Mr. Sparkson has returned from surgery, current vital signs are T 37 C, HR 101, RR 28, BP 158/94 and SpO2 89%. Assessment reveals abdominal dressing intact with a moderate amount of sanguineous drainage and peripheral IV with normal saline running at 100ml per hour. What should the practical nurse do first? a. Encourage deep breathing and coughing b. Reassess vital signs in 30 minutes c. Change the abdominal dressing d. Decrease the rate of the IV infusion
In this scenario, Mr. Sparkson has returned from surgery, and several vital signs and assessment findings need attention. Let’s evaluate each option to determine the best course of action:
a. Encourage deep breathing and coughing: While encouraging deep breathing and coughing is an essential post-operative nursing intervention to prevent complications such as atelectasis and pneumonia, it may not be the top priority in this case. Mr. Sparkson’s low SpO2 (oxygen saturation) of 89% suggests that he is not adequately oxygenating, and addressing this issue should take precedence.
b. Reassess vital signs in 30 minutes: Waiting for 30 minutes to reassess vital signs is not advisable, especially when Mr. Sparkson’s SpO2 is as low as 89%. Delaying assessment and intervention could lead to further oxygen deprivation and complications.
c. Change the abdominal dressing: While monitoring the abdominal dressing is important to assess for any signs of bleeding or infection, addressing Mr. Sparkson’s low oxygen saturation should be the immediate concern.
d. Decrease the rate of the IV infusion: This is the most appropriate initial action in this scenario. Mr. Sparkson’s low oxygen saturation (SpO2 of 89%) could be due to fluid overload, which may affect his respiratory function. Reducing the rate of the IV infusion allows for a more controlled fluid balance and may improve his oxygenation.
Therefore, the practical nurse should first d. Decrease the rate of the IV infusion.** After making this adjustment, the nurse should closely monitor Mr. Sparkson’s vital signs, especially his SpO2, and be prepared to take further action if his oxygen saturation does not improve. Encouraging deep breathing and coughing, reassessing vital signs, and assessing the abdominal dressing can follow once the immediate concern of oxygenation is addressed.
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