Question

A nurse is planning care for a client who has a closed traumatic brain injury from a fall and is receiving mechanical ventilation. Which of the following interventions is the nurse's priority?

a) Administering pain medication
b) Monitoring oxygen saturation
c) Providing emotional support
d) Adjusting the room temperature

Answer 1

The nurse's priority is to monitor the oxygen saturation for a client with a closed traumatic brain injury on mechanical ventilation, as it is critical for preventing secondary brain injury.

Step-by-step explanation:

The priority intervention for a nurse planning care for a client who has a closed traumatic brain injury and is receiving mechanical ventilation is b) Monitoring oxygen saturation. This is crucial because maintaining adequate oxygenation is essential for preventing secondary brain injury. The other options, such as administering pain medication, providing emotional support, and adjusting the room temperature, are important aspects of care but are secondary to ensuring the patient's immediate physiological stability.

The surgeon, nurse, and anesthesia professional review aloud the key concerns for the recovery and care of the patient, which often include close monitoring of the patient's vital signs, especially oxygen levels, to ensure that the patient's brain receives sufficient oxygen to minimize injury and promote healing.