Sorry OP, I was really whacked last night and asking a lot of questions can't be called helpful.
If this is something you're going to be assessed on, you start with recovery set up and routine; like theater it must be damp-dusted daily and essential stocks replenished, like Venturi masks, yankauers, suction catheters. Equipment must be checked and ensured that it is in a safe working condition, Aquapaks fitted, suction equipment working, >50kPa. BP cuffs clean, no leaks; ventilation bags also clean, no leaks. Medication cart with anti-emetics eg Zofran, Clopamon and Kytril. Reversal medication esp Neostigmine and Narcan, and you will also need Robinul or possibly Atropine.
Familiarise yourself with the emergency drugs and their uses, you will probably be questioned on them, and the maintenance and use of the defibrillator. make sure you know the layout of the trolley, so that if you are asked for an item, you can whip it out immediately.
Ensure that your most commonly-used IV fluids are readily available and replenished daily. Also make sure that IV cannulas of each size are ready to hand-the general favourite where I work is the Venflon, but any cannula with an administration port is ok.
Brush up on care and control of scheduled drugs-recovery sisters always get stuck with that responsibility. Be sure to revise correct procedure on ordering and recording. Make sure you know the correct procedure to be followed should an item "go missing." We do daily counts, morning and evening, and it's good to have a bloodhound quality when tracking down unrecorded substances. As you know, it sometimes gets a bit hectic in theater and it's easy for the nurse to miss something. You may very well be asked something like, "who may carry the drug cupboard keys" and the safekeeping of those keys is very
Always know the whereabouts of the latex-free items and difficult intubation equipment. Check that Guedal airways, nasopharyngeal airways, LMAs and ET tubes are close at hand-extubated patients can sometimes go into respiratory arrest and you need to be prepared for that. Practise using a ventilator mask and bag while elevating the chin, sometimes inserting a Guedal airway and ventilating for a few minutes is enough to tide your patient over until they start breathing again. On the subject of airway maintenance, check your intubation tray daily, paying special attention to the laryngoscope; you should have a selection of different sizes of curved and straight blades available, and the light should be white, bright and not flickering. Also check that there is an introducer on the tray and understand its use. You may also be asked to explain the use of the Magills forceps.
If you're out of practice with intubation, ask a friendly anaesthetist to let you intubate a couple of patients-likewise with the other types of artificial airways. It's a very
useful skill to have in recovery! Orient yourself to the position of the medication fridge, if you don't have one in recovery, and make sure you know where to find the scoline, and where to find it. You may be asked the difference between depolarising and non-depolarising muscle relaxants; make sure you learn that, and which ones are reversible by neostigmine.
Canesdukesgirl has done a pretty good job of explaining the nitty-gritty of actually recovering a patient, but in a practical assessment, always remember the basics, they can fail you if you forget to wash your hands and put on gloves between patients! And one other thing; before you worry about your monitors look to see if your patient is breathing
A tutor caught me
out with that!
Now, if I haven't already put you to sleep, here's something out of a training manual:
The 20 Golden Rules of the Recovery Room.
1: The confused, restless and agitated patient is hypoxic until proven otherwise.
2: Patients must never be left alone for any reason.
3: The blood pressure does not necessarily fall in haemorrhagic shock.
4: Never ignore a tachycardia, find the cause.
5: Post-operative hypertension is dangerous.
6: Do not use painful stimuli to rouse a patient.
7: Noisy breathing is obstructed breathing; however, not all obstructed breathing is noisy.
8: Nurse comatose patients in the coma position-subject to circumstances.
9: Let the patient remove his own airway.
10: Patients must be able to lift their heads from the pillow, cough and take deep breaths before being discharged from the recovery room.
11: Treat the patient, not the monitor.
12: Opioids do not cause a fall in blood pressure in stable patients.
13: Pain prevention is easier than pain relief.
14: Cuddle crying children (my personal favorite!).
15: Warm blood with an in-line blood warmer.
16: Hypothermia is insidious and common.
17: When giving drugs to the elderly, give half as much, twice as slowly.
18: If you do not know the pharmacology of a drug, don't give it. (my medicines formulary is always at hand)
19: Be alert for thrombophebitis and remove dodgy IVs.
20: If confused, go back to rule no. 1!