A 53-year-old female is cyanotic with intercostal retractions. What is the first action you should take?

In this scenario, the presence of cyanosis and intercostal retractions indicates that the patient is likely experiencing significant respiratory distress and might be in a state of hypoxia. Administering oxygen via a non-rebreather mask is the most appropriate initial action because it delivers a high concentration of oxygen, which is crucial for a patient who is demonstrating signs of inadequate oxygenation.

This method allows for rapid oxygen delivery to address the immediate need for increased oxygen saturation in a critically affected patient. A non-rebreather mask can provide up to 90% oxygen concentration, making it ideal for situations where the patient is in severe respiratory distress, as indicated by cyanosis.

While assessing vital signs is important and administering oxygen via nasal cannula provides oxygen as well, neither of those actions would provide the immediate high-level support needed in a case of suspected severe hypoxia. Gathering the patient's past medical history, while valuable for overall care, should not take precedence when the patient is showing acute signs of respiratory failure. Focusing on restoring adequate oxygen levels is the priority.