Your PACU patient’s vital signs are concerning: BP 171/92 mmHg, HR 120, RR 24, and they are grimacing and moaning. What medication should you prepare to give first?

In the scenario presented, the patient's vital signs indicate potential pain and discomfort, as evidenced by the elevated heart rate, respiratory rate, and behavioral signs of distress such as grimacing and moaning. When addressing immediate postoperative care, especially in the PACU, the priority is to manage pain effectively.

Administering fentanyl intravenously is a rapid method for pain relief. Fentanyl, a potent synthetic opioid, provides effective analgesia quickly, which is critical given the patient's distress signals and concerning vital signs. This medication can significantly improve the patient's comfort level and potentially stabilize their heart rate and blood pressure as pain is addressed.

The other medications listed, while they may serve specific purposes, do not directly address the immediate concern of acute pain relief in this scenario. Midazolam is primarily used for sedation and anxiety, which is not the immediate issue here. Morphine, while also effective for pain relief, may take longer to act compared to fentanyl, which is crucial in an acute setting. Atropine is typically used for bradycardia and would not be appropriate given the context of the patient's condition, particularly with a heart rate above 100 bpm indicating tachycardia.

Thus, preparing fentanyl for administration aligns with the