A 74-year-old male patient with a history of hypertension and atrial fibrillation, for which he takes an anticoagulant, presents to the emergency department with a severe nosebleed that has not stopped after 30 minutes of direct pressure. The nurse observes the patient frequently swallowing and spitting up blood. Which nursing intervention is the highest priority?
The correct answer is preparing for emergent airway management. Frequent swallowing and spitting up blood in the setting of a severe nosebleed are hallmark signs of a posterior epistaxis, where blood flows down the oropharynx. This poses a significant and immediate risk for airway compromise due to aspiration. While obtaining vital signs and labs is important for assessing hemodynamic stability and coagulation status, and preparing for nasal packing is a likely next step, protecting the airway is always the first priority in emergency care. Initiating a hypertensive medication is also a relevant consideration, as high blood pressure can exacerbate bleeding, but it is not as immediately life-threatening as a compromised airway.
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Maxillofacial and Ocular Emergencies
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