which is priority in the post-op pt
- 0Feb 16, '09 by RNnTrainin'I just wondered what you guys would have put for this question....it was one on our test this morning...
Basically it said "which takes priority in the post op client"....the only two that made sense were...
oxygen @ 85%
temp @ 94.3
There was no specific pt information, no predetermining factors such as COPD or anything like that. Just a normal post op client.
I chose the oxygen, but others chose the temp. Just wondered your thoughts.....THanks!!!
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- 1Feb 16, '09 by rmd47So typical of Nursing tests.....I would go w/O2 because that temp if high would=infection. Not the case here, 94 is hypothermia which as indicated above can occur w/surgery. It is not uncommon, however, all efforts must be made to elevate this temp as soon as possible. Any other ?'s
- 2Always remember: airway, breathing, circulation as the priorities.
The operating rooms are kept cold to prevent bacterial growth, so the majority of patients come out with low temps; but, the priority when they get to the PACU is: airway, breathing, circulation (in that order). First thing in the PACU that goes on the patient is oxygen, then the pulse ox monitor. So, you would have to say that the low oxygen saturation is the priority over the low temperature.
- 1Quote from misswhitneyI have seen elderly septic patients present with low temperatures in the ER and ICU. Infection can present with either an abnormally high or low temperature.Their temp is low, not high. If it was high, it would be a sign of infection.
The key to answering the question given was that the patient was post-surgical and it is normal (expected/anticipated) to be hypothermic after surgery. An elevated temperature immediately after or during surgery could be an indication of malignant hyperthermia, not an infection. It takes time for an infection to develop and the immune system to respond by elevating the temperature.
- 1Quote from RNnTrainin'You have good instincts. Don't let others have you second guess yourself. Always go with your gut!That's what I based my answer on (the ABC's), but when we got out and everyone started talking, I started second guessing myself! Anyway, thanks for the response!
Use 'ABC' as a mantra when others start going off in a tangent. We still use that phrase often as a way to focus on the priorites and it helps us to prioritize in a chaotic situation. It will also help you get the correct answer on tests (including NCLEX) because thinking ABC's simplifies things to allow prioritization.
Good Luck, you seem like you will be a great nurse.
- 1Feb 16, '09 by Daytonite"which takes priority in the post op client"....the only two that made sense were...
oxygen @ 85%if you couldn't recall maslow's hierarchy of needs (http://en.wikipedia.org/wiki/maslow's_hierarchy_of_needs), think of the abcs or which condition will kill the person faster. a person won't die from a fever faster than they will from not having enough oxygen. not enough oxygen kills brain cells and causes arrhythmias. the answer is "oxygen @ 85%".
temp @ 94.3