CAPA Certification Study Guide with
Complete Solutions
Preanesthesia phase - correct answer-- Focused on preparation for surgery
- Assessment of pts physical, mental, and spiritual needs to completed to identify issues
needing to be addressed
- May also include education on what to expect in the following phases of care and
possibly discharge teaching
- Staffing depends on pt acuity, age of pts and if needed, sedation for preoperative
nerve blocks
Postanesthesia Phase 1 - correct answer-- Immediate post-operative area
- Pt may need assistance with breathing or other life saving measures
- Requires constant attention
- New admissions should be closely monitored until critical needs are met, such as
airway and VS are stable, the initial assessment is completed, and the pt is calm without
competitiveness or agitation
- VS every 15min
Postanesthesia Phase 1 staffing - correct answer-- Staffing should be 1:1 or 2:1
- There should be at least 2 nurses in the unit, 1 who is carding for the pt and one is
immediately available to provide assistance as needed
- 1 nurse in the unit must be competent in phase 1
- The nurse may have 2 pts if both are hemodynamically stable, conscious, over age 8,
or under 8 with family/caregiver at bedside
- The nurse may have 1 pt if under 8 years old and unconscious
- The nurse may have 1 pt who is not conscious but hemodynamically stable, with a
stable airway over the age of 8 and 1 pt who is conscious and stable
- Occasionally 1 pt who is critical and unstable may require 2 nurses
Postanesthesia phase 2 - correct answer-- The pts in this area are preparing to go
home
- Here pt receives discharge instructions
- Still requires monitoring for complications related to surgery or medications
- VS every 30-60min (at arrival and discharge)
Postanesthesia phase 2 staffing - correct answer-- 1:3 if over the age of 8 or under 8
with family present
- if the pt is under 8 w/out family, ration should be 1:2
- 2 staff members are required to be in the unit at all times (1 RN competent in phase 2)
,- Staffing will be 1 nurse to 1 pt if pt becomes unstable and requires transfer to higher
level of care
Extended care - correct answer-- Area where pts require extended observation after
discharge from phase 2
- Staffing should be 1:3-5
- These pts are typically waiting for transport home/inpt bed
- 2 staff members should be in the unit at all times (1 RN who is competent in caring for
pt population)
Blended care - correct answer-- Care of pts who belong in multiple phases of care
- Clinical judgement is required to determine safe staffing
- Pts in different levels may share same physical space
- An effort must be made to ensure privacy and confidentiality
Recommendations to combat alarm fatigue - correct answer-- Identify important alarms
- Develop policies that identify when alarms can be disabled
- Use alarms that change back to default settings when the pt is discharged from device
- Adjust the alarms to the pt needs
Capnography - correct answer-- Can detect early hypoxia to allow correction of
hypoventilation, apnea, or airway obstruction
- Can be used in areas other than operating rooms for procedures or peripheral nerve
blocks
- Can increase safety for pts when included with use of pulse ox
- O2 supplementation may correct for pulse ox readings but may mask hypoventilation
Minimal sedation, anxiolysis - correct answer-- Pt responds normally
- Coordination may be impaired
- Pt is able to maintain airway
Moderate sedation, analgesia - correct answer-- "Conscious sedation"
- Pt has depressed level of consciousness but can respond to verbal commands or light
touch
- Can maintain their own airway
Deep sedation, analgesia - correct answer-- Pt responds purposefully to painful
stimulation
- Pt may not be able to maintain their own airway
General anesthesia - correct answer-- Pt loses consciousness, pts are not arousable,
usually cannot maintain airway and ventilatory function
- Cardiovascular function may be compromised
- 3 phases of general anesthesia: induction, maintenance, and emergence
Stages of anesthesia - correct answer-I: stage of anesthesia and amnesia
, II: stage of delirium
III: stage of surgical anesthesia
IV: cessation of respiration to circulatory collapse
Stage I of anesthesia and amnesia - correct answer-- Begins with initiation of
anesthesia and ends with loss of consciousness
- Pt can follow simple commands
- Protective reflexes remain intact
Stage II of delirium - correct answer-- Starts with loss of consciousness and ends with
disappearance of lid reflex
- Respirations irregular
- May be passed through quickly with newer anesthetic agents
- High risk for aspiration, laryngospasm and bronchospasm
Stage III of surgical anesthesia - correct answer-- Cessation of spontaneous
respirations
- Absence of eyelash response, blink, & swallow reflexes
- Airway management essential
Stage IV cessation of respirations to circulatory collapse - correct answer-Considered
overdose of general anesthetics
Regional anesthesia - correct answer-- Loss of sensation to specific region of the body
- Ex: spinal, epidural, and peripheral nerve blocks
Local anesthesia - correct answer-Local infiltration or topical application of anesthetic
agent
Horner's syndrome - correct answer-- A sign of medical issue that has caused nerve
damage
- The nerve from the eye and face to the brain can be damaged and cause drooping
eye lid, decreased pupil size, and decreased sweating
- Can be cause dby tumor, stroke, or spinal cord injury
Retrobublar - correct answer-Eye nerve block
Intercostal - correct answer-Block of nerves that supply the ribs and abdominal wall
Brachial plexus - correct answer-- Block of spinal nerves from C5-T1 vertebrae
- Each bundle divides and eventually end in radial, ulnar, and median nerves
- Used for hand, forearm, and shoulder surgeries
- Interscalene, supraclavicular, infraclavicular, axillary
Lower extremity blocks - correct answer-- Performed for knee and foot surgeries
- Lumbar and sacral nerves divide into sciatic, gemoral, popliteal, and tibial nerves
Complete Solutions
Preanesthesia phase - correct answer-- Focused on preparation for surgery
- Assessment of pts physical, mental, and spiritual needs to completed to identify issues
needing to be addressed
- May also include education on what to expect in the following phases of care and
possibly discharge teaching
- Staffing depends on pt acuity, age of pts and if needed, sedation for preoperative
nerve blocks
Postanesthesia Phase 1 - correct answer-- Immediate post-operative area
- Pt may need assistance with breathing or other life saving measures
- Requires constant attention
- New admissions should be closely monitored until critical needs are met, such as
airway and VS are stable, the initial assessment is completed, and the pt is calm without
competitiveness or agitation
- VS every 15min
Postanesthesia Phase 1 staffing - correct answer-- Staffing should be 1:1 or 2:1
- There should be at least 2 nurses in the unit, 1 who is carding for the pt and one is
immediately available to provide assistance as needed
- 1 nurse in the unit must be competent in phase 1
- The nurse may have 2 pts if both are hemodynamically stable, conscious, over age 8,
or under 8 with family/caregiver at bedside
- The nurse may have 1 pt if under 8 years old and unconscious
- The nurse may have 1 pt who is not conscious but hemodynamically stable, with a
stable airway over the age of 8 and 1 pt who is conscious and stable
- Occasionally 1 pt who is critical and unstable may require 2 nurses
Postanesthesia phase 2 - correct answer-- The pts in this area are preparing to go
home
- Here pt receives discharge instructions
- Still requires monitoring for complications related to surgery or medications
- VS every 30-60min (at arrival and discharge)
Postanesthesia phase 2 staffing - correct answer-- 1:3 if over the age of 8 or under 8
with family present
- if the pt is under 8 w/out family, ration should be 1:2
- 2 staff members are required to be in the unit at all times (1 RN competent in phase 2)
,- Staffing will be 1 nurse to 1 pt if pt becomes unstable and requires transfer to higher
level of care
Extended care - correct answer-- Area where pts require extended observation after
discharge from phase 2
- Staffing should be 1:3-5
- These pts are typically waiting for transport home/inpt bed
- 2 staff members should be in the unit at all times (1 RN who is competent in caring for
pt population)
Blended care - correct answer-- Care of pts who belong in multiple phases of care
- Clinical judgement is required to determine safe staffing
- Pts in different levels may share same physical space
- An effort must be made to ensure privacy and confidentiality
Recommendations to combat alarm fatigue - correct answer-- Identify important alarms
- Develop policies that identify when alarms can be disabled
- Use alarms that change back to default settings when the pt is discharged from device
- Adjust the alarms to the pt needs
Capnography - correct answer-- Can detect early hypoxia to allow correction of
hypoventilation, apnea, or airway obstruction
- Can be used in areas other than operating rooms for procedures or peripheral nerve
blocks
- Can increase safety for pts when included with use of pulse ox
- O2 supplementation may correct for pulse ox readings but may mask hypoventilation
Minimal sedation, anxiolysis - correct answer-- Pt responds normally
- Coordination may be impaired
- Pt is able to maintain airway
Moderate sedation, analgesia - correct answer-- "Conscious sedation"
- Pt has depressed level of consciousness but can respond to verbal commands or light
touch
- Can maintain their own airway
Deep sedation, analgesia - correct answer-- Pt responds purposefully to painful
stimulation
- Pt may not be able to maintain their own airway
General anesthesia - correct answer-- Pt loses consciousness, pts are not arousable,
usually cannot maintain airway and ventilatory function
- Cardiovascular function may be compromised
- 3 phases of general anesthesia: induction, maintenance, and emergence
Stages of anesthesia - correct answer-I: stage of anesthesia and amnesia
, II: stage of delirium
III: stage of surgical anesthesia
IV: cessation of respiration to circulatory collapse
Stage I of anesthesia and amnesia - correct answer-- Begins with initiation of
anesthesia and ends with loss of consciousness
- Pt can follow simple commands
- Protective reflexes remain intact
Stage II of delirium - correct answer-- Starts with loss of consciousness and ends with
disappearance of lid reflex
- Respirations irregular
- May be passed through quickly with newer anesthetic agents
- High risk for aspiration, laryngospasm and bronchospasm
Stage III of surgical anesthesia - correct answer-- Cessation of spontaneous
respirations
- Absence of eyelash response, blink, & swallow reflexes
- Airway management essential
Stage IV cessation of respirations to circulatory collapse - correct answer-Considered
overdose of general anesthetics
Regional anesthesia - correct answer-- Loss of sensation to specific region of the body
- Ex: spinal, epidural, and peripheral nerve blocks
Local anesthesia - correct answer-Local infiltration or topical application of anesthetic
agent
Horner's syndrome - correct answer-- A sign of medical issue that has caused nerve
damage
- The nerve from the eye and face to the brain can be damaged and cause drooping
eye lid, decreased pupil size, and decreased sweating
- Can be cause dby tumor, stroke, or spinal cord injury
Retrobublar - correct answer-Eye nerve block
Intercostal - correct answer-Block of nerves that supply the ribs and abdominal wall
Brachial plexus - correct answer-- Block of spinal nerves from C5-T1 vertebrae
- Each bundle divides and eventually end in radial, ulnar, and median nerves
- Used for hand, forearm, and shoulder surgeries
- Interscalene, supraclavicular, infraclavicular, axillary
Lower extremity blocks - correct answer-- Performed for knee and foot surgeries
- Lumbar and sacral nerves divide into sciatic, gemoral, popliteal, and tibial nerves
