A patient in the PACU has a blood pressure drop from 138/84 to 100/58 with a pulse change from 68 to 94 and SpO2 98% on 3 L oxygen. In which order should the nurse take these actions? Put a comma and space between each answer choice.

• A. Raise the IV infusion rate, Increase the oxygen flow rate, Assess the patient's dressing, Check the patient's temperature.
• B. Raise the IV infusion rate, Assess the patient's dressing, Increase the oxygen flow rate, Check the patient's temperature.
• C. Increase the oxygen flow rate, Raise the IV infusion rate, Assess the patient's dressing, Check the temperature.
• D. Check the patient's temperature, Raise the IV infusion rate, Increase the oxygen flow rate, Assess the dressing.

Answer: (A)

When a post-op patient in the PACU becomes hypotensive with a rising heart rate, the immediate concern is improving circulating volume to restore perfusion. The first action is to raise the IV infusion rate to treat suspected hypovolemia from intraoperative blood loss or third-spacing. Restoring preload helps increase cardiac output and stabilize blood pressure.

Next, increasing the oxygen flow rate supports tissue oxygen delivery. Even though SpO2 reads 98%, higher FiO2 can help compensate for any potential drops in perfusion or rising oxygen demand due to tachycardia, ensuring tissues continue to receive adequate oxygen while circulation is being corrected.

After those stabilization steps, assess the surgical dressing to determine ongoing blood loss and the need for additional interventions, such as further fluid management or investigation for hemorrhage. Checking temperature is important but less urgent in this acute stabilization context, so it’s addressed after evaluating bleeding and hemodynamics.