CAPA (ABPANC) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Clear liquid fasting interval

Adults and children may take clear liquids up to 2 hours before elective anesthesia; clears include water, pulp-free juice, and tea or coffee without milk.

Mallampati class III

Soft palate and base of uvula are visible but the oropharyngeal arches are obscured; classes III and IV predict difficult intubation and difficult mask ventilation.

STOP-BANG questionnaire

Eight-item obstructive sleep apnea screen: snoring, tiredness, observed apnea, pressure, BMI over 35, age over 50, neck over 40 cm, and male sex. Score 3 or more is intermediate risk.

ASA physical status I

A normal healthy patient without systemic disease. Status II is mild systemic disease, III severe systemic disease, and IV severe disease that is a constant threat to life.

Informed consent elements

Must cover the diagnosis, nature and purpose of the procedure, risks and benefits, reasonable alternatives, and the right to refuse; obtained and verified by the responsible practitioner.

Malignant hyperthermia susceptibility history

Requires avoiding all volatile anesthetics and succinylcholine, using a nontriggering anesthetic technique, and having dantrolene immediately available in the procedure area.

Preprocedure pregnancy testing

Facilities screen women of childbearing age before elective procedures; a positive result changes the anesthetic and surgical plan and requires updated consent and documentation.

Moderate sedation characteristics

Drug-induced depression of consciousness in which the patient responds purposefully to verbal commands, with or without light touch, while airway, ventilation, and circulation remain adequate.

Deep sedation characteristics

Drug-induced depression of consciousness in which the patient responds purposefully only to repeated or painful stimulation; airway intervention may be needed and spontaneous ventilation may be inadequate.

Capnography in procedural sedation

Continuous end-tidal carbon dioxide monitoring detects respiratory depression and apnea earlier than pulse oximetry alone and is recommended during moderate and deep sedation.

Naloxone reversal dosing

Give 0.04 to 0.4 mg intravenously and titrate every 2 to 3 minutes to restore adequate ventilation; its duration is shorter than most opioids, so continued monitoring is required.

Lidocaine maximum dose

For infiltration, the maximum is 4.5 mg/kg without epinephrine and 7 mg/kg with epinephrine; exceeding these limits increases the risk of local anesthetic systemic toxicity.

Lipid emulsion for LAST

For local anesthetic systemic toxicity, give 20% lipid emulsion as a 1.5 mL/kg bolus followed by a 0.25 mL/kg/min infusion, after airway management and seizure control.

Aldrete score components

Scores activity, respiration, circulation, consciousness, and oxygen saturation from 0 to 2 each, for a maximum of 10; 9 or higher is typically required to leave phase I recovery.

Apfel PONV score

Four predictors: female sex, nonsmoker status, prior postoperative nausea or motion sickness, and postoperative opioid use. Each adds about 20% to the baseline risk.

Malignant hyperthermia treatment

Give dantrolene 2.5 mg/kg intravenously and repeat until symptoms resolve, up to 10 mg/kg, while stopping triggers, giving 100% oxygen, cooling the patient, and treating hyperkalemia.

Laryngospasm first-line management

Remove the stimulus and apply 100% oxygen with jaw thrust and continuous positive airway pressure; if it persists, give propofol or succinylcholine 0.5 to 1 mg/kg intravenously.

Phase I recovery

The immediate postanesthesia period in a monitored recovery area with continuous observation and vital sign assessment, continuing until phase I discharge criteria are met.

Multimodal PONV prophylaxis

Combining antiemetics from different classes, such as a 5-HT3 antagonist, dexamethasone, droperidol, or scopolamine, is more effective than increasing the dose of a single agent.

Discharge vital sign criteria

Airway is stable, oxygen saturation has returned to baseline on room air, and vital signs are within the facility's accepted range of preoperative values before discharge.

Escort requirement after sedation

A responsible adult must transport the patient home and stay overnight, because anesthetic agents impair judgment, coordination, and reflexes for up to 24 hours.

Teach-back method

The clinician asks the patient or caregiver to restate discharge instructions in their own words, confirming comprehension and revealing gaps before the patient leaves.

PADSS discharge scoring

The Post Anesthetic Discharge Scoring System rates vital signs, activity, nausea and vomiting, pain, and bleeding from 0 to 2 each; a total of 9 or higher is required.

24-hour activity restrictions

After sedation or anesthesia, patients must avoid driving, operating machinery, drinking alcohol, signing legal documents, and making important decisions for 24 hours.

When to call the provider

Fever above 38 C, uncontrolled bleeding, worsening pain, persistent vomiting, difficulty breathing, or inability to void after discharge require prompt contact with the facility.

Documentation of discharge teaching

The record must show the content taught, the method used, who received it, the patient's demonstrated understanding, and confirmation that a written copy was provided.

Two patient identifiers

Identity is verified with two independent identifiers, such as name and date of birth, before every medication, procedure, blood product, or transfer of care.

Surgical safety time-out

A standardized verbal pause before the procedure begins in which the whole team confirms patient identity, site, procedure, consent, positioning, and availability of imaging.

SBAR handoff

A structured communication tool standing for Situation, Background, Assessment, and Recommendation, used to transfer patient information accurately between providers and units.

Fire triangle in procedure room

Fire requires an oxidizer, an ignition source, and fuel; removing any one element prevents ignition, and stopping the flow of oxidizing gas is the immediate response.

Sentinel event

An unexpected occurrence involving death or serious physical or psychological injury that requires immediate investigation, root cause analysis, and reporting per organizational policy.

ASPAN standards

Professional perianesthesia nursing standards that address staffing, environment of care, patient assessment, monitoring, pain management, and discharge criteria across all phases of care.