An unresponsive 79-year-old is admitted to the emergency department (ED) during a summer heat wave. The patient's core temperature is 105.4° F (40.8° C), blood pressure (BP) 88/50, and pulse 112. The nurse initially will plan to
a. apply wet sheets and a fan to the patient.
b. provide O2 at 6 L/min with a nasal cannula.
c. start lactated Ringer's solution at 1000 mL/hr.
d. give acetaminophen (Tylenol) rectal suppository.
ANS: A
The priority intervention is to cool the patient. Antipyretics are not effective in decreasing temperature in heat stroke, and 100% oxygen should be given, which requires a high flow rate through a non-rebreather mask. An older patient would be at risk for developing complications such as pulmonary edema if given fluids at 1000 mL/hr.
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