Asked by Ranz Nyle Cortez on Jun 14, 2024
Verified
The nurse admits a patient to the surgical unit from the postanesthesia care unit.The patient has an oral airway in place and awakens only to painful stimuli.What is the priority nursing action?
A) Remove the oral airway and elevate the head of the bed.
B) Position the patient with the head turned to the side.
C) Measure vital signs and check surgical dressing.
D) Call the surgeon and obtain postoperative prescriptions.
Oral Airway
A medical device used to keep the airway open by preventing the tongue from covering the epiglottis, often used in emergency situations or anesthesia.
Postanesthesia Care Unit
A specialized hospital unit where patients are closely monitored for recovery after undergoing anesthesia, before being transferred to another unit or discharged.
- Carry out and establish priorities for nursing interventions targeting patients with decreased oxygenation and dependence on mechanical ventilation.
- Identify the initial actions to be taken by nurses for patients experiencing acute respiratory distress.
Verified Answer
KP
Komal PaddaJun 18, 2024
Final Answer :
B
Explanation :
The oral airway should not be removed until the patient is more awake,and elevating the head of the bed is not appropriate until the patient is more responsive.The most important priority is to position the patient with the head turned to the side to prevent aspiration of secretions or emesis if the patient should vomit.Vital signs and dressing checks are important but not the highest priority.Postsurgical prescriptions are written when the patient is in postanesthesia care and come to the floor with the patient.
Learning Objectives
- Carry out and establish priorities for nursing interventions targeting patients with decreased oxygenation and dependence on mechanical ventilation.
- Identify the initial actions to be taken by nurses for patients experiencing acute respiratory distress.
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