Exam (elaborations)
CHAPTER 19 POSTANESTHESIA CARE PACU T1 TEST
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CHAPTER 19 POSTANESTHESIACARE PACU T1 TEST
PACU
• The surgeon, operating nurse, and anaesthesia give a HAND-OFF
report to the PACU nurse
postoperative period begins immediately after surgery and continues
until the patient is discharged
immediate recovery period is managed in a post-anesthesia care unit
(PACU).
usually next to the operating room (OR).---limits the transportation of the
patient right after surgery and gives ready access to anaesthesia and
OR staff.
goals of PACU care are to maintain patient safety during recovery from
anaesthesia and identify actual and potential patient problems
patient's admission to the PACU is a joint effort among the anaesthesia
care provider (ACP), OR nurse, and PACU nurse.
PACU Progression
3 phases - each phase have diff levels of care depending on pt needs
If a patient assigned to Phase I care on admission to the PACU is stable
and recovering well, the patient may rapidly progress through Phase I to
either Phase II care or an inpatient unit (RPP = Rapid PACU
progression)
fast-tracking - accelerated system, involves admitting ambulatory
surgery patients directly to Phase II care.
Phase I
• Care during the immediate postanesthesia period
• ECG and more intense monitoring (e.g., arterial BP monitoring,
, mechanical ventilation)
Goal: Prepare patient for transfer to Phase II level of care, an inpatient
unit, or intensive care setting
Phase II
• Ambulatory surgery patients
• Fast-tracking (i.e., patients who have bypassed Phase I level of care)
Goal: Prepare patient for transfer to extended observation, home, or
extended care facility
Extended Observation • Extended care or observation after
transfer/discharge from
Phase I or Phase II levels of care
Goal: Prepare patient for self-care
Blended Levels of Care
• Various levels of care offered in the same environment
Phase I Initial Assessment
ACP gives report to admitting PACU nurse (hand-off report)
-ACP should stay in the PACU until you accept responsibility for the care
of the patient
Begin your initial assessment by evaluating the patient's airway,
breathing, and circulation (ABC) status.
priority care=
- Begin by evaluating ABC's
- Be alert for signs of inadequate oxygenation and ventilation = prompt
intervention
- monitoring an managing respiratory and circulatory function, pain,
temperature and surgical site (VITAL SIGNS!!!) assess rate
and rhythm of breaths
- Note and assess changes in ECG findings from the preoperative
baseline. Measure the BP and compare it with baseline readings.
- Focus the initial neurologic assessment on level of consciousness;
orientation; sensory and motor status; and size, equality, and reactivity
of the pupils.
- Assess the urinary system by measuring intake and output and
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