A patient’s data shows the following: Oxygen saturation is 94% on room air, pain is 4 on a scale of 0 to 10, temperature is 99.6°F (37.6°C) orally, and heart rate is 95 beats/minute.
Which physician orders would the nurse anticipate being prescribed after reporting these findings? Select all that apply.
A Place client on oxygen 2 to 4 liters and maintain oxygen saturation at or above 95%.
B Stat ventilation/perfusion (V/Q) of chest.
C Stat 2 views chest x-ray.
D Stat Complete blood count (CBC), basic metabolic panel (BMP), and blood cultures.
E Send sputum for culture & sensitivity.
The Correct Answer and Explanation is :
Given the patient’s data—oxygen saturation of 94% on room air, pain level of 4, temperature of 99.6°F (37.6°C), and heart rate of 95 beats per minute—the following physician orders are anticipated:
A. Place client on oxygen 2 to 4 liters and maintain oxygen saturation at or above 95%.
B. Stat ventilation/perfusion (V/Q) of chest.
C. Stat 2 views chest x-ray.
D. Stat Complete blood count (CBC), basic metabolic panel (BMP), and blood cultures.
E. Send sputum for culture & sensitivity.
Correct Answers: A, B, C, D, E.
Explanation:
Oxygen Supplementation (Option A): The patient’s oxygen saturation is 94% on room air, which is slightly below the ideal threshold of 95% or higher. Although 94% is not critically low, it is close enough to warrant supplemental oxygen to maintain or improve oxygen saturation levels. This intervention helps ensure adequate oxygenation and prevents further decline in oxygen levels, which could be indicative of underlying respiratory issues.
Ventilation/Perfusion (V/Q) Scan (Option B): A V/Q scan is used to assess the distribution of airflow and blood flow in the lungs. This test is crucial when there is a suspicion of a pulmonary embolism or other pulmonary abnormalities that could affect ventilation and perfusion. The patient’s symptoms and data might suggest a need to rule out such conditions.
Chest X-Ray (Option C): A chest x-ray is a standard diagnostic tool to evaluate the condition of the lungs and chest cavity. It can help identify issues such as pneumonia, pleural effusion, or other structural abnormalities. Given the patient’s elevated temperature and slight decrease in oxygen saturation, a chest x-ray can provide important diagnostic information.
Laboratory Tests (Option D): A CBC, BMP, and blood cultures are essential in diagnosing potential infections or systemic issues. The patient’s fever and slightly increased heart rate could indicate an infection or inflammation, making these tests necessary to identify or rule out underlying causes of the symptoms.
Sputum Culture & Sensitivity (Option E): Sending sputum for culture and sensitivity is important if there is a suspicion of a respiratory infection. This test helps identify the specific pathogen causing the infection and determines the most effective antibiotics for treatment.
In summary, these orders are anticipated based on the combination of symptoms (fever, low oxygen saturation) and diagnostic needs to rule out or confirm respiratory or infectious conditions.