Final answer:
A client in the PACU requires further observation and should not be discharged if they need tactile stimulation to respond. Indicators of discharge readiness include stable vital signs, adequate pain control, baseline return of sensory and motor functions, and the absence of infection or other complications.
Step-by-step explanation:
When assessing a client in the Post Anesthesia Care Unit (PACU) for discharge readiness, the nurse must ensure that the client is stable and exhibits no complications. One sign that a client is not ready for discharge is if they require tactile stimulation to achieve consciousness or responsiveness. Readiness for discharge is generally indicated by the client's ability to maintain airway control, stable vital signs, oriented status, and adequate pain management. Sensation and motor function should also return to baseline levels after anesthesia. Tests such as gauging response to tactile stimuli, strength against resistance, proprioception, and the ability to perform simple motor tasks help determine neurological function. A lack of sensation or difficulty in feeling touch indicates potential issues that need to be addressed before considering discharge.
Clients like Barbara and Mark, who exhibit signs of infection, such as redness at the site of a catheter, warm skin, fever, rapid progression of symptoms, pus drainage, or signs of severe systemic infections such as necrotizing fasciitis, would not be ready for discharge. Instead, their conditions would necessitate further treatment and observation within the hospital.