Lesson 1Discharge criteria from PACU (physiologic stability, pain control, nausea control, surgical criteria)Describes standard PACU go-home rules, body steady, pain/nausea handled, surgery needs, scores, safe for ward or day unit.
Common PACU discharge scoring toolsHemodynamic and respiratory stabilityPain and nausea control thresholdsSurgical and procedural requirementsDecision‑making and escalation pathwaysLesson 2Monitoring priorities in PACU: respiratory rate, SpO2, ETCO2 if available, heart rate, blood pressure, temperatureSets PACU watch priorities, breaths, oxygen sat, CO2 if there, heart, BP, temp, trends, alarms, early bad signs.
Baseline observations on arrivalRespiratory rate, SpO2, and ETCO2 useHemodynamic monitoring and trendsTemperature monitoring and shiveringResponding to abnormal vital signsLesson 3Patient education at discharge from PACU: breathing exercises, activity restrictions, medication instructionsCovers main teach before PACU out, breath work, move limits, wound care, meds, warnings, plain words, check-back for home/ward safe heal.
Teaching breathing and coughing exercisesExplaining activity and lifting limitsBasic wound and drain care adviceMedication schedules and side effectsWarning signs and when to seek helpLesson 4Nausea and vomiting management: assessment, rescue antiemetics, prevention strategiesHandles after-surgery sick risks, checks, scores, rescue anti-sick timing, non-drug, stop plans fit to patient/surgery in PACU.
Risk factors and PONV prediction toolsAssessment and nausea scoring in PACURescue antiemetic drug choices and dosingNonpharmacologic nausea relief strategiesPrevention plans for high‑risk patientsLesson 5Surgical site assessment and wound bleeding surveillanceFocuses on ordered surgery site looks in PACU, dressings, bleed measure, drain flow, early lump/germ signs, quick call, surgeon team.
Initial wound and dressing inspectionQuantifying blood loss and saturationAssessing drains and surgical devicesRecognizing hematoma and compartment signsEscalation thresholds and surgeon notificationLesson 6Glycemic monitoring and management in the immediate postoperative periodLooks at around-surgery high/low sugar risks, check times, insulin/sugar plans, team with anesthesia/surgeons for safe sugar aims post-op.
Indications for PACU glucose monitoringTarget ranges and institutional protocolsInsulin infusion and bolus adjustmentsRecognition and treatment of hypoglycemiaDocumentation and communication of valuesLesson 7Neurological assessment: level of consciousness, GCS, orientation, emergence delirium recognitionCovers ordered brain checks post-anesthesia, awake level, score, know where, move, early wake wildness, stir, stroke, drug leftover needs quick fix.
Level of consciousness and arousal scalesUsing GCS and orientation questionsMotor strength and pupil assessmentRecognizing emergence delirium patternsDifferentiating pain, hypoxia, and deliriumLesson 8Immediate PACU checks on arrival: airway patency, spontaneous breathing, supplemental oxygen needsDetails first ordered checks on PACU arrive, airway open, own breaths, oxygen need, flow, watch setup, order check for early spot, safe steady.
Structured ABCDE on PACU arrivalAirway patency and adjuncts reviewBreathing pattern and oxygen selectionInitial circulation and perfusion checksSetting up monitors and safety equipmentLesson 9Receiving handover from OR: essential components to expect (airway, fluids, blood loss, medications, intraop events)Outlines info PACU nurses get from theatre, airway state, fluids, bleed, meds, happenings, tools to clear risks, expect problems.
Structured OR‑to‑PACU handover formatsAirway devices, difficulty, and plansFluids, blood loss, and hemodynamicsIntraoperative medications and timingUnexpected events and specific concernsLesson 10Documentation and handover to ward: what to include and standard formatsExplains must-note in PACU and ward hand-over, tools, big events, ongoing treatments, safety checks for steady care, less info loss.
Key elements of PACU nursing notesUsing standardized handover toolsCommunicating ongoing therapies and linesHighlighting complications and concernsConfirming understanding with ward staffLesson 11Emotional support and addressing postoperative anxiety or deliriumCovers spotting post-op worry, fear, wildness, talk ways, non-drug calm, team with docs for drug help, keep dignity, safe.
Screening for anxiety and distressTherapeutic communication techniquesFamily involvement when appropriateNonpharmacologic calming strategiesEscalation for severe agitation or deliriumLesson 12Pain assessment and multimodal analgesia options; nursing titration and escalation pathwaysFocuses on ordered pain checks with good scales, multi pain relief, nurse adjust, side watch, call paths if pain stays in PACU.
Pain scoring tools for adults and childrenOpioid titration and monitoringNon‑opioid and regional techniquesManaging analgesia‑related side effectsEscalation when pain remains severe
