A 72-year-old patient on a medical-surgical unit presents with SpO2 88% on room air, tachypnea, and use of accessory muscles. What is the priority nursing action?

• A. Administer supplemental oxygen to improve saturation.
• B. Obtain a chest radiograph.
• C. Administer a diuretic.
• D. Call the physician.

Answer: (A)

When a patient is hypoxic with signs of respiratory distress, the immediate priority is to improve oxygenation. SpO2 of 88% on room air, along with tachypnea and use of accessory muscles, shows the body is not getting enough oxygen and is working harder to breathe. Providing supplemental oxygen right away raises the arterial oxygen level, reduces the work of breathing, and helps stabilize the patient for further assessment and interventions. Begin with an oxygen delivery method appropriate for the severity of distress and monitor the response, adjusting as needed to reach a safer saturation range.

After oxygen is started, you can pursue additional steps (such as a chest radiograph, diuretic therapy if indicated, or contacting the physician) based on the underlying cause and the patient’s response, but the first action is to improve oxygenation. Delaying oxygen in this scenario could permit further hypoxemia and deterioration.