A client with atrial fibrillation is scheduled for an elective cardioversion.

The nurse prepares for the procedure by inserting two intravenous (IV) catheters and connecting the monitoring lead wires to the client.
Which action is most crucial for the nurse to take before initiating the cardioversion?

Management of respiratory distress in a long-term smoker requires knowledge of oxygen delivery systems and airway humidification. The nurse must apply principles of respiratory therapy to select equipment that ensures precise flow regulation and moisture addition to prevent mucosal drying during supplemental oxygen administration.

Choice A rationale: Lamb’s wool is occasionally used to protect skin from pressure sores caused by medical tubing. However, it is not a standard or essential component for initiating oxygen therapy, as modern medical-grade foam dressings or specialized tubing protectors are more commonly utilized in clinical practice.

Choice B rationale: Sterile water is essential for the humidification process when oxygen flow rates exceed 4 liters per minute. It serves as the reservoir liquid in the humidifier bottle to ensure the inhaled gas is moist, preventing the drying of sensitive respiratory mucosa and secretions.

Choice C rationale: Tape is generally avoided when securing nasal cannulas because it can cause skin irritation or breakdown on the face. The cannula is designed to be secured using the integrated sliding bolo or by looping the flexible tubing comfortably behind the patient's ears.

Choice D rationale: A suction canister is used for removing secretions from the oropharynx or trachea. While it may be present at the bedside for safety, it is not a functional component of the oxygen delivery system itself, which focuses on gas inhalation rather than extraction.

Choice E rationale: A humidifier bottle is necessary to add water vapor to the dry oxygen gas provided by the wall source. Humidification is vital for patient comfort and to maintain the integrity of the mucociliary escalator, especially for patients with chronic lung irritation from smoking.

Choice F rationale: The nasal cannula is the primary interface for delivering low-to-medium concentrations of oxygen. It consists of two prongs that fit into the nares, allowing the patient to breathe supplemental oxygen while still being able to speak and consume fluids or meals.

Choice G rationale: A flowmeter is a critical device that attaches to the oxygen wall outlet to regulate the liters per minute delivered. It allows the nurse to accurately titrate the oxygen dose according to the healthcare provider's specific orders and the patient's oxygenation needs.

Choice A rationale
Performing a thorough physical assessment is crucial when elder mistreatment is suspected. It helps to identify any signs of physical abuse or neglect.
Choice B rationale
Developing a safety plan is an important step in ensuring the safety of the elder. This plan can include strategies to avoid potential harm and steps to take if the elder feels unsafe.
Choice C rationale

Taking photographs to document the abuse or neglect can provide concrete evidence of the mistreatment. These photographs can be used in investigations and legal proceedings.
Choice F rationale
Completing a comprehensive history is necessary to understand the full context of the elder’s situation. This includes the elder’s health status, living conditions, and the nature of their relationship with the caregiver.
Choice H rationale
Reporting findings to Adult Protective Services is a critical step in addressing elder mistreatment. Adult Protective Services can conduct further investigations and take necessary actions to protect the elder.