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HESI THE POST ANESTHESIA CARE UNIT PACU, MRS PAUL EXAM QUESTIONS AND ANSWERS
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HESI THE POST ANESTHESIA CARE UNITPACU, MRS PAUL EXAM QUESTIONS AND
ANSWERS
Mrs. Paul's ANSWER to surgery may be influenced by physiological changes
brought on by age. These will need to be considered while providing care.
Changes related to ageing include:
- calcification in coronary arteries
- reduced reactivity of the protective airway reflexes.
- reduced capacity to deal with temperature variations.
- Increase in subcutaneous fat.
- reduced tolerance for fluid volume fluctuations.
- reduced liver function - ANSWER A. Calcification of the coronary arteries
B. Reduced reactivity of protective airway reflexes.
C. lower capacity to deal with temperature variations.
E. lower tolerance to fluctuations in fluid volume.
F. reduced liver function.
Mrs. Paul has no positional restrictions as a result of her surgery. However,
considering her low blood pressure, you appropriately choose to position her:
- supine, with one pillow.
- semi-Fowler's.
- Fowler's - Answer A. supine, with one pillow.
Mrs. Paul is still prone to hypotension as a result of spinal anaesthesia. The
supine position allows for the optimum circulation of essential organs. For
added comfort, elevate the head of the bed slightly and use one pillow.
The onset of a headache is unrelated to the patient's position after anesthesia.
Which of the following may be related with postdural puncture headache after
regional anesthesia?
- Younger age
- Male gender.
, - Pregnancy - Answer: A. Younger age
Postdural puncture headache (PDPH) is a possible consequence of regional
anesthesia. Younger people are more susceptible to postdural puncture
headaches than older adults. Postdural puncture headache is most prevalent in
people under 40, with the maximum frequency occurring between the ages of
18 and 30.
C. Pregnancy
Postdural puncture headache (PDPH) is a possible consequence of regional
anesthesia. The most common cause of postdural puncture headache in pregnant
women is epidural anesthesia provided during childbirth. If the dura is
damaged, labor may cause increased cerebrospinal fluid (CSF) leakage. Using
smaller spinal needles reduces the likelihood of rips and leaks.
Mrs. Paul is at high risk of venous thromboembolism. Which of the following is
the most effective evidence-based perianesthesia nursing intervention for VTE
prevention with Mrs. Paul?
- Continue using intermittent pneumatic compression (IPC) sleeves.
- Encourage leg and ankle exercise.
Encourage early ambulation.
- Provide early oral hydration - ANSWER A. Continue using intermittent
pneumatic compression (IPC) sleeves.
For patients who are at high risk of venous thromboembolism (VTE),
pharmacologic prophylaxis with low-dose unfractionated heparin (LDUH) or
low-molecular weight heparin (LMWH) is recommended. Mechanical
prophylaxis using appropriately fitted graduated compression stockings or
intermittent pneumatic compression (IPC) sleeves is also recommended for
high-risk individuals. To prevent VTE in the PACU, the nurse must ensure that
Mrs. Paul continues to wear pneumatic compression sleeves.
You also evaluate Mrs. Paul's dorsalis pedis pulses. This is indicated because:
- It is usual practice in the PACU to examine all pulse points.
- The peripheral pulse quality will fluctuate with small changes in systemic vital
signs.
- Pedal pulses will indicate the recovery of function following spinal anesthesia.
- Mrs. Paul's operation may have damaged her peripheral circulation -
ANSWER D. Mrs. Paul's operation may cause reduced peripheral circulation.
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