If the patient’s oxygenation and vitals remain unstable despite initial measures, what is the next recommended step?

• A. Assess oxygenation
• B. Administer oxygen as ordered
• C. Monitor vitals
• D. Escalate care as needed

Answer: (D)

When a patient’s oxygenation and vitals stay unstable despite initial measures, the priority is to bring in higher-level support right away. This means escalating care as needed by notifying the physician or rapid-response team and following your facility’s escalation protocol. The goal is to obtain more advanced assessment and interventions—such as intensified oxygen therapy, airway management, ventilatory support, or transfer to a higher level of care—to reverse deterioration. Continuing to rely only on the same initial steps won’t address the ongoing instability. Ongoing monitoring and reaffirming oxygen delivery remain important, but the immediate action is to escalate to ensure timely, more aggressive treatment.