A client with liver failure is at risk for bleeding due to impaired synthesis of clotting factors.
Which assessment should the nurse prioritize?

Pulmonary embolism disrupts the ventilation-perfusion ratio, leading to sudden hypoxemia and respiratory distress. Prioritizing interventions requires applying the airway, breathing, circulation framework. Knowledge of gas exchange and emergency protocols is necessary to stabilize the client and maintain systemic cellular oxygenation.

Choice A rationale

Oxygen administration is the priority to treat hypoxemia caused by the physiological dead space created by the embolism. Improving arterial oxygen saturation supports myocardial and cerebral function while reducing the workload of the right ventricle during obstruction.

Choice B rationale

Morphine acts as an analgesic and vasodilator which can reduce anxiety and preload. However, it does not address the primary physiological threat of impaired gas exchange. Breathing and oxygenation must be stabilized before managing pain or sedation.

Choice C rationale

Cardiac monitoring identifies arrhythmias and right-sided heart strain associated with pulmonary hypertension. While diagnostic, it is a secondary action that follows the restoration of oxygenation. Assessment tools should not delay the implementation of life-saving oxygen therapy.

Choice D rationale

Lactated Ringer's is used for volume expansion and electrolyte replacement. In pulmonary embolism, excessive fluid can worsen right ventricular failure and pulmonary edema. Circulatory support is important but remains secondary to correcting the immediate life-threatening respiratory deficit..

Understanding skin grafting techniques is essential for postoperative burn care. Knowledge of autograft processing, specifically meshing, is required to explain how small donor skin samples are expanded to cover large wound areas while allowing for fluid drainage during healing.

Choice A rationale

While edema occurs during burn healing, the lattice pattern is a mechanical result of graft preparation rather than tissue stretching from fluid seepage. Tissue expansion occurs naturally but does not create a systematic, geometric mesh-like appearance.

Choice B rationale

Bulky dressings protect the graft site and maintain moist environments but do not cause permanent indentations in the skin. The lattice structure is a deliberate surgical modification of the donor tissue before it is applied.

Choice C rationale

Allografts are temporary covers from donors, but the lattice appearance is not caused by freezing. Meshing can be done on various graft types, but it is a physical process, not a byproduct of cryopreservation techniques.

Choice D rationale

Meshing an autograft involves cutting the skin in a geometric pattern to allow expansion. This allows a donor site to cover a larger recipient area and provides openings for exudate to escape, preventing graft displacement by fluid.