An older patient with renal insufficiency has been NPO for 8 hours before a bronchoscopy. When the patient returns from the test, which patient datum is the nurse's priority assessment?
a. Hydration status
b. Level of orientation
c. Skin integrity status
d. A reaction to contrast medium used
A
Older patients are especially prone to dehydration, and the risk increases after a prolonged NPO period because the nurse withholds food and fluid to prepare the patient for the procedure. The patient's urinary output needs to be watched after hydration has been established. Emptying the stomach decreases the risk of aspiration of gastric contents during and after the procedure. Dis-orientation is a reasonable assessment for an older adult who has received inadequate fluid and risks dehydration; it may be a clinical indicator of dehydration. The risk of skin breakdown is increased with dehydration. It is not as important as early detection of dehydration because pre-venting dehydration helps to prevent skin breakdown. A contrast medium is not used during a bronchoscopy. The procedure is a direct visualization.
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