13 Anesthesia, Physiological Monitoring, and Post Anesthesia Recovery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 13.1: Anesthesia Selection and Preparation
- 1. Explain important anesthesia concepts
- 2. Identify anesthesia personnel
- 3. Describe the components of an anesthesia evaluation
- 4. Discuss the anesthesia selection process
- 5. Explain the preparation of the patient for anesthesia
- 6. Describe the components of physiological monitoring
Lesson 13.2: Anesthesia in the OR
- 7. Describe basic anesthesia equipment and its use
- 8. Describe the concepts of airway management
- 9. Define general anesthesia and describe induction, maintenance, and emergence
- 10. Discuss the difference between dissociative anesthesia and conscious sedation
- 11. Explain how regional anesthesia is used
- 12. Define common types of regional anesthesia
- 13. Define the role of the surgical technologist during the use of regional anesthesia
Lesson 13.3: Post Anesthesia Recovery
- 14. Describe the layout of the post anesthesia care unit (PACU)
- 15. Discuss the elements of a handover from the circulating nurse to the PACU nurse
- 16. Describe the Glasgow Coma Scale
- 17. Discuss unanticipated PACU outcomes
- 18. Define the purpose of discharge planning
Classroom Preparation
Lesson 13.1: Anesthesia Selection and Preparation
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Explain important anesthesia concepts
- 2. Identify anesthesia personnel
- 3. Describe the components of an anesthesia evaluation
- 4. Discuss the anesthesia selection process
- 5. Explain the preparation of the patient for anesthesia
- 6. Describe the components of physiological monitoring
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 13.1: Anesthesia Selection and Preparation
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Part I: Anesthesia • Anesthesia Concepts ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Anesthesia Personnel Anesthesia Provider Certified Anesthesia Assistant Certified Anesthesia Technologist ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Preoperative Patient Assessment Anesthesia Classification Medications and Allergies Previous Anesthesia Airway Evaluation Musculoskeletal Assessment Neurological Status Psychological and Emotional Status Social Assessment Preoperative Investigations ANSWER – Textbook • Review Questions 2, 3 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Preoperative Patient Assessment Type and Method of Anesthesia ANSWER – Textbook • Review Question 4 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Patient Preparation: One Day Before Surgery Medication Personal Hygiene Makeup Bowel Prep Alcohol, Tobacco, and Recreational Drugs Preoperative Fasting • Immediate Preoperative Preparation of the Patient Preoperative Verification Selective Preoperative Medication ANSWER – Textbook • Case Studies 1, 2 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 6 | READ – Chapter Heading(s) • Physiological Monitoring During Surgery Ventilation, Oxygenation, and Perfusion Fluid and Electrolyte Balance Circulatory Function and Perfusion Renal Function Body Temperature Neuromuscular Response Level of Consciousness ANSWER – Textbook • Review Questions 5, 6, 7, 8 • Case Study 3 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 13.1: Anesthesia Selection and Preparation
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | ANESTHESIA CONCEPTS: SLIDES 4-5 | • Part I: Anesthesia • Anesthesia Concepts |
| 2 | ANESTHESIA PERSONNEL: SLIDE 6 | • Anesthesia Personnel Anesthesia Provider Certified Anesthesia Assistant Certified Anesthesia Technologist |
| 3 | ANESTHESIA EVALUATION: SLIDE 7 | • Preoperative Patient Assessment Anesthesia Classification Medications and Allergies Previous Anesthesia Airway Evaluation Musculoskeletal Assessment Neurological Status Psychological and Emotional Status Social Assessment Preoperative Investigations |
| 4 | ANESTHESIA SELECTION: SLIDE 8 | • Preoperative Patient Assessment Type and Method of Anesthesia |
| 5 | PATIENT PREPARATION: SLIDE 9 | • Patient Preparation—One Day Before Surgery Medication Personal Hygiene Makeup Bowel Prep Alcohol, Tobacco, and Recreational Drugs Preoperative Fasting • Immediate Preoperative Preparation of the Patient Preoperative Verification Selective Preoperative Medication |
| 6 | PHYSIOLOGICAL MONITORING: SLIDE 10 | • Physiological Monitoring During Surgery Ventilation, Oxygenation, and Perfusion Fluid and Electrolyte Balance Circulatory Function and Perfusion Renal Function Body Temperature Neuromuscular Response Level of Consciousness |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (30 min) • Discuss the terms used to describe important anesthesia concepts. Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (30 min) • Draw a table on the board with columns headed “Symptoms,” “ACP,” “Surgeon,” “Circulator,” “Surgical Technologist,” and “None of These.” Give each student a self-stick note containing a symptom of malignant hyperthermia, an action a surgical staff would take, or a false answer (e.g., “induce vomiting,” “skin turns blue,” etc.). Have each student come to the front and place his or her note in the correct column. Once all the notes are placed on the board, review the answers as a class. Appropriate Settings: Traditional/online/flipped classroom ROLE PLAY (50 min) • Students should role play the different anesthesia personnel. Have the students switch roles until each student has played each person. Appropriate Settings: Traditional classroom |
| 3 | DISCUSS (20 min) • Discuss components of an anesthesia evaluation. Appropriate Settings: Traditional/online/flipped classroom |
| 4 | DISCUSS (20 min) • Discuss the anesthesia selection process. Appropriate Settings: Traditional/online/flipped classroom DISCUSS (30 min) • Draw four columns on the board and label each with one of the four physiological requirements for surgery (sedation, analgesia, amnesia, and muscle relaxation). Have students name medicines or other drugs that fit under one or more of these categories and list these on the board in the appropriate column(s). Review the characteristics of these four classes using well-known drugs as examples or reminders of these categories. Appropriate Settings: Traditional/online/flipped classroom |
| 5 | PRESENT (30 min) In pairs, students will present a PowerPoint presentation or poster board on the preparation of a patient for anesthesia. Appropriate Settings: Traditional/online/flipped classroom |
| 6 | DISCUSS (30 min) • Discuss the components of physiological monitoring. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Why do ACPs require so much specialized training?
Discussion Guidelines: The drugs used to produce desired effects, such as loss of sensation (and sometimes loss of consciousness), can also alter key body functions such as breathing and blood pressure. The ACP must not only manage the patient’s response to pain and stimulus, but also ensure that the patient is safe during the procedure.
Your friend is worried about an impending surgical procedure and tells you he’s thinking about taking a few extra pills of his prescription Valium before the surgery. What, if anything, do you say about it?
Discussion Guidelines: Students might discuss the fact that, surgery or no, this person should not be taking “extra” prescription pills for any reason. You, as his friend, can remind him of that. Students might also discuss letting the friend know that it is critical for him to tell the anesthesia provider about any medication or other drug he takes before the surgery. The surgical tech should ask his friend to discuss this “idea” with his surgeon before the operation. The surgeon might prescribe the friend a preoperative medication that would be appropriate.
Classroom Preparation
Lesson 13.2: Anesthesia in the OR
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 7. Describe basic anesthesia equipment and its use
- 8. Describe the concepts of airway management
- 9. Define general anesthesia and describe induction, maintenance, and emergence
- 10. Discuss the difference between dissociative anesthesia and conscious sedation
- 11. Explain how regional anesthesia is used
- 12. Define common types of regional anesthesia
- 13. Define the role of the surgical technologist during the use of regional anesthesia
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 13.2: Anesthesia in the OR
STUDENT PREPARATION (1 hr)
| 7 | READ – Chapter Heading(s) • Anesthesia Equipment and Devices Anesthesia Workstation Scavenging System Drug and Equipment Carts Medical Gases Soda Lime Canister ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 8 | READ – Chapter Heading(s) • Anesthesia Equipment and Devices Airway Devices Anesthesia Mask Endotracheal Tube Laryngoscope and Accessories Laryngeal Mask Oropharyngeal Airway Nasopharyngeal Airway Airway Tubing Oxygen Mask and Cannulas Care of Artificial Airways and Ventilation Systems ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 9 | READ – Chapter Heading(s) • General Anesthesia • Stages of General Anesthesia Pre-Induction Induction Endotracheal Intubation Maintenance Neuromuscular Blockade (“Muscle Relaxation”) Emergence Recovery ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 10 | READ – Chapter Heading(s) • Procedural Sedation Levels of Sedation Clarification: MAC and Moderate Sedation • Dissociative Anesthesia • Historical Highlights ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 11 | READ – Chapter Heading(s) • Regional Anesthesia Drug Dosage ANSWER – Textbook • Review Question 1 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 12 | READ – Chapter Heading(s) • Regional Anesthesia Topical Anesthesia Local Infiltration Peripheral Nerve Block Intravenous (Bier) Block Spinal Anesthesia Epidural and Caudal Block ANSWER – Textbook • Review Questions 9, 10 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 13 | READ – Chapter Heading(s) • Regional Anesthesia Topical Anesthesia Local Infiltration Peripheral Nerve Block Intravenous (Bier) Block Spinal Anesthesia Epidural and Caudal Block • Emergencies Regional Drug Toxicity and Allergic Response Cardiopulmonary Arrest Difficult Airway Airway Emergency Laryngospasm Anaphylaxis Shock Malignant Hyperthermia Severe Hemorrhage Hemolytic Reaction Deep Vein Thrombosis ANSWER – Textbook • Review Question 11 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 13.2: Anesthesia in the OR
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 7 | ANESTHESIA EQUIPMENT: SLIDE 12 | • Anesthesia Equipment and Devices Anesthesia Workstation Scavenging System Drug and Equipment Carts Medical Gases Soda Lime Canister |
| 8 | AIRWAY MANAGEMENT: SLIDES 13-15 | • Anesthesia Equipment and Devices Airway Devices Anesthesia Mask Endotracheal Tube Laryngoscope and Accessories Laryngeal Mask Oropharyngeal Airway Nasopharyngeal Airway Airway Tubing Oxygen Mask and Cannulas Care of Artificial Airways and Ventilation Systems |
| 9 | GENERAL ANESTHESIA: SLIDES 16-17 | • General Anesthesia • Stages of General Anesthesia Pre-Induction Induction Endotracheal Intubation Maintenance Neuromuscular Blockade (“Muscle Relaxation”) Emergence Recovery |
| 10 | DISSOCIATIVE ANESTHESIA VS. CONSCIOUS SEDATION: SLIDE 18 | • Procedural Sedation Levels of Sedation Clarification: MAC and Moderate Sedation • Dissociative Anesthesia • Historical Highlights |
| 11 | REGIONAL ANESTHESIA USE: SLIDE 19 | • Regional Anesthesia Drug Dosage |
| 12 | REGIONAL ANESTHESIA TYPES: SLIDE 19 | • Regional Anesthesia Topical Anesthesia Local Infiltration Peripheral Nerve Block Intravenous (Bier) Block Spinal Anesthesia Epidural and Caudal Block |
| 13 | ROLE OF SURGICAL TECHNOLOGIST: SLIDES 20-23 | • Regional Anesthesia Topical Anesthesia Local Infiltration Peripheral Nerve Block Intravenous (Bier) Block Spinal Anesthesia Epidural and Caudal Block • Emergencies Regional Drug Toxicity and Allergic Response Cardiopulmonary Arrest Difficult Airway Airway Emergency Laryngospasm Anaphylaxis Shock Malignant Hyperthermia Severe Hemorrhage Hemolytic Reaction Deep Vein Thrombosis |
Learning Activities (choose one or more to equal 50 min)
| 7 | DEMONSTRATE (50 min) • Demonstrate the function of the basic anesthesia equipment and how it is used. If time remains, allow the students to demonstrate these functions. Appropriate Settings: Traditional/online/flipped classroom INVITE (50 min) • Invite a sales representative of anesthesia equipment to come and demonstrate how the equipment is used. Allow the students to ask any questions. Note that this activity may require an additional class period. Appropriate Settings: Traditional classroom |
| 8 | DEMONSTRATE (30 min) • Show students the location of the cricoid cartilage on your own neck and help them locate the spot on their own necks. The students should NOT apply pressure on themselves or another student. If a training model is available, instructor demonstrates Sellick’s maneuver and allows students to practice on the model as well. Appropriate Settings: Traditional classroom PRESENT (30 min) • In pairs, students will present a PowerPoint presentation or poster board on the concepts of airway management. Appropriate Settings: Traditional classroom |
| 9 | DISCUSS (50 min) • Discuss patient awareness, asking the following questions: How often does patient awareness occur? Is there any consensus on what the frequency actually is? Why does patient awareness occur? What can be done to minimize the likelihood of patient awareness? What technologies are being researched as possible ways to monitor patient awareness? What should be done for a patient who believes he or she was aware during the surgery? Appropriate Settings: Traditional classroom |
| 10 | DISCUSS (30 min) • Discuss the difference between dissociative anesthesia and conscious sedation. Appropriate Settings: Traditional/online/flipped classroom |
| 11 | DEMONSTRATE (50 min) • Demonstrate the different types of regional anesthesia and how each is used. If time permits, allow the students to demonstrate to gauge how much they understand. Appropriate Settings: Traditional classroom |
| 12 | ANALYZE (50 min) • Analyze the common types of regional anesthesia. Students should critically think through the advantages, disadvantages, safety concerns, and application. Appropriate Settings: Traditional/online/flipped classroom |
| 13 | ROLE PLAY (30 min) • Each student should play the role of the surgical technologist during the use of regional anesthesia. Define the role of the ST and the use of aseptic technique. Appropriate Settings: Traditional classroom DISCUSS (30 min) • Discuss the common anesthesia emergencies and the role of the ST during an emergency. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
What are the most important roles of the scrubbed surgical technologist handling drugs used for patient anesthesia during surgery?
Discussion Guidelines: The surgical technologist’s key roles in this situation are to make sure he or she knows the exact identity, concentration, and amount of each drug that has been delivered to the sterile field, to mark all medication containers, and to inform the surgeon and the ACP if the amount is nearing the maximum safe level for that patient.
Aunt Emma is telling you (again…) about an operation she had back in the 1950s and that she still remembers how funny that gas mask smelled. You mention to her that many patients are no longer “put to sleep” with a gas mask, and she wonders why that changed since “back in her day.” What do you tell her?
Discussion Guidelines: Students might talk about the advances in anesthesiology during the past 50 years, and how it is often safer for the patient if the induction (“putting to sleep”) can be accomplished as quickly as possible. For adults who can tolerate having an IV put in while they are awake, intravenous drugs work quickly for induction and have fewer complications than inhaled drugs.
You are transporting a patient who will be having an epidural before surgery. She tells you that she is very nervous about the procedure and asks you what risks you are aware of. What do you tell her?
Discussion Guidelines: Students might discuss the limits on what a surgical technologist can and cannot say to patients. In particular, patient counseling is outside the surgical technologist’s scope of practice. Students might note that even though they cannot provide medical advice, they can help their patients by being calm and professional. The surgical technologist can tell the patient that he or she will ask the ACP to spend a few minutes discussing the procedure with the patient and that she should feel free to ask the ACP any questions she has.
Classroom Preparation
Lesson 13.3: Post Anesthesia Recovery
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 14. Describe the layout of the post anesthesia care unit (PACU)
- 15. Discuss the elements of a handover from the circulating nurse to the PACU nurse
- 16. Describe the Glasgow Coma Scale
- 17. Discuss unanticipated PACU outcomes
- 18. Define the purpose of discharge planning
National Standards Covered
- 1. See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 13.3: Post Anesthesia Recovery
STUDENT PREPARATION (1 hr)
| 14 | READ – Chapter Heading(s) • Part II: Postoperative Care Unit (PACU) • Description of the PACU Facility ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 15 | READ – Chapter Heading(s) • PACU Procedures Admission Handover (Hand-Off) ANSWER – Textbook • Review Questions 12, 13 • Case Studies 4, 5 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 16 | READ – Chapter Heading(s) • Patient Assessment and Care Respiratory System Circulation Temperature Abdomen Fluid and Electrolyte Balance Neurological Function (Level of Consciousness) Renal Function Wound Assessment Catheters and Tubing Psychosocial • Postoperative Complications Pain Respiratory System Cardiovascular Complications Hypothermia Malignant Hyperthermia Nausea and Vomiting Alterations of Consciousness ANSWER – Textbook • Review Questions 14, 15, 16 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 17 | READ – Chapter Heading(s) • Unanticipated PACU Outcomes Failure to Meet Discharge Criteria Discharge Against Medical Advice • Death in the PACU ANSWER – Textbook • Case Study 6 ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 18 | READ – Chapter Heading(s) • Elements of Discharge Planning Discharge Criteria General Planning ANSWER – Workbook • Chapter 13 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 13.3: Post Anesthesia Recovery
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 14 | PACU LAYOUT: SLIDE 25 | • Part II: Postoperative Care Unit (PACU) • Description of the PACU Facility |
| 15 | PATIENT HANDOVER: SLIDE 26 | • PACU Procedures Admission Handover (Hand-Off) |
| 16 | PATIENT ASSESSMENT: SLIDES 27-29 | • Patient Assessment and Care Respiratory System Circulation Temperature Abdomen Fluid and Electrolyte Balance Neurological Function (Level of Consciousness) Renal Function Wound Assessment Catheters and Tubing Psychosocial • Postoperative Complications Pain Respiratory System Cardiovascular Complications Hypothermia Malignant Hyperthermia Nausea and Vomiting Alterations of Consciousness |
| 17 | UNANTICIPATED OUTCOMES: SLIDES 30-31 | • Unanticipated PACU Outcomes Failure to Meet Discharge Criteria Discharge Against Medical Advice • Death in the PACU |
| 18 | DISCHARGE PLANNING: SLIDE 32 | • Elements of Discharge Planning Discharge Criteria General Planning |
Learning Activities (choose one or more to equal 50 min)
| 14 | DISCUSS (30 min) • Show the class a graphic of a typical PACU floorplan and discuss the activities performed in each area. Appropriate Settings: Traditional/online/flipped classroom |
| 15 | INVITE (50 min) • Ask a PACU nurse to talk with your students about his or her experiences. Specifically, ask the guest how he or she got into this field, including preparation and training. Ask the nurse to discuss the rewards and challenges of the job and answer questions. Appropriate Settings: Traditional/online/flipped classroom DISCUSS (50 min) • Discuss all of the elements of a handover from a circulating nurse to a PACU nurse. • Divide the class into two groups. One group represents the circulator, and the other group represents the PACU nurse. Have each group list its responsibilities in the handover. Have the groups present their ideas to the rest of the class. Appropriate Settings: Traditional/online/flipped classroom |
| 16 | DISCUSS (30 min) • Have students list the parameters for the Glasgow Coma Scale. Discuss as a class its application in the postoperative recovery phase. Appropriate Settings: Traditional/online/flipped classroom |
| 17 | DISCUSS (20 min) • Discuss selected types of postoperative complications. Appropriate Settings: Traditional/online/flipped classroom |
| 18 | DISCUSS (30 min) • Provide students with an example of a discharge criteria plan. Discuss the various parameters for measuring discharge readiness and the importance of using a standard plan. • Discuss what students learned about discharge against medical advice and the factors that influence a patient’s decision. Include the following points in discussion: How often does discharge against medical advice happen? Why would an institution or organization track this information? What factors can lead to a patient leaving the hospital against medical advice? What can be done to reduce the risk of patients leaving the hospital against medical advice? Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Why are patients transported to the post anesthesia care unit (PACU) for recovery?
Discussion Guidelines: Postoperative patients are at risk for complications that may necessitate emergency medical response. Critical care nurses who are trained in postoperative recovery and emergency treatment staff the PACU. The unit contains all necessary physiological monitoring equipment, drugs, and emergency supplies.
What are some potential postoperative complications?
Discussion Guidelines: Physiological complications can include airway obstruction, atelectasis, cardiovascular disturbances, hypotension or hypertension, hemorrhage, pulmonary embolism, hypothermia, malignant hyperthermia, nausea, vomiting, or an alteration in consciousness.
Your 8-year-old male patient has just undergone tonsillectomy without complication. The procedure was performed using inhalation anesthetic via endotracheal tube. Your role during surgery is to assist the circulator with an RN in the room at all times. Surgery is complete and the patient is emerging from anesthetic. The surgeon extubates the patient in the OR. There is a small amount of bleeding in the throat following extubation. The ACP applies suction to the throat and monitors the color and amount of output. The patient appears stable and the ACP gives permission to proceed to the PACU. During transport, the patient suddenly becomes agitated, thrashing and moaning. He begins to vomit. What are the immediate dangers for this patient in transit? What can the surgical technologist do to assist the ACP and circulating nurse? When reaching the PACU, what is the team’s immediate response?
Discussion Guidelines: The circulator remains with the patient at all times during transport to the PACU. This example illustrates the need for both the ACP and the circulator to be present. Pediatric patients are prone to agitation and delirium during emergence. This patient is in danger of aspiration related to postoperative nausea and vomiting. In addition, bleeding was evident following extubation and this may resume with retching and agitation, which may dislodge clots in the tonsil area. The immediate response is to think “ABC: airway, breathing, and circulation.” The patient’s airway is protected to prevent aspiration. The jaw thrust position is maintained (as during CPR) to help breathing. Suction is critical to clear the airway, and the patient is positioned in reverse Trendelenburg, which allows gravity to aid in keeping secretions away from the lungs. The delirious patient is prevented from self-injury with gentle restraint. As soon as the patient arrives in the PACU, the wall suction and oxygen are activated. Antiemetic drugs are delivered. The patient will be retained in reverse Trendelenburg until stable. The surgical technologist assists as directed by nursing and medical staff in transit and in the PACU.
Assessments
Chapter 13: Anesthesia, Physiological Monitoring, and Post Anesthesia Recovery
ASSESSMENTS BY OBJECTIVE
| 1-18 | Workbook • Chapter 13 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 13 – Graded quizzes (Mastery Levels 1, 2, and 3) |
