Standards for Post Anesthesia Care

 
Standard I
All patients who received General or regional anesthesia or monitored anesthesia care shall receive appropriate post anesthesia management.

Standard II
A  patient transported to the PACU shall be accompanied by a member of the anesthesia care team who is knowledgeable about the patient’ condition. The patient should be continually evaluated and treated during transport with monitoring and support appropriate to the patient’s condition.

Standard III
Upon arrival in the PACU, the patient shall be re-evaluated and a verbal report provided to the responsible PACU nurse by the member of the anesthesia care team who accompanies the patient.

Standard IV
The patient’s conditon shall be evaluated continually in the PACU.

Standard V
A Physician is responsible for the discharge of the patient from the PACU.

-American Society of Anesthesiologist

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Glucose

Glucose
Glucose is the basic sugar needed to provide energy for all  parts of the body. Glucose is the primary source of energy for the body’s cells, and blood lipids (in the form of fats and oils) are primarily a compact energy store. Glucose is transported from the intestines or liver to the body cells via the bloodstream, and is made available for cell absorption via the hormone insulin, produced by the body primarily in the pancreas. Fasting normal is between 65-100 mg/dl. A low value (hypoglycemia) may be a precursor to diabetes but may also be the result of a tumor or thyroid disease. A high value (hyperglycemia) may also indicate diabetes.

Range
Minimum - 70 mg/dl
Maximum - 115 mg/dl

Cause
Fasting Hypoglycemia

Clinical
If blood sugar levels drop too low, a potentially fatal condition called hypoglycemia develops. Symptoms may include lethargy; shaking, twitching, weakness on arm and leg muscles; pale complexion; sweating; paranoid or aggressive mentality and loss of consciousness. Brain damage is even possible.

Nutrition
Maintaining a stable blood glucose concentration is necessary in order to keep it high enough to ensure normal functioning of the brain, while also preventing the harmful consequences which can arise when the concentration is too high.

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Polyuria

A relatively common sign, polyuria is the daily production and excretion of more than three (3) liters of urine. It's usually reported by the patient as increasead urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of caffeine or alcohol, and excessive ingesrion of salt, glucose, or other hyperosmolar substances.

Polyuria usually results from the use of certain drugs, such as a diuretic, or from a psychological, neurologic, or renal disorder. It can reflect central nervous system dysfunction that diminishes or supresses antidiuretic hormone (ADH) secretion, which regulates fluid balance. Or, when ADH levels are normal, it can reflect renal impairment. In both of these pathophysiologic mechanisms, the renal tubules fail to reabsorb sufficient water, causing polyuria.

Medical Causes

1. Acute Tubular Necrosis (ATN)
2. Diabetes Insipidus (DI)
3. Diabetes Mellitus (DM)
4. Glonerulonephritis (chornic)
5. Postobstructive Urophathy
6. Psychogenic Polydipsia 

Other Causes

1. Diagnostic Test: Transient polyuria can result from radiographic tests that use contrast media
2. Drugs: Diuretics characteristically produce polyuria.  Cardiotonics, vitamin D, demeclocycline, phenytoin, lithium, methoxyflurane, and propoxyphene can also produce polyuria.

Nursing Considerations

• Record intake and output, and weigh the patient daily.
• Monitor the patient's vital signs.
• Encourage the patient to drink adequate fluids and administer I.v. fluids as necessary.
• Prepare the patient for serum electrolyte, osmolality, blood urea nitrogen, and creatinine studies to monitor fluid and electrolyte status and for a fluid deprivation  test to determine the cause of polyuria.

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Nurses Information Site

 

Nurses Information Site

Online information source for nurses. Nurse Licensure Examination Result, Nursing review, Nursing Care Plan, Pathophisiology, Drug Studies, Medical-Surgical, all about nursing.

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