A patient who is just waking up after having a general anesthetic is agitated and confused. Which action should the nurse take first?

• A. Check the O2 saturation.
• B. Administer the ordered opioid.
• C. Take the blood pressure and pulse.
• D. Notify the anesthesia care provider.

Answer: (A)

Immediately after waking from anesthesia, agitation can signal problems with breathing or oxygenation. The first priority is to confirm whether the patient is adequately oxygenating, which is fastest and most informative. Checking the oxygen saturation with a pulse oximeter tells you if hypoxemia is present and guides the next steps—such as providing supplemental oxygen or assisting ventilation if needed. Giving an opioid at this moment could worsen respiratory depression if oxygenation is poor, so it’s not the right first move. Monitoring blood pressure and pulse is important, but it doesn’t directly address the immediate cause of agitation. If the saturation is normal, you can then assess other causes (pain, residual sedative effects) and involve the anesthesia care provider as needed.