Practice Question
A surgical client has been in the PACU for the past 3 hours. What are the determining factors for the client to be discharged from the PACU? Select all that apply.
Answer Choices:
Correct Answer:
Adequate respiratory function
Rationale:
Adequate respiratory function:
🔷 Airway patency and an effective respiratory rate/depth are core criteria for PACU discharge because they determine the client’s ability to ventilate without assistance.
🔷 Clients must demonstrate spontaneous, unlabored breathing with no signs of obstruction or accessory-muscle use.
🔷 Adequate ventilation lowers the risk of hypoventilation, hypoxemia, and CO₂ retention once monitoring decreases on the ward.
🔷 PACU scoring tools (e.g., Aldrete) weight respiration heavily when determining readiness.
🔷 Ensuring respiratory adequacy supports safe transition from the highly monitored PACU to a lower-acuity setting.
Sufficient oxygen saturation:
🔷 A stable SpO₂ at or near baseline (commonly ≥ 92–94% on room air or with minimal supplemental O₂) confirms effective gas exchange.
🔷 Adequate saturation verifies that oxygen delivery to tissues will remain sufficient after transfer.
🔷 It reduces the chance of occult hypoxemia as sedatives/anesthetics wear off.
🔷 SpO₂ is an objective metric that complements respiratory assessment and validates discharge readiness.
🔷 Documented, stable SpO₂ is a standard discharge parameter in PACU pathways.
Stable blood pressure:
🔷Hemodynamic stability (BP and HR near preop baseline) indicates effective circulatory compensation after anesthesia and fluid shifts.
🔷Stable BP lowers risk of syncope, organ hypoperfusion, and bleeding after transfer.
🔷It suggests adequate volume status and recovery from anesthetic-related vasodilation.
🔷PACU discharge criteria typically require BP within ~20% of baseline without escalating support.
🔷Together with mentation and respiration, stable vitals confirm safe progression of care.
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This question is from Adult Nursing II-Exam 1 which contains 56 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Medical-Surgical
- Answer Choices: 5