A home health nurse is caring for a client who has chemotherapy-induced nausea that has been resistant to relief from pharmacological measures. Which of the following interventions should the nurse initiate? (Select all that apply.)

The nurse should choose a client who is exhibiting agonal respirations with fixed and dilated pupils for transport to the emergency department first. Agonal respirations are a sign of impending respiratory arrest and fixed and dilated pupils indicate that the client's brainstem is herniating, which is a life-threatening condition. Therefore, this client has the highest priority for emergency treatment. The other clients in the question can wait for treatment, although they also require medical attention.

A client who has a fracture of the humerus with a 2+ radial pulse in the affected arm is stable and does not require immediate emergency treatment. The client can wait for treatment and receive pain medication and immobilization of the affected arm until the client is transported to the hospital. A client who has full thickness burn injuries over 30% of his total body surface area also requires medical attention, but this client's condition is not immediately life-threatening. The client needs to be assessed for airway patency, breathing, and circulation and then receive fluid resuscitation and pain management. Finally, an ambulatory client who has a nosebleed and reports feeling dizzy can be assessed and treated in the triage area, as the client's condition is not life-threatening.

The correct answers are A, D, and E. Primary prevention activities aim to prevent the onset of disease or injury. Teaching a class about the risks of cigarette smoking and organizing a program to promote skateboard safety are examples of primary prevention activities. Lobbying for funding for health promotion efforts is also a primary prevention activity because it aims to prevent the occurrence of illness or injury in the community. Creating a plan of care for children who have a diagnosis of diabetes mellitus and recommending a seating arrangement for a child in a body cast are examples of secondary prevention activities, which aim to detect and treat health problems early to prevent complications.