Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

For a patient with a history of COPD and hypotension following spinal anesthesia, what is the perianesthesia nurse's first action?

1. Check the patient's capillary blood sugar

2. Administer O2 at 3L/min via nasal cannula

3. Apply O2 via mask at 10L/min

4. Prepare the patient for intubation

The correct answer is: Administer O2 at 3L/min via nasal cannula

Administering O2 at 3L/min via nasal cannula is the most appropriate first action for a patient with a history of chronic obstructive pulmonary disease (COPD) and hypotension following spinal anesthesia. In this scenario, the patient may be at risk for hypoxia due to their respiratory condition and the potential effects of spinal anesthesia on their respiratory drive and blood pressure. Administering supplemental oxygen helps ensure that the patient's tissues receive adequate oxygenation, which is crucial considering the history of COPD. Using a nasal cannula at a low flow rate allows for a controlled increase in oxygenation without overwhelming the patient's respiratory system, which is particularly important for patients with COPD who are sensitive to high concentrations of oxygen. It is important to monitor the patient's response to the oxygen therapy and assess their respiratory effort. While applying O2 via mask at 10L/min or preparing for intubation may also provide oxygenation or support in critical situations, these actions are more invasive and may not be necessary as an initial response. Checking the patient's capillary blood sugar is not immediately relevant to the respiratory issues at hand. Validating the need for further intervention will depend on the patient's ongoing assessment after the initial oxygen administration.