A client with paranoia is admitted to the mental health unit and immediately goes to the corner of the room and sits quietly without communicating. In approaching the client, what intervention should the practical nurse (PN) implement first?

Based on the given information, the statements that indicate the client's confusion is resolving are:

• Asks how long he has been in the hospital: This shows cognitive awareness and the ability to ask relevant and coherent questions.
• States he is hungry: This indicates a return to normal appetite and the ability to recognize and express basic needs.
• Recognizes his daughter: This demonstrates the ability to recognize and identify a familiar individual, suggesting an improved level of cognitive functioning.
• Oriented to time, place, and self: Being aware of the current time, location, and personal identity reflects an improved level of orientation and mental clarity.

• The statement "Drinking broth" does reflect the client's willingness and ability to consume food.

The following statements suggest ongoing confusion or potential issues:

• Clawing at the air: This behavior may indicate restlessness, agitation, or disorientation.
• Keeps trying to get out of bed to find the swimming pool: This behavior may indicate confusion or an altered perception of reality.

The statement "Oxygen saturation on 0.5L of 100%" provides information about the client's oxygen saturation level but does not specifically address the resolution of confusion.

This is the most important complication for the practical nurse (PN) to anticipate because it is a common and potentially life-threatening condition that can occur in clients with severe burns. Curling's ulcer, also known as stress ulcer, is a type of peptic ulcer that develops in the stomach or duodenum as a result of stress, shock, trauma, or burns. It is caused by decreased blood flow and increased acid secretion in the gastrointestinal tract, which damages the mucosal lining and leads to ulceration and bleeding.

The PN should anticipate Curling's ulcer in a client who experienced partial-thickness burns over 30% of the body surface area (BSA) 3 days ago, as this is a major risk factor for developing stress ulcers. The PN should monitor the client for signs and symptoms of Curling's ulcer, such as abdominal pain, nausea, vomiting, hematemesis, melena, and anemia. The PN should also administer prophylactic medications such as antacids, histamine-2 blockers, or proton pump inhibitors as prescribed by the health care provider.