Download Recovery Room Critical Thinking Handout File

DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES
NURSING 3910
RECOVERY ROOM (RR)
DEVELOPED: 2011-09-02
WELCOME TO THE
RECOVERY ROOM
This handout is meant to help prepare you for your Observational Day in the RR.
There are many dimensions to the role of the nurse in the RR environment and this handout will outline some
of the major nursing responsibilities that are included in the RR nursing scope. Please use this handout to
become familiar with some of the essential concepts of Recovery Room/Post-Operative Care Nursing in
Recovery Room and as a learning tool while you are enjoying your time in the RR.
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DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES
NURSING 3910
RECOVERY ROOM – CRITICAL THINKING QUESTIONS
1. The Recovery Room nurses have several responsibilities when caring for a patient following surgery. What are some
of these responsibilities?
2. Communication plays a vital role when caring for post-operative patients. What are some positive communication
techniques used in the Recovery Room?
3. What are (3) potential respiratory complications that may occur during the immediate post-operative phase? Name
some clinical manifestations and nursing interventions for each complication.
4. What are some of the adjuncts used to help control a sedated patient’s airway? What are the criteria for these
adjuncts to be removed?
5. What are the (3) most important assessments to perform when a patient is received into the RR immediately
following a surgical procedure?
6. What type of pain control methods are implemented in the RR and what is the significance of effective pain control
to a patient’s recovery?
7. Why is continued thermoregulation so important for surgical patients in the recovery room?
8. What are some clinical manifestations of over sedation? What happens in the recovery room when a patient is nonresponsive due to over sedation?
9. What are the discharge criteria for a post operative patient in order to be transferred from RR to the acute care
floor?
10. What information should a RR nurse include in their verbal report when transferring care to an acute care nurse?
What is the significance of the information in the post-operative period?
11. Do you think that post anesthetic care, specifically in the Recovery Room, should be considered a Critical Care
Specialty? Why or why not?
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DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES
NURSING 3910
RECOVERY ROOM – CRITICAL THINKING QUESTIONS
12. Complete the following chart:
TYPE OF
DESCRIPTION
ANAESTHESIA
 Involves the injection of medicine to block
sensations of pain from a specific area of the body.
*EXAMPLE*
 Used for minor procedures on a limited part of the
body.
LOCAL
 Usually given by injection into the body area that
needs to be anesthetized
 Injected into the bloodstream (intravenous, IV).
PROCEDURE(S)
COMMON MEDICATIONS




dental procedures
eye surgery
suturing


lidocaine (injectable;
topical creams; drops;
spray)
lidocaine/prilocaine
combination (EMLA
patch)
tetracaine
COMMON SIDE EFFECTS




prolonged anesthesia
parasthesia
injection site hematoma
/ infection
hypersensitivity (usually
more potent types)
REGIONAL
PERIPHERAL
NERVE BLOCK
EPIDURAL
SPINAL
GENERAL
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DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES
NURSING 3910
RECOVERY ROOM – CRITICAL THINKING QUESTIONS
PARENTAREL DRUG CONCENTRATIONS
Percentage Solutions
 The number tells you how many grams of drug are in 100ml of solution.
 Eg. In a 1% solution there is 1Gm of drug in 100ml of solution
 Eg. Lidocaine 2% - there are 2Gm of lidocaine in 100ml of solution. (So there are 2000mg of lidocaine in 100ml of
solution. So there are 20mg of lidocaine in 1ml of solution.)
 To know how many mg of drug are in one ml of solution, multiply the percentage by 10. This will always work.
 Test yourself: If you mix 2Gm of lidocaine in 500ml NS, what is the % concentration of the drip?
Solution: You need to know how many grams of drug are in 100ml of solution. To find out, divide both
numbers by 5. If there are 2Gm of drug in 500ml solution, then there are 400mg (0.4Gm) of drug in 100ml
of solution. Since 400mg equal 0.4 Gm, you have mixed a 0.4% drip.
Ratio Solutions
 Ratio solutions – In a ratio, the first number refers to the number of grams of drug and the second number tells you
in how many milliliters of solution the drug is contained. 1:1000 means there is 1Gm of drug in 1000ml of solution
(So there is 1mg of drug in 1ml of solution)
 To know how many mg of drug are in 1ml of solution convert the 1st number to mg by multiplying by 1000. Then
divide both sides of the ratio by 1000.
 Eg. Epinephrine 1:1,000. There is one Gm of drug in 1000ml of solution.
Step 1: Convert to milligrams (multiply by 1000)
1000mg : 1000ml
Step 2: Divide both sides of the ratio by 1000.
1mg:1ml = 1mg/ml
 eg. Epinephrine 1:10,000 – there is 1Gm epinephrine in 10,000ml of solution. So there is 1mg of
epinephrine in 10ml of solution. (This is the 10ml pre-filled syringe in the crash cart)
 eg. Epinephrine 1:100,000 there is 1Gm epinephrine in 100,000ml of solution. So there are 1,000mg
epinephrine in 100,000ml of solution. So there are 10mg of epinephrine in 1000ml of solution. So there
is 1mg epinephrine in 100ml of solution.
 Test yourself – What is the concentration of epinephrine if the ratio given is 1:200,000?
Solution - Epinephrine 1:200,000 there is 1Gm of drug in 200,000ml of solution.
Step 1: 1000mg:200,000ml
Step 2 – 1mg:200ml
What is equal to What?
 1000mcg (or 1000ug) = 1mg
 1000mg = 1Gm
 1 Liter = 1000milliliters = 1000 cm3 = 1000cubic centimeters = 1000cc
 1L = 1000ml = 1000cc (see line above)
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DEPARTMENT OF NURSING EDUCATION & HEALTH STUDIES
NURSING 3910
RECOVERY ROOM – CRITICAL THINKING QUESTIONS
Calculating a Drug Dosage Using a Ratio to Help You
 E.g. If the concentration of the drug is 80mg/ml and you want to give 50mg.
Solution
80mg : 1ml
50mg : xml
 Multiply the 2 numbers that are diagonal to one another (the green numbers) and divide by the number opposite
the x.
 50 x 1 = 50  80 = .625ml.
 Now you say “Great – how the heck do I do that?”
 Remember that it would be easier to dilute the 80mg to 4ml (because 5 and 8 are factors of 40) – then you could
give 2.5ml. To do this all you have to do is draw up 1ml (80mg) of the drug in a 5ml syringe and then draw up 3cc of
a compatible IV solution.
 Now you have 80mg of drug in 4cc of solution. (This would be OK if it’s an IV med – and it would be easier to be
accurate)
 You can verify this:
80mg : 4ml
50mg : xml
50 x 4 = 200 and 200  80 = 2.5ml
 Always ensure that the dose “makes sense”. In this case you want to give an amount that is just slightly more than
what is contained in 2ml of diluted medication, so it is sensible that the calculated dose should be a bit more than
2ml – which it is.
The 6 R’s
For peace of mind with any medication, remember the 6 “R”s – and if you’ve had to do calculations check them twice (or
have another nurse double check) – before you give the med to the patient – rather than afterwards when your conscience
begins to nag at you.






Right Patient
Right Drug
Right Dose
Right Route
Right Time
Right to Refuse
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