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A 68-year-old male patient is brought to the emergency department (ED) by ambulance after being found unconscious on the bathroom floor by his spouse. Which action will the nurse take first?

a. Check oxygen saturation.
b. Assess pupil reaction to light.
c. Verify Glasgow Coma Scale (GCS) score.
d. Palpate the head for hematoma or bony irregularities.

1 Answer

3 votes

Final answer:

The first action for an unconscious patient in the ED is to check oxygen saturation to immediately address potential life-threatening breathing issues. Subsequent rapid neurological assessments and aspirin therapy may follow based on the patient's condition and symptoms.

Step-by-step explanation:

A 68-year-old man is brought to the emergency department (ED) unconscious, and immediate action is necessary. Among the listed choices, the first action to take is to check oxygen saturation. Monitoring oxygen saturation will inform the healthcare provider about the patient’s respiratory efficacy and the potential need for supplemental oxygen, addressing the most immediate life-threatening issue which is airway and breathing. Once stable, a rapid assessment of neurological function may be performed, assessing pupil reaction, Glasgow Coma Scale (GCS) score, and palpating the head for abnormalities. In the context of a potential stroke, indicated by a 'pins-and-needles' sensation, further neurological examinations are crucial. These exams provide insight into the patient’s neurological status and help identify the stroke location. Aspirin therapy may also be considered to prevent further blood clot formation, assuming no contraindications.

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