which is priority in the post-op pt

I would have chosen temp also. O2 at 85% isn't good, but a temp of 94 is really cold.

I would think the oxygen sat. Their temp is low, not high. If it was high, it would be a sign of infection. Our teachers like to throw in questions like that with abnormalities that make you think about the question.

Your temp. is also normally low after surgery because of anesthesia hence why they have heated blankets in the PACU. It is a standard procedure in the PACU I went to keep the patients warm after surgery.

So 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

Always 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.

Their temp is low, not high. If it was high, it would be a sign of infection.

I 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.

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.

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!

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![/quote']

You have good instincts. Don't let others have you second guess yourself. Always go with your gut!

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.

You have good instincts. Don't let others have you second guess yourself. Always go with your gut!

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.

Thanks, today of all days I really needed to hear something positive. It's been a bad, well not bad, but rough day......it's one of those.."I'm not gonna make it through this semester" day's. I needed a little "positive" in my corner. For the past week, I have studied and read over 23 assigned chapters for today's test, spent no time with my family, written out endless questions, reviewed a tremendous amount of drugs, took as many practice tests as I could find, honestly devoted all of my time to passing this test only to get there this morning to realize I questioned myself on 17 out of the 50 questions asked! Left there, went to the hospital for my assignment, feeling hopeless the whole time and like a failure, called my husband and he is so positive and gave me a long pep talk of how I can do this, only to hang up and sit in my driveway for about 15 mins crying. I haven't broken down like that yet. I am a fighter and I don't give up, and I know I CAN do this, but for some reason, today has just been "one of those days". So thank you for the nice comment!!!

"which takes priority in the post op client"....the only two that made sense were...

oxygen @ 85%

temp @ 94.3

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%".

i did remember maslow, but i have a terrible habit of the "second-guess syndrome"....i am going to have to kick that one fast or i'll never make it!!! thanks for the reply!

do you mind if i ask you one more question from today that i can't find the answer to?

i don't remember the choices, but the question was basically "why would a post op pt remain in a supine postion for 24 hours after receiving spinal anesthesia?"

spinal headache was one

change in bp was another, but i don't remember the other two options. any idea what it would be?

I did remember Maslow, but I have a terrible habit of the "second-guess syndrome"....I am going to have to kick that one fast or I'll never make it!!! Thanks for the reply!

Do you mind if I ask you one more question from today that I can't find the answer to?

I don't remember the choices, but the question was basically "why would a post op pt remain in a supine postion for 24 hours after receiving spinal anesthesia?"

spinal headache was one

change in bp was another, but I don't remember the other two options. Any idea what it would be?

It is hard to say because the other two options would be needed.

I say that because you usually don't need 24 hours of supine to prevent a spinal headache or a change in BP. Was one of the choices related to a dural tear? The spinal headache would be caused by a leak of spinal fluid and all you need is a couple of hours max to prevent the leak. For those that have a leak that doesn't subside, the headache is the clue and a blood patch would be performed to stop the leak-with that you still only need a couple of hours supine max, after that. Orders are usually 24 hours supine if a dural tear occurs; but, I don't think that they would get that complicated for you as a student.

Hope I didn't complicate things further for you. I think the answer lies in the exact wording of the question and a look at all the choices you had.