An unconscious patient who was transferred from surgery to the postanesthesia care unit (PACU) 15 minutes ago has an oxygen saturation of 89%. Which action should the nurse take first?
Increase the oxygen flowrate.
Elevate the patient's head on two pillows.
Suction the patient's mouth.
Perform the jaw-thrust maneuver.
The Correct Answer is A
A. The most appropriate first action would be to increase the oxygen flowrate to improve the patient's oxygen saturation levels. This intervention directly addresses the hypoxemia and can help prevent further complications related to low oxygen levels in the blood.
B. Elevating the patient's head can help improve ventilation and oxygenation. By raising the head, the patient's airway may become more patent, allowing for better airflow and oxygen exchange in the lungs. However, this should follow oxygenation.
C. Suctioning the patient's mouth aims to remove any secretions or obstructions that may be compromising the airway and contributing to the low oxygen saturation. However, this should follow oxygenation.
D. This maneuver can be helpful if the airway is obstructed by the tongue or soft tissues, potentially improving ventilation and oxygenation. However, this should follow oxygenation.
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Related Questions
Correct Answer is D
Explanation
D. Quadriceps setting exercises help strengthen the quadriceps muscles, which play a crucial role in knee stability and function. These exercises can be initiated early in the postoperative period and are typically part of the rehabilitation program following a partial meniscectomy.
A. Full weight bearing may place excessive stress on the knee joint and hinder the healing process.
B. Heat therapy is generally not recommended immediately after a partial meniscectomy. Heat can increase blood flow and swelling, which may exacerbate pain and inflammation in the early postoperative period.
C. Range of motion (ROM) exercises help prevent stiffness and promote flexibility in the knee joint after surgery. However, these exercises should not be initiated immediately.
Correct Answer is C
Explanation
C. The client’s laboratory values are all within normal range. It is therefore, safe for the nurse to proceed with preparation for theatre.
A. Notifying the provider immediately is a preferred action in the case of any abnormal laboratory values of concern.
B. Questioning on the recent infection would be relevant if the white blood count is elevated which is not the case in this scenario.
D. The client’s hemoglobin is within normal range and therefore, no need for transfusion at this point.
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