A nurse is caring for a postoperative client on the surgical unit.The client's blood pressure was 142/76 mm Hg 30 minutes ago,and now is 88/50 mm Hg.What action by the nurse is best?

Question

Quizplus · Accepted Answer

The purpose of the Rapid Response Team (RRT)is to intervene when clients are deteriorating before they suffer either respiratory or cardiac arrest.Since the client has manifested a significant change,the nurse should call the RRT.Changes in blood pressure,mental status,heart rate,and pain are particularly significant.Documentation is vital,but the nurse must do more than document.The primary care provider should be notified,but this is not the priority over calling the RRT.The client's blood pressure should be reassessed frequently,but the priority is getting the rapid care to the client.

A Nurse Is Caring for a Postoperative Client on the Surgical