Certified Post Anesthesia Nurse (CPAN) Practice Exam

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After a lumbar posterior nerve root rhizotomy, what is the priority nursing action if the patient has no movement or sensation in the lower extremities?

  1. Notify the anesthesiologist of muscle paralysis

  2. Notify the operating room of the complications

  3. Notify the surgeon of the absence of sensation

  4. Notify the surgeon of lack of motor ability

The correct answer is: Notify the surgeon of lack of motor ability

The priority nursing action in the scenario of a patient following a lumbar posterior nerve root rhizotomy with no movement or sensation in the lower extremities is to notify the surgeon of the lack of motor ability. After such a procedure, it is critical to assess the patient's neurological status, particularly motor function in the lower extremities, as this can indicate potential complications such as nerve damage or inadequate sedation recovery. Notifying the surgeon is necessary because they need to evaluate whether the absence of motor ability is anticipated due to the surgical intervention or if it signifies an unexpected complication that requires immediate attention. The surgeon is primarily responsible for evaluating the surgical outcomes and addressing any issues that may arise from the procedure. While it is equally important to assess sensation and communicate findings regarding both motor and sensory function, the lack of motor ability can have more immediate implications for the patient’s safety and recovery process. The surgeon's assessment and intervention can help determine the next steps for care and rehabilitation. In clinical practice, prompt communication about a patient's neurological status is crucial, especially after surgeries that may affect nerve function. This helps ensure a timely response to any complications and aids in the patient's overall recovery.