Final answer:
The first intervention for a client with an active gastrointestinal bleeding ulcer preparing for a rapid infusion of blood should be to administer oxygen, due to the low peripheral oxygen saturation indicating potential circulatory shock. Oxygen therapy should be followed by urgent and monitored blood transfusion.
Step-by-step explanation:
Clinical Focus: Nursing Priorities in Acute Care
A client with an active gastrointestinal bleeding ulcer is preparing to receive two units of packed red blood cells by rapid infusion. When reviewing the client's vital signs, which present as a temperature of 96F, a heart rate of 132 beats per minute, respirations at 22 bpm, a blood pressure of 100/80 mmHg, and a peripheral oxygen saturation of 85%, the key concern for the nurse is the potential development of circulatory shock. These symptoms indicate that the client is already displaying signs of blood volume loss and inadequate oxygen delivery to tissues.
The first intervention the nurse should implement is to administer oxygen to the patient. Each additional minute that tissues go without adequate oxygen, the risk of organ dysfunction and shock increases. Following the initiation of oxygen therapy, the nurse should ensure that the blood transfusion is performed promptly and safely, while continuously monitoring the client's vital signs for any further indications of deterioration.
In this scenario, the patient's low peripheral oxygen saturation is the most critical issue and needs immediate intervention to prevent further decline into hypovolemic shock, which is characterized by a rapid heart rate, low blood pressure, and a decrease in urine output. Administering oxygen will help increase the oxygen saturation levels and assist in stabilizing the patient's condition as further interventions, such as the blood transfusion, are carried out. Therefore, oxygen administration takes precedence.