When assessing a patient taking stimulant medications, the nurse should monitor for which of the following?

A. Discharge teaching: Phase III of post-anesthesia care focuses on preparing the patient for discharge, including teaching about post-operative care, medication instructions, and follow-up care.

B. Recovery from anesthesia: This occurs in Phase I, where patients are closely monitored as they emerge from anesthesia and regain protective reflexes.

C. Urinary catheterization if no voiding: This may be considered in Phase II, especially if urinary retention is present, but is not a defining activity of Phase III.

D. Vital signs every 15 to 30 minutes: Frequent monitoring of vital signs is a key part of Phase I, when patients are at the highest risk for complications.

A. Administer oxygen at 2 L/min.: Oxygen is necessary, but raising the head of the bed first can improve oxygenation more effectively and quickly.

B. Encourage coughing and deep breathing.: While effective, this should be done after positioning the patient appropriately to optimize oxygenation.

C. Raise the head of the bed.: The priority intervention for low oxygen saturation is to improve ventilation and perfusion by raising the head of the bed. This enhances lung expansion, making it easier for the patient to breathe.

D. Administer prescribed analgesic medication.: Pain management is important, but it is not the priority when oxygen levels are dangerously low.