The nurse is caring for a post-op client who is drowsy but arousable. The client will take a few deep breaths when instructed but drifts to sleep when left alone. The O2 saturation while sleeping drops to 82% on 3 liters of nasal oxygen. The client received a dose of oxycodone/acetaminophen 2 tabs one hour ago.

What is the nurse's best action at this time?

1. Keep the O2 sat machine at the bedside and set the alarm to beep loudly when O2 sat drops below 93%.
2. Give a bath to arouse the client and then report that oxycodone/acetaminophen 2 tabs is too much for the next dose.
3. Let the client sleep until he has rested, then discuss the abuse potential of narcotics.
4. Call the primary healthcare provider and report the client assessment findings.

The most appropriate action for the nurse in this scenario would be to (4) call the primary caregiver and report the client's assessment findings due to potential respiratory complications.

Explanation:

Given the client's current state, the nurse's best plan of action is to phone the client's primary healthcare practitioner and inform them of the results of the evaluation. The client's persistent drowsiness and diminished O₂ saturation levels even after the administration of nasal oxygen indicate potential respiratory complications, potentially a repercussion of the medication (oxycodone/acetaminophen) administered.

Oxycodone is an opioid and could suppress the client's respiratory drive, leading to diminished oxygen saturation. This is a serious condition that needs to be addressed right away. Hence, option 4 appears to be the most appropriate in this scenario.

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