you are the receiving nurse accepting a patient to a med-surg floor from the pacu. what is the first thing you do?
a. check patient's level of consciousness
b. see if patient's family is present
c. check patient's vital signs
d. order the patient dinner
upon receiving a patient who has had significant changes in their condition (surgery) you always
institute the nursing process, step #1, and assess
. that eliminates choices b
. which physiological need is going to kill the patient first if impeded (this comes from maslow's hierarchy of needs - http://en.wikipedia.org/wiki/maslow's_hierarchy_of_needs
)? breathing in oxygen. you also need to know that during surgery the anesthesiologist administers drugs and gasses that result in the alteration of consciousness. assessing the level of consciousness is done in the pacu using something called the aldrete score which measures consciousness, activity on command, respiration, circulation (blood pressure) and oxygen saturation. a patient doesn't leave the pacu without an aldrete score of 9 out of a possible 10. answer choice a
is eliminated since it doesn't involve immediate assessment of oxygenation and because an altered level of consciousness is expected immediately after surgery.
the answer is c. check patient's vital signs
since checking the vital signs will give immediate feedback on the patient's respiratory, circulation and oxygenation status.