A mother rushes into the emergency department carrying her toddler who has been exposed to some cleaning products.

The child has a chemical smell on their hands, face, and clothes.
After ensuring the airway is patent, which action should the nurse take first?

Choice A rationale
Osteoarthritis is a type of arthritis that occurs when the cartilage that cushions the ends of your bones in your joints gradually deteriorates. Osteoarthritis symptoms often develop slowly and worsen over time. They can include: Pain in the joint during or after use, or after periods of inactivity, Tenderness in the joint when you apply light pressure to or near it, Stiffness in the joint, that may be most noticeable when you wake up in the morning or after a period of inactivity, Loss of flexibility in the joint, Grating sensation or sound when you use the joint. But in this case, the client’s symptoms do not align with those of osteoarthritis.

Choice B rationale
Rheumatoid Arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints, Joint stiffness that is usually worse in the mornings and after inactivity, Fatigue, fever and loss of appetite. The client’s symptoms align with those of Rheumatoid Arthritis.

Choice C rationale
Carpal Tunnel Syndrome is a condition that causes numbness, tingling and other symptoms in the hand and arm. Carpal tunnel syndrome is caused by a compressed nerve in the carpal tunnel, a narrow passageway on the palm side of your wrist. The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome. But in this case, the client’s symptoms do not align with those of Carpal Tunnel Syndrome.

Choice D rationale
Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe. An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable. But in this case, the client’s symptoms do not align with those of Gout.

Choice D rationale
Scheduling frequent rest periods can help manage the fatigue and concentration problems reported by the client. These symptoms are common in clients with CKD and elevated BUN and serum creatinine levels.
Choice A rationale
Administering PRN oxygen may not be necessary unless the client is showing signs of respiratory distress or hypoxia. There is no indication of this in the question.
Choice B rationale
Providing high protein snacks is not recommended for clients with CKD. High protein diets can increase the workload on the kidneys and worsen kidney function.
Choice C rationale
Monitoring glucose levels every 4 hours is not directly related to the client’s reported symptoms or the elevated BUN and serum creatinine levels.