questions and Answers
Question 1: What is the minimum oxygen saturation threshold for PACU discharge per standard Aldrete scoring?
- 85% on room air
- 92% on room air or at baseline (Correct answer)
- 100% on supplemental oxygen
- 95% on supplemental oxygen
Correct answer: 92% on room air or at baseline
An SpO2 ≥92% on room air or at the patient's baseline oxygen requirements is part of standard PACU discharge criteria.
Question 2: What are the most common causes of postoperative nausea and vomiting (PONV)?
- Antibiotic administration
- Opioid use and volatile anesthetic agents (Correct answer)
- Excessive IV fluid administration
- Postoperative hypothermia
Correct answer: Opioid use and volatile anesthetic agents
Opioids stimulate the chemoreceptor trigger zone and volatile anesthetics directly trigger nausea pathways, making them the primary PONV drivers.
Question 3: Which factor is NOT included in the Apfel PONV risk score?
- Female sex
- Non-smoking status
- History of PONV or motion sickness
- ASA physical status classification (Correct answer)
Correct answer: ASA physical status classification
The Apfel score includes female sex, non-smoking status, PONV/motion sickness history, and postoperative opioid use — not ASA classification.
Question 4: What condition should be suspected when a PACU patient develops agitation, hypertension, and tachycardia simultaneously?
- Adequate analgesia
- Inadequate pain control or emergence agitation (Correct answer)
- Anesthetic drug overdose
- Isolated hypovolemia
Correct answer: Inadequate pain control or emergence agitation
The triad of agitation, hypertension, and tachycardia in the PACU suggests inadequate analgesia or emergence agitation requiring prompt assessment and treatment.
Question 5: What is the Aldrete score used to assess in the PACU?
- Intraoperative hemodynamic stability
- Readiness for PACU discharge (Correct answer)
- Prediction of postoperative complications
- Anesthetic depth during the case
Correct answer: Readiness for PACU discharge
The Aldrete score evaluates activity, respiration, circulation, consciousness, and oxygen saturation to determine PACU discharge readiness.
Question 6: What is the primary concern with prolonged postoperative shivering in the PACU?
- Decreased metabolism
- Significantly increased oxygen consumption by 200-300% (Correct answer)
- Bradycardia
- Decreased pain perception
Correct answer: Significantly increased oxygen consumption by 200-300%
Postoperative shivering increases oxygen consumption by 200-300%, stressing cardiopulmonary reserves particularly in patients with limited reserve.
MAC Postoperative Care & PACU Management 1
What is the minimum oxygen saturation threshold for PACU discharge per standard Aldrete scoring?