If a patient is hypotensive and tachycardic after a procedure, what should the nurse prioritize?

• A. Contact family
• B. Assess for signs of hemorrhage or shock, stabilize vitals, and notify the provider immediately
• C. Wait and recheck later
• D. Increase IV fluids without assessment

Answer: (B)

When a patient is hypotensive and tachycardic after a procedure, the priority is to identify and treat potential hemorrhage causing shock and to stabilize the patient urgently. The most important step is to assess for signs of bleeding or hypovolemia—examine the surgical site and drains, look for abdominal distension or abnormal dressings, and monitor mental status, skin color, capillary refill, and urine output to gauge perfusion. At the same time, stabilize the patient’s vital functions: ensure an open airway and adequate breathing (provide oxygen as needed), and secure IV access for rapid fluid resuscitation. Begin circulation support with isotonic fluids per protocol and anticipate blood product administration if hemorrhage is suspected or confirmed, while continuously rechecking vitals and response to interventions. Notify the provider immediately so further orders can be given promptly, such as imaging, surgical assessment, or transfusion.

Contacting family or waiting to recheck later don’t address the immediate life-threatening risk, and increasing IV fluids without assessment could worsen bleeding or mask ongoing instability, so they’re not appropriate first steps.