which is priority in the post-op pt

babyrn2 · Feb 16, 2009

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

misswhitney · Feb 16, 2009

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.

misswhitney · Feb 16, 2009

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.

rmd47 · Feb 16, 2009

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

loricatus · Feb 16, 2009

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.

loricatus · Feb 16, 2009

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.

RNnTrainin' · Feb 16, 2009

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!

loricatus · Feb 16, 2009

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.

Daytonite, BSN, RN · Feb 17, 2009

"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%".

RNnTrainin' · Feb 17, 2009

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!!!

RNnTrainin' · Feb 17, 2009

"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?