Notes in 08 PACU

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Published	07/30/2024	{{c1::Respiratory complication}} is the most frequently encountered serious complication in PACU.
Published	07/30/2024	Routine monitoring of {{c1::pulse oximetry}} allowed early recognition of respiratory complications and fewer adverse outcomes.
Published	07/30/2024	{{c1::Airway obstruction}} is due to the tongue falling back against the posterior pharynx and is usually observed in patients with {{c1::obstructive …
Published	07/30/2024	{{c1::CPAP (continuous positive airway pressure)}} is a machine that uses mild air pressure to keep breathing airways open while you sleep.
Published	07/30/2024	{{c1::Partial}} airway obstruction is usually sonorous in which you can hear the patient snoring while in {{c1::near total}} airway obstruction, there…
Published	07/30/2024	In airway obstruction, there is {{c1::paradoxical movement/seesaw respiration}} wherein the chest descends as the abdomen rises during each inspiratio…
Published	07/30/2024	{{c1::Laryngospasms}} is characterized by high-pitched crowing noises during ventilation but silent with complete glottic closure.
Published	07/30/2024	POST ANESTHESIA CARE UNIT (PACU)previously known as the {{c1::recovery room}}
Published	07/30/2024	Treatment for laryngospasm involves {{c1::jaw-thrust maneuver}} with gentle positive airway pressure via tight-fitting face masks.
Published	07/30/2024	POST ANESTHESIA CARE UNIT (PACU)When are patients taken to the PACU?{{c1::At the conclusion of any procedure requiring anesthesia}}
Published	07/30/2024	POST ANESTHESIA CARE UNIT (PACU)Who do you give the hand off report for patient endorsement?{{c1::PACU nurses or another anesthesiologist}}
Published	07/30/2024	To prevent recurrence of laryngospasm, {{c1::secretions, blood, or other foreign materials in the hypopharynx must be suctioned}}.
Published	07/30/2024	POST ANESTHESIA CARE UNIT (PACU)Why does PACU require heightened vigilance?{{c1::Characterized by an increase incidence of potentially life-threatenin…
Published	07/30/2024	If laryngospasm is still refractory, it should be treated with {{c1::succinlycholine and positive pressure ventilation}}.
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIAQC: 1. Speed of emergence 2. Alveolar ventilation{{c1::A}}
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIAQC: 1. Ventilation2. Delay in emergence{{c1::B}}
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIAQC: 1. Duration of anesthesia2. Blood solubility of the agent{{c1::A}}
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIAThe more time that the patient is exposed to inhalational anesthesia, the speed of emergence will be {{c1::slower}}
Published	07/30/2024	Treatment of glottic edema in infants and young children involves {{c1::intravenous corticosteroids and aerosolized racemic epinephrine}}.
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIA{{c1::Total tissue uptake}} is a function of lipid solubility
Published	07/30/2024	The most common cause of glottic edema in adults is {{c1::hematoma}}.
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIAQC:1. Total Administered Dose2. Speed of Emergence{{c1::B}}
Published	07/30/2024	Treatment of glottic edema in adults involves {{c1::opening the wound}} which relieves tracheal compression.
Published	07/30/2024	EMERGENCE FROM GENERAL ANESTHESIABasis for the concept on {{c1::context-sensitive half time}}Increased total administered dose causingProlon…
Published	07/30/2024	Significant hypoventilation is characterized by greater than {{c1::60mmHg}} PaCO2 or arterial blood pH less than {{c1::7.25}}.
Published	07/30/2024	Severe respiratory acidosis produces {{c1::circulatory depression}}.
Published	07/30/2024	Assessment and management of suspected hypoventilation are facilitated by {{c1::capnography}} and {{c1::arterial blood gas measurement}}.
Published	07/30/2024	{{c1::Hypoventilation}} is most commonly due to residual depressant effect of anesthetic and analgesic agents on the respiratory drive, often made wor…
Published	07/30/2024	{{c1::Opioid-induced respiratory depression}} is characterized by slow respiratory rate, often with large tidal volumes.
Published	07/30/2024	Hypoventilation can be caused by {{c1::residual muscle weakness}} wherein there is inadequate muscle relaxant reversal, drug interaction, altered phar…
Published	07/30/2024	DELAYED EMERGENCEMost common cause for delayed emergence is {{c1::residual drug effect}}
Published	07/30/2024	Splinting due to incisional pain, diaphragmatic dysfunction following upper abdominal or thoracic surgery, abdominal distention, and tight abdominal d…
Published	07/30/2024	DELAYED EMERGENCECBADrug interaction of anethetic agents with chronic alcoholic drinkers to emergenceA. AntagonismB. SynergismC. PotentiationD. Additi…
Published	07/30/2024	{{c1::PaCO2}} can increase due to shivering, hyperthermia, or sepsis.
Published	07/30/2024	{{c1::Hypoxemia}} is common in patients recovering from anesthesia without administration of supplemental oxygen.
Published	07/30/2024	DELAYED EMERGENCEVR: Speed of Emergence1. 33 C2. 37 C{{c1::2}}
Published	07/30/2024	DELAYED EMERGENCEQC:1. Random blood sugar of 62 mg/dl2. Speed of emergence{{c1::B}}
Published	07/30/2024	DELAYED EMERGENCEQC:1. Infusion of 2L of PNSS2. Delay of emergence{{c1::A}}
Published	07/30/2024	{{c1::Hypoxemia}} is common in patients recovering from anesthesia without administration of supplemental oxygen
Published	07/30/2024	DELAYED EMERGENCERare but is still considered in delayed emergence{{c1::Peri-operative stroke}}
Published	07/30/2024	The most common cause of hypoxemia following general anesthesia is {{c1::increased intrapulmonary shunting}} from a decreased functional residual capa…
Published	07/30/2024	A {{c1::semi-upright (“head-up”)}} position helps maintain functional residual capacity (FRC).
Published	07/30/2024	Marked right-to-left intrapulmonary shunting is usually caused by {{c1::atelectasis}}.
Published	07/30/2024	Routine administration of {{c1::30%-60% oxygen}} is usually enough to prevent hypoxia with even moderate hypoventilation and hypercapnia.
Published	07/30/2024	Patients with underlying {{c1::pulmonary or cardiac disease}} may require higher concentrations of oxygen.
Published	07/30/2024	Patients with severe or persistent hypoxemia should be given {{c1::100% oxygen}} via a nonrebreathing mask, LMA, or endotracheal tube until the cause …
Published	07/30/2024	{{c1::Hypovolemia}} is the most common cause of hypotension in the PACU.
Published	07/30/2024	Spinal and epidural anesthesia produce hypotension from a combination of {{c1::arterial vasodilation and venous pooling of blood}}.
Published	07/30/2024	After anesthesia, especially spinal and epidural, there is decreased {{c1::SVR}}, so patient is dependent on {{c1::CO}} to bring up the BP.
Published	07/30/2024	In significant hypotension, there is a {{c1::20-30% reduction in BP}} below the patient’s baseline level.
Published	07/30/2024	In severe hypotension, a {{c1::vasopressor or inotrope}} may be necessary to increase arterial BP.
Published	07/30/2024	Marked hypertension should be treated with an {{c1::intravenous infusion of antihypertensives}}.
Published	07/30/2024	ROUTINE RECOVERY: GENERALSubsequent blood pressure, heart rate and respiratory rate measurements are routinely made at least {{c1::every 5-15 min…
Published	07/30/2024	{{c1::Respiratory disturbances}} will commonly provoke cardiac arrhythmias.
Published	07/30/2024	{{c1::Bradycardia}} in the PACU often represents the residual effects of cholinesterase inhibitors, opioids, or β-adrenergic blockers.
Published	07/30/2024	ROUTINE RECOVERY: GENERALAnesthesia provider should give a report to the PACU nurse that includes:{{c1::Relative preoperative history}}{{c2::Pertinent…
Published	07/30/2024	{{c1::Tachycardia}} in the PACU is most commonly caused by pain, hypovolemia, or fever and may also be due to the effects of an anticholinergic agent,…
Published	07/30/2024	{{c1::Anesthesic-induced depression of baroreceptor function}} makes heart rate an unreliable monitor of intravascular volume in the PACU.
Published	07/30/2024	{{c1::Premature atrial and ventricular beats}} may be the result from hypokalemia, hypomagnesemia, increased sympathetic tone, or, less commonly, myoc…
Published	07/30/2024	ROUTINE RECOVERY: GENERAL ANESTHESIAWhy do you give supplemental oxygen and monitor pulse oximeter in patients recovering from GA?{{c1::Due to th…
Published	07/30/2024	ROUTINE RECOVERY: GENERAL ANESTHESIAPosition to optimize oxygenation{{c1::Back-up position, or Head-up position}}
Published	07/30/2024	ROUTINE RECOVERY: GENERAL ANESTHESIA{{c1::Deep breathing and coughing}} should be encouraged periodically to open up the alveoli that may have cl…
Published	07/30/2024	ROUTINE RECOVERY: REGIONAL ANESTHESIAHow do you check if regional block has progressed or not?{{c1:: Periodic monitoring and documentation of sen…
Published	07/30/2024	ROUTINE RECOVERY: REGIONAL ANESTHESIANurse to patient ratio in the recovery room: {{c1::1 nurse to 2-3 patients}}
Published	07/30/2024	ROUTINE RECOVERY: REGIONAL ANESTHESIA{{c1::Blood pressure}} should be closely monitored following spinal and epidural anesthesia
Published	07/30/2024	ROUTINE RECOVERY: AGITATIONBefore the recovering patient is fully awake, {{c1::pain}} may be manifested as postoperative restlessness or agitation
Published	07/30/2024	ROUTINE RECOVERY: AGITATIONMarked agitation may necessitate {{c1::arm and leg restraints}} to avoid self injury, particularly in children
Published	07/30/2024	ROUTINE RECOVERY: AGITATIONPersistent agitation may require sedation with intermittent intravenous dose of {{c1::Midazolam}}.
Published	07/30/2024	ROUTINE RECOVERY: POST OPERATIVE NAUSEA AND VOMITINGPN/V: {{c1::Most common (30%) immediate complication}}
Published	07/30/2024	ROUTINE RECOVERY: RISK FACTORS FOR POST OPERATIVE NAUSEA AND VOMITING{{c1::Patient Factors (i.e. Young age, Female gender)}}{{c2::Anesthetic Tech…
Published	07/30/2024	ROUTINE RECOVERY: SHIVERING AND HYPOTHERMIAShivering can occur as a {{c1::result of intraoperative hypothermia or effects of anesthetic agents, or bot…
Published	07/30/2024	ROUTINE RECOVERY: SHIVERING AND HYPOTHERMIANearly all anesthetics {{c1::decrease the normal vasoconstrictive response}} to hypothermia by decreasing s…
Published	07/30/2024	ROUTINE RECOVERY: SHIVERING AND HYPOTHERMIAEffects of shivering: {{c2::Precipitous rises in oxygen consumption, CO2 production, and cardiac output}}Ca…
Published	07/30/2024	DISCHARGE CRITERIABefore PACU discharge, patients should have been observed for respiratory depression for {{c1::at least 20-30 mins}} after the last …
Published	07/30/2024	DISCHARGE CRITERIAPostanesthetic aldrete recovery highest score: {{c1::10}}
Published	07/30/2024	DISCHARGE CRITERIA: BROMAGE SCOREOriginal bromage score - only concerned about {{c1::movement. }}Modified bromage score - also checks for the {{c…
Published	07/30/2024	DISCHARGE CRITERIA: OUTPATIENTSPost Anesthesia Discharge Scoring System (PADS): {{c1::Score ≥ 9}} is required for discharge.
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