A 38-year-old male complains of nausea and vomiting. He has a history of alcoholism. His abdomen is distended, and he has left upper quadrant tenderness on palpation. His vital signs are P 112, R 18, BP 116/88, and SpO2 is 95% on room air. You should:

• A. assess rebound tenderness.
• B. administer oxygen.
• C. allow him to take sips of water.
• D. determine if he can ambulate with assistance.

Answer: (B)

The key idea is to protect oxygen delivery during an acute abdominal illness. This patient has signs of physiologic stress—tachycardia and vomiting—in a context (alcohol use) that raises concern for pancreatitis or splenic issues. Providing supplemental oxygen is a safe, immediate step to ensure adequate tissue oxygenation and to support perfusion while you continue evaluation and monitoring. Even though his SpO2 reads 95% on room air, giving oxygen proactively helps cover for potential rapid changes and prevents occult hypoxemia as the situation evolves.

Assessing rebound tenderness would come after securing airway and breathing and completing initial assessment. Allowing him to sip water risks aspiration in the setting of vomiting, and asking about ambulation with assistance does not address the immediate need to optimize oxygenation and stability.