Post-Anesthesia Recovery
You're watching a preview. 300,000+ students are watching the full lesson.
Included In This Lesson
NURSING.com students have a 99.25% NCLEX pass rate.
Outline
Overview
- What is post-anesthesia recovery
- Destination of anesthetized surgical patients
- “Wake up” after surgery
- Post-anesthesia care unit (PACU)
- PACU RN provides care
- Post-anesthesia care unit (PACU)
- “Wake up” after surgery
- Destination of anesthetized surgical patients
- Sequence of events in PACU
- Immediate admission
- Hand-off from
- Anesthesia
- Perioperative RN
- Initial assessment
- Implementation of interventions
- Evaluation
Nursing Points
Assessment
- Upon immediate admission into PACU
- PACU nurse performs
- Initial assessment (ABC’s)
- Airway
- Patency determined
- Breathing
- Oxygen applied
- Respirations counted
- Pulse oximetry applied
- Circulation
- Connect to cardiac monitor
- Evaluate
- Heart rate
- Rhythm
- Evaluate
- Blood pressue
- Connect to cardiac monitor
- Airway
- Initial assessment (ABC’s)
- PACU nurse performs
- Hand-off report from
- Anesthesia provider
- Information provided
- ASA classification
- “Sickness” of pateint
- Anesthesia type
- Current medications
- Lines
- Fluids
- Losses
- Estimated blood loss
- ASA classification
- Information provided
- Perioperative RN
- Information provided
- Preoperative diagnosis
- Procedure performed
- Location of
- Drains
- Dressings
- Catheters
- Tubes
- Packing
- Medications given by surgeon
- Communication of
- Family issues
- Patient deficits
- Patient special requests
- Information provided
- Hand-off not complete until
- PACU assumes responsibility for patient
- Anesthesia provider
- Initial assessment
- After ABC’s and Hand-off
- Assessment specific to type of surgery
- Includes
- Vital signs
- Respiratory status
- Airway patency
- Breath sounds
- Artificial airway settings
- Blood pressure
- Arterial line
- Cuff
- Pulse
- Apical/peripheral
- Temperature
- Hemodynamic pressure reading
- Respiratory status
- Pain assessment
- Sedation level
- Comfort assessment
- Position of patient
- Condition/color of skin
- Neurovascular check
- Peripheral pulses
- Sensation of extremities
- If applicable
- Condition of
- Dressings
- Suture line
- Drains
- Tubes
- Muscular response
- Pupillary response
- Intake and output
- Post-anesthesia score
- Aldrete score
- Scoring system for safe discharge
- Aldrete score
- Vital signs
- Implementation of interventions
- PACU RN
- Continues vigilant monitoring
- Promotes
- Deep breathing
- Coughing
- Repositioning
- Comfort
- Temperature control
- Mobilization
- Pain management
- Oxygen delivery
- Monitored and decreased
- Per patient condition and PACU order
- Monitored and decreased
- PACU RN
- Evaluation
- Patient exhibits
- Adequate
- Ventilation
- Expansion of lungs
- Perfusion
- Blood pressure
- Heart rate
- Tolerable pain level
- Pharmacologic and nonpharmacologic
- interventions initiated
- Understands discharge instructions
- Ventilation
- Adequate
- Patient exhibits
Nursing Concepts
- Safety
- Oxygenation
- Comfort
Patient Education
- Teach patient
- Express pain and comfort needs
- Ask questions!
Unlock the Complete Study System
Used by 300,000+ nursing students. 99.25% NCLEX pass rate.
- Full lesson outlines
- NCLEX simulator (SIMCLEX)
- 6,500+ practice questions
- 2,000+ lesson videos
- 300+ cheatsheets
200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.
Transcript
Hi guys! Today I am going to talk a little about post-anesthesia recovery!
So what is post-anesthesia recovery? So guys this is the destination or where surgical patients go to “wake up” after receiving anesthesia. We call this area the PACU or post-anesthesia care unit and the PACU RN is going to be the one providing the care.
So what are the sequence of events that occur in the PACU? So guys I just want to mention that things can occur slightly different than this list as all facilities are different but this will give you a good idea of what occurs. Ok so after surgery the surgical patient is going to come into PACU from the OR and will be met by the PACU RN who will provide an immediate admission assessment, hand-off from the anesthesia provider and the perioperative RN will provide information to the PACU RN, a more thorough assessment will be completed along with implementation of interventions and an evaluation to prepare the patient for discharge.
Ok so lets look a little closer look at the steps! Ok so when the patient arrives and is immediately admitted to the PACU the RN will perform an initial assessment that includes the ABCs or airway confirming patency, breathing which would include applying oxygen and a pulse oximeter, and circulation by connecting the patient to a cardiac monitor to evaluate the heart rate, rhythm, and blood pressure.
So once the patient has arrived and an immediate assessment by the PACU RN is completed the hand-off report will take place. The anesthesia provider will give any important information about the patient and the surgery. This can include information like the anesthesia type, the ASA classification of the patient or basically how sick the patient is, anesthesia medications and fluids given, lines, and estimated blood loss or EBL.
The hand-off report from the perioperative RN will give the PACU RN slightly different information. This information can include the perioperative diagnosis, procedure performed, any complications, location of drains, dressings, incision site, any medications given by the surgeon during the procedure as well as any specific patient information that needs to be provided. It is very important to mention that the hand-off of the patient is never complete until the PACU RN assumes responsibility of the patient.
Alright guys so after the hand-off the PACU RN is going to complete a thorough initial assessment this is typically specific to the surgery that the patient has had. So guys there are quite a few things that the PACU RN assesses in their patient to determine their safety in the moments just after surgery. Ok so lets go through this list! Of course the vital signs are going to be continued to be assessed which includes the respiratory status of the patient confirming the airway patency, breath sounds, or even the artificial airway settings if the patient is on a vent. Also the patient’s blood pressure will be assessed by cuff or even arterial line. Temperature is very important to assess in surgical patients as they are prone to perioperative hypothermia. Guys be sure to check out the lesson on intraoperative complications for more information.
Assessing pain, sedation level, and comfort are all included in the initial assessment. Also guys the condition and color of the skin will be considered. A neurovascular check will be completed especially if the surgery occurred on an extremity which includes the peripheral pulses and sensation of the extremity. Also guys it is important for the PACU RN to verify the condition of the dressings, suture line, drains, as this could really indicate a serious issue if the drains are draining too much or the dressings are saturated. Guys be sure to check out our lesson on post-operative complications!
Also guys the muscular response of surgical patients is also important to indicate any issues and also the pupillary response and the post-anesthesia score which can help to indicate if the patient is still sedated and how ready the patient is for discharge. There are different scoring systems for this but a super common one is the Aldrete Score. So the Aldrete score like I mentioned is a scoring system that evaluates how ready a patient is to go home safely. So based on a few different categories like consciousness, mobility, color, breathing, and circulation the patient will receive a score, 0 being the lowest and worst score and 8-10 being a score that is needed for discharge….just remember 8 is great!! Also guys we always want to monitor the intake and output of the patient as this could indicate an issue like dehydration.
So what happens after the patient receives a very thorough assessment by the PACU RN? Well of course the RN is going to continue monitoring the patient closely but they are also going to begin promoting interventions like deep breathing, oxygen delivery that can eventually be decreased, mobilization, and pain management. So guys the hospital where I work is super quick with some of the patients being discharged within an hour. So as you can imagine the PACU RN must be very efficient and focused in the care of their patients.
So finally guys the PACU RN will evaluate the patient to assess their readiness for discharge. We want to see the patient exhibit adequate ventilation, blood pressure, heart rate, and a tolerable pain level. We also at this point want to make sure that pharmacologic and nonpharmacologic interventions have been initiated and we also want to be sure that the patient is starting to gain an understanding of discharge instructions. And don’t forget about any post-operative orders from the provider!
So after a patient receives anesthesia they can be sleepy or even a little out of it in recovery. So with that in mind sometimes teaching is difficult until they wake up a bit. But always try your best to teach and encourage patients to express their pain and comfort needs and of course ask questions!
So when we consider nursing concepts that apply to the topic of post-anesthesia recovery safety is the first to come to mind! Oxygenation is huge as our surgical patients have just emerged from anesthesia with comfort being key.
Ok guys lets look at some key points! Post-anesthesia recovery is the destination of anesthetized patients where they “wake up” after surgery, this occurs in the post-anesthesia care unit and care is provided by the PACU RN. The anesthesia provider and perioperative RN will provide information regarding the surgery like anesthesia type, procedure performed, lines, drains, incision site, complications. After the hand-off an initial assessment is performed that is usually specific to the surgery but includes vital signs, pain, sedation, comfort, muscular, neurovascular check, and post-anesthesia score or Aldrete. The PACU Rn implements interventions while still monitoring the patient with deep breathing, mobilization, comfort interventions. The end goal is discharging the patient so evaluation is necessary to be sure the patient is adequately ventilating, they have an adequate vital signs, and a tolerable pain level.
Okay guys I hope you enjoyed this lesson on post-anesthesia recovery! Make sure you check out all the resources attached to this lesson, as well as the rest of the lessons in this course! Now, go out and be your best self today. And, as always, happy nursing!
Study Faster with Full Video Transcripts
99.25% NCLEX Pass Rate vs 88.8% National Average
- Full lesson outlines
- NCLEX simulator (SIMCLEX)
- 6,500+ practice questions
- 2,000+ lesson videos
- 300+ cheatsheets
200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.
Nursing School Doesn't Have To Be So Hard
Go from discouraged and stressed to motivated and passionate
Study Plan for Test Taking for the NCLEX® designed for Bolivar Technical College
Concepts Covered:
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Respiratory Disorders
- EENT Disorders
- Prenatal Concepts
- Studying
- Prefixes
- Suffixes
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Legal and Ethical Issues
- Preoperative Nursing
- Integumentary Disorders
- Oncology Disorders
- Musculoskeletal Trauma
- Bipolar Disorders
- Disorders of the Posterior Pituitary Gland
- Hematologic Disorders
- Community Health Overview
- Immunological Disorders
- Renal Disorders
- Childhood Growth and Development
- Labor Complications
- Upper GI Disorders
- Medication Administration
- Neurological Emergencies
- Adulthood Growth and Development
- Disorders of Pancreas
- Musculoskeletal Disorders
- Cardiac Disorders
- Disorders of the Thyroid & Parathyroid Glands
- Integumentary Important Points
- Pregnancy Risks
- Urinary Disorders
- Vascular Disorders
- Eating Disorders
- Learning Pharmacology
- Anxiety Disorders
- Basic
- Basics of NCLEX
- Factors Influencing Community Health
- Lower GI Disorders
- Intraoperative Nursing
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Trauma-Stress Disorders
- Central Nervous System Disorders – Brain
- Somatoform Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Depressive Disorders
- Personality Disorders
- Cognitive Disorders
- Substance Abuse Disorders
- Psychological Emergencies
- Circulatory System
- Postoperative Nursing
- Hematologic Disorders
- Liver & Gallbladder Disorders
- Infectious Respiratory Disorder
- Central Nervous System Disorders – Spinal Cord
- Emergency Care of the Cardiac Patient
- Concepts of Population Health
- Peripheral Nervous System Disorders
- Emotions and Motivation
- Note Taking
- Female Reproductive Disorders
- Delegation
- Oncologic Disorders
- Prioritization
- Postpartum Complications
- Endocrine and Metabolic Disorders
- Fetal Development
- Shock
- Emergency Care of the Neurological Patient
- Respiratory Emergencies
- Labor and Delivery
- Gastrointestinal Disorders
- Communication
- Concepts of Mental Health
- Health & Stress
- EENT Disorders
- Urinary System
- Digestive System
- Tissues and Glands
- Developmental Theories
- Postpartum Care
- Cardiovascular Disorders
- Newborn Care
- Renal and Urinary Disorders
- Newborn Complications
- Musculoskeletal Disorders
- Infectious Disease Disorders
- Nervous System
- Behavior
- Respiratory System
- Basics of Human Biology
- Neurological Trauma
- Concepts of Pharmacology
- Microbiology
- Psychotic Disorders
- Emergency Care of the Trauma Patient