A nurse is caring for a patient receiving oxygen therapy via a nasal cannula at a flow rate of 3 liters per minute (LPM). The patient has chronic obstructive pulmonary disease (COPD) and is experiencing increased shortness of breath. The nurse observes the patient's oxygen saturation (SpO2) has dropped to 88%. What should be the nurse's initial action?

A. Apply ice bags to the neck and groinis correct because a temperature of 105.2°F (40.7°C) indicates severe hyperthermia or possible heat stroke, which is a medical emergency. The priority is rapid cooling to prevent cellular damage, organ failure, and neurologic injury. Applying ice packs to major vascular areas such as the neck, axillae, and groin promotes heat loss through conduction and helps lower core temperature quickly.

B. Measure the amount of urine being producedis incorrect as the first action because although monitoring urine output is important to assess kidney perfusion and possible rhabdomyolysis, it does not address the immediate life-threatening hyperthermia. Cooling is the priority.

C. Reduce the ambient temperature to 60°F (15.5°C)is incorrect because while lowering room temperature may assist with cooling, it is not the most immediate or effective intervention compared to direct cooling measures such as ice packs or cooling blankets.

D. Obtain a blood sample for arterial blood gassesis incorrect as the first action because laboratory testing is important for evaluation, but stabilizing the client’s elevated core temperature takes priority according to emergency care principles (ABCs and immediate threat management).

A. Fever alone indicates an infectious processbut is generally not immediately life-threateningunless accompanied by systemic instability, altered mental status, or hypotension. This client can safely wait for evaluation after clients with higher-acuity conditionsare assessed.

B. Slurred speech is a neurological symptomthat may indicate acute stroke, transient ischemic attack (TIA), hypoglycemia, or other central nervous system compromise. According to triage principles, time-sensitive conditions affecting neurological function are considered high priority because delays in treatment can lead to permanent disability or death. Rapid assessment and intervention, including imaging and stabilization, are crucial. This client should be seen immediately, following the “golden hour” concept for stroke care.

C. While these symptoms may indicate a urinary tract infection, they are low-acuityin the absence of systemic symptoms such as fever, hypotension, or altered mental status. This client’s evaluation can be safely delayed after more urgent cases are addressed.

D. Ear pain is usually non-life-threateningand represents a low-acuity complaint, even if discomfort is significant. The client can wait until higher-priority patients, such as the one with neurological compromise, have been stabilized.