Pointers from seasoned PACU nurses, please!


Hi everyone!

I am getting ready to go into the final quarter of my ADN program, which is the transition to nursing portion & I will have a preceptor. I just received the e-mail informing me that I have been assigned to PACU! I'm really excited, especially since this was one of my top 3 picks!

While I'm on break for holidays I am trying to review as much as I can so that I will be prepared for my exit exam & my boards. I thought while I had the time that I would try to review some things that would be pertinent to PACU nursing. Can you please suggest things that I should brush up on, certain meds to know, pointers, etc?

thanks in advance for any help... :)

sharann, BSN, RN

1,758 Posts

How exciting for you!

Let's see. You should know the opioids and the antidoes. Morphine, Fentanyl, Demerol,Dilaudid and their doses. Narcan and Romazicon for reversal. Zofran, Droperidol for nausea. Know where the ambu bag and crash cart are located.

Know how to recognize signs of hypoxia and know arrythmia interpretation. The basics for the most part.


3 Posts

Wow, thanks! I am getting more excited (and more nervous! :) ) each day that gets closer to my start date!

Happy Holidays!

sharann, BSN, RN

1,758 Posts

Sure. It would help if this seasoned PACU nurse could spell!

Reversal agents for benzodiadepines(Valium, Versed) is Romazicon.

Reversing Opioids(morphine etc..) is Narcan.

You shouldn't worry about it, it takes a while to learn these things. The main thing is to be motivated and eager and ask alot of questions:)

Oh, a piece of advice, any time a teenage boy comes out, stand a couple feet away while he wakes up or you could get whacked!

We have failed to mention the basics of the ABC's, the most important assessment in the PACU if you ask me. You better know the interventions too.............


24 Posts

Specializes in PACU. Has 25 years experience.

If you need a reference book, the PeriAnesthesia Nursing Core Curriculum ed. Donna M. DeFazio Quinn and Lois Schick which is published by the American Society of PeriAnesthesa Nurses is an excellent reference book. I used it to study for CPAN as well as the ASPAN Standards of Care. It helped me a lot.


3 Posts

Specializes in Rehab., Tele., Post Anesthesia. Has 24 years experience.

Know how to attach EKG leads, bp cuff and pulse ox. Not in that order.:mad:


2 Posts

how often and at what intervals do you give fentanyl for post op pain?

azhiker96, BSN, RN

1 Article; 1,127 Posts

Specializes in PACU, ED. Has 16 years experience.

My typical orders for sublimaze are 25 mcg q5min. How often I give it depends on the pt. For someone who's tolerant, 5 minutes isn't quick enough. For a 78 yr old dialysis pt, I may wait a bit longer between doses.


84 Posts

Specializes in Recovery (PACU)-11 yrs, General-13yrs. Has 23 years experience.

The most important is breathing, breathing, breathing


even if you don't know why, if someone doesn't look right/something doesn't seem right, then it's not right-get help straight away.

My motto has always been-there are two places you can look stupid; a)here in front of your workmates, or b)in a coroner's court. I choose (a) everytime.

On a lighter note;

Oh, a piece of advice, any time a teenage boy comes out, stand a couple feet away while he wakes up or you could get whacked!

and teenage girls will cry/sob uncontrollably, though not necessarily for a reason

and the guy with all the tats may be the politest patient you have all day.

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