PACU- POST ANESTHESIA CARE UNIT. BY ARUN ANGADI M.Sc. MSN CRITICAL CARE NURSING

1. POST- ANAESTHESIA CARE
UNIT
PREPARED BY
MR.ARUN. S. ANGADI
M. Sc MSN. Critical Care Nursing
MTIN CHARUSAT

2. DEFINITION
The post-operative period of the surgical
experience extends from the time the client is
transferred to the recovery room or post-
anesthesia care unit (PACU) to the moment he
or she is transported back to the surgical unit,
discharged from the hospital until the follow-
up care.

3. Goals during the Postoperative Period
• Maintaining adequate body system functions.
• Restoring body homeostasis.
• Pain and discomfort alleviation.
• Preventing postoperative complications
• Promoting adequate discharge planning and
health teaching.

4. ASSESSMENT
• Assess air exchange status and note patient’s
skin color
• Verify patient identity. The nurse must also know
the type of operative procedure performed and
the name of the surgeon responsible for the
operation.
• Neurologic status assessment. Level of
consciousness (LOC) assessment and Glasgow
Coma Scale (GCS) are helpful in determining the
neurologic status of the patient.

5. • Cardiovascular status assessment. This is done
by determining the patient’s vital signs in the
immediate postoperative period and skin
temperature.
• Operative site examination. Dressings should
be checked.

6. Promoting Patient Safety
Safety checks when transferring the patient from OR to RR:
S – Securing restraints for I.V. fluids and blood transfusion.
A – Assist the patient to a position appropriate for him on
his based on the location of incision site and presence of
drainage tubes.

7. F – Fall precaution implementation by making sure the
side rails are raised and restraints are secured well.
E – Eliminating possible sources of injuries and
accidents when moving the patient from the OR to
RR or PACU.

8. Nursing Care for Patient in the
PACU or RR
• AIRWAY: Maintain a patent airway.
2. Suction secretions as needed

9. BREATHING:
Maintaining adequate respiratory
function
B – Bilateral lung auscultation frequently.
R – Rest and place the patient in a lateral position with
the neck extended, if not contraindicated, and the arm
supported with a pillow.
This position promotes chest expansion and facilitates
breathing and ventilation.

10. E – Encourage the patient to take deep breaths. This
aerates the lung fully and prevents hypostatic
pneumonia.
A – Assess and periodically evaluate the patient’s
orientation to name or command.
Cerebral function alteration is highly suggestive of
impaired oxygen delivery

11. T – Turn the patient every 1 to 2 hours to facilitate
breathing and ventilation.
H – Humidified oxygen administration.
During exhalation, heat and moisture are normally
lost, thus oxygen humidification is necessary.
And secretion removal is facilitated
Also, dehydrated patients have irritated respiratory
passages thus, it is very important make sure that the
inhaled oxygen is humidified.

12. CIRCULATION: Assess status of circulatory
system.
• Obtain patient’s vital signs as ordered and report any
abnormalities.
• Monitor intake and output closely.
• Recognize early symptoms of shock or hemorrhage such
as
Cold extremities,
Decreased urine output – less than 30 ml/hr,
Slow capillary refill – greater than 3 seconds,
Dropping blood pressure,
Narrowing pulse pressure,
Tachycardia – increased heart rate.

13. THERMOREGULATION:
• Hourly temperature assessment to detect hypothermia or
hyperthermia.
• Report temperature abnormalities to the physician.
• Monitor the patient for post-anethesia shivering or PAS.
This is noted in hypothermic patients, about 30 to 45
minutes after admission to the PACU. PAS represents a
heat-gain mechanism and relates to regaining the thermal
balance.
• Provide a therapeutic environment with proper
temperature and humidity. Warm blankets should be
provided when the patient is cold.

14. FLUID VOLUME: Maintaining adequate
fluid volume.
• Assess and evaluate patient’s skin color and turgor,
mental status and body temperature.
• Monitor and recognize evidence of fluid and
electrolyte imbalances such as nausea and vomiting
and body weakness.
• Monitor intake and output closely.

15. • HYPOVOLEMIA
• HYPERVOLEMIA

16. SAFETY: Promoting patient safety
COMFORT: Promoting patient comfort.
SKIN INTEGRITY: Minimizing skin impairment.

17. POST OPERATIVE INTERVENTION
P– Preventing and/orrelieving complications
O – Optimal respiratory function
S – Support: psychosocial well-being
T – Tissue perfusion and cardiovascular status
maintenance
O – Observing and maintaining adequate fluid
intake
P – Promoting adequate nutrition and
elimination

18. A – Adequate fluid and electrolyte balance
R– Renal function maintenance
E – Encouraging activity and mobility within
limits
T – Thorough wound care for adequate wound
healing
I – Infection Control
V – Vigilant to manifestations of anxiety and
promoting ways of relieving it
E –Eliminating environmental hazards and
promoting client safety

21. THANK YOU