The nurse is assessing a patient who has returned to the care area after surgery. What should the nurse do to ensure the patient receives appropriate care?
1. Check the physician's orders to see if preoperative orders have been reordered.
2. Schedule the patient for vital signs assessments every four hours.
3. Orient the patient to person, place, and time.
4. Assess the patient's mental status.
Correct Answer: 1
The nurse needs to check the patient's medical record to ensure that all orders written before surgery have been reordered after surgery, since the patient's condition has changed. Even though vital signs should be assessed according to hospital policy, the frequency of a postoperative patient's vital signs assessment will be more frequent than every four hours. Orienting the patient to person, place, and time, and assessing the patient's mental status are activities of the PACU nurse.
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