In responding to a patient with respiratory distress, which action is the first priority?

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

Answer: (B)

In respiratory distress, the first step is to determine how well oxygen is getting to the tissues. Assess oxygenation right away using tools like pulse oximetry and by watching for signs of hypoxia (increased work of breathing, cyanosis, altered mental status) and, if available, arterial blood gases. This initial assessment provides the real-time status of the patient’s gas exchange and guides the next actions—such as whether to initiate or adjust oxygen therapy, choose a delivery method, or escalate care. Administering oxygen as ordered is important, but it should follow the assessment so the treatment matches the patient’s current needs. Ongoing vitals monitoring and decisions about escalating care are actions that occur as you reassess after starting support, ensuring the response is appropriate and timely.