Chapter 17

Question 1

What is the PACU in charge of?

Answer 1

• Diagnostic tests
• Pain management
• Anastasia complications
• Surgical complications

Question 2

What does PACU stand for?

Answer 2

Post Anastasia care unit

Question 3

What does a handoff report consist of with postoperative patients?

Answer 3

• Name and date of birth
• What type of anesthesia they are on
• Who was the surgeon
• Where was the surgical site
• What kind of dressing is on it
• Are there any drains
• Intake and output
• What was the estimated blood loss (EBL)
• Last time they were given medications
• How their airway and breathing is

Question 4

What is the score used in the PACU?

Answer 4

• The Aldrete score

Question 5

What are some complications in the PACU?

Answer 5

• Atelectasis
• Pneumonia
• Infection
• DVT’s

Question 6

What is it important to remind patients to do in post op?

Answer 6

• Deep breathe and cough often

Question 7

What are early signs of hypoxia?

Answer 7

• Patient becomes restless
• Patient becomes anxious
• tachycardia
• trouble breathing

Question 8

What are the late signs of hypoxia?

Answer 8

• Bradycardia
• Extreme restlessness
• Dyspnea

Question 9

What should never be pushed through an IV?

Answer 9

Potassium because it can alter heart functioning

Question 10

What do you need in order to be released according to the Aldrete score?

Answer 10

• A score of 10 or more or at what they were at preoperatively or better

Question 11

What are 7 common complications that can occur postoperatively?

Answer 11

• Infection
• Respiratory depression
• Lack of mental awareness
• Change in skin tone
• Dehiscence
• Evisceration
• Atelectasis

Question 12

Who is sterile on a surgical team?

Answer 12

• Surgical tech/scrub nurse
• Surgeon
• Surgical assistants

Question 13

Who are the 3 non sterile on a surgical team?

Answer 13

• CRNA
• CNA
• Circulating nurse

Question 14

What two things Must happen prior to surgery?

Answer 14

• Time out
• Sites need to be marked (no matter what)

Question 15

What is Succinylcholine?

Answer 15

• A paralytic drug so there is no twitching or movement during the surgery

Question 16

What is Dantrolene?

Answer 16

• It is given to reverse the process of malignant hyperthermia

Question 17

What is Propofol?

Answer 17

• It is a drug given to make you fall asleep

Question 18

Whose job is it to monitor the airway during surgery?

Answer 18

• The CRNA

Question 19

What are the 4 common intraoperative positions

Answer 19

• Supine
• Prone
• Lateral
• Lithotomy

Question 20

What populations are at risk during surgery?

Answer 20

• Geriatric patients
• Pediatric patients
• Extremely thin patients
• Obese
• Paralyzed
• Diabetic
• Prosthetic arthritic joints
• Patients with infections
• Patients with traumas

Question 21

What devices are used for positioning?

Answer 21

• Foam devices

Question 22

What is the RN’s Role in informed consent?

Answer 22

• To witness concentration and help educate patients on what the procedure means

Question 23

What is consent needed for?

Answer 23

• Consent is needed for photography, viewers, and anyone who is welcome in the room

Question 24

What does DNI mean?

Answer 24

Do not intubate

Question 25

What should preoperative questions include?

Answer 25

- Age - Allergies - Medical history - Anastasia - Implants - Last oral intake - Abuse - Mental illness - Social awareness/support - Piercings

Question 26

Why is assessment important?

Answer 26

- So we have a baseline of what the patient is like and feeling beforehand

Question 27

What are the 4 labs required before surgery?

Answer 27

- CBC - Type and crossmatch - BMP - Pregnancy test

Question 28

What radiologic tests can be needed before surgery?

Answer 28

- Chest xray - CT - MRI - Ultrasounds

Question 29

What can be taught to the patient prior to surgery?

Answer 29

- Teach them they may have pain - Use incentive spirometer - How to use call lights - How to use PCA

Question 30

What needs to be prepared on the patient before surgery?

Answer 30

- Remove dentures - Remove undergarments - Remove prosthetic devices - Use the bathroom - Shower with antibacterial soap - Glasses off

Question 31

What are the 3 roles a nurse takes on prior to surgery?

Answer 31

1. educator 2. advocator 3. admittance nurse

Question 32

What 4 things need to be confirmed in a time out phase?

Answer 32

- All information on the id band is correct - Name of the surgeon - The procedure that will be completed by the surgeon - The correct side that the surgery will occur on

Question 33

What 7 things are required to be part of a consent form?

Answer 33

1. name of the surgery 2. Name of the surgeon 3. Reason the intervention will benefit the patient 4. All alternative options to surgery 5. Potential outcomes of the surgery 6. Consent for anestesia 7. Consent to administer blood

Question 34

When does the preoperative phase begin and end?

Answer 34

Begins when the decision to have surgery is made and ends when the patient is transferred to the surgical suite.

Question 35

What are the 4 priority assessments right before surgery begins?

Answer 35

- The completion of the preoperative assessment - The surgical pause - The surgical scrub - The donning of surgical attire

Question 36

What are the 4 main goals of the preoperative assessment?

Answer 36

1. Determine the patients level of knowledge about the procedure 2. Confirm consent has been received 3. Determine the patients level of anxiety about the procedure 4. Obtain relevant information about the patient

Question 37

How long does the postoperative period last?

Answer 37

From the second surgery ends to the first follow up physician visit

Question 38

How long do patients need to be NPO for prior to surgery at a minimum?

Answer 38

- 8 hours at a minimum

Question 39

What is a normal WBC count?

Answer 39

4500-10000

Question 40

What is the normal range for platelets?

Answer 40

150,000-450,000 Low platelets places you at risk for bleeding and can result in a postpone of surgery