A nurse in an emergency department is caring for a client who has a closed head injury. Which of the following actions should the nurse take first?

The correct answer is choice D. Avoid using nail polish remover around the client. Nail polish remover contains acetone, which is a flammable substance that can ignite in the presence of oxygen.

Using nail polish remover around the client can increase the risk of fire and burn injuries.

Choice A is wrong because synthetic fabrics can generate static electricity, which can also cause sparks and ignite oxygen.

The client’s bedding should be made of cotton or wool, which are natural fabrics that do not produce static electricity.

Choice B is wrong because petroleum jelly is a petroleum-based product that can react with oxygen and cause skin irritation or burns.

The client should use water-based moisturizers to soothe the mucous membranes.

Choice C is wrong because alcohol-based cleaning products are also flammable and can cause fires or explosions when exposed to oxygen.

The client should use mild soap and water to clean the equipment, and follow the manufacturer’s instructions for maintenance.

Some general safety tips for home oxygen therapy are:

• Keep away from heat and flame, such as candles, matches, lighters, stoves, fireplaces, etc.
• Do not smoke or allow others to smoke near the oxygen source
• Do not use aerosols, vapor rubs, oils, or other products that contain flammable substances near the oxygen source
• Store oxygen tanks or cylinders in a well-ventilated area away from direct sunlight and heat sources
• Secure oxygen tanks or cylinders to prevent them from falling or rolling
• Use the exact rate of oxygen prescribed by the doctor for each activity
• Check the oxygen gauge or level regularly and call the medical supply company when it is low
• Use a humidifier bottle if prescribed by the doctor to prevent dryness of the mucous membranes
• Change the nasal cannula, mask, and tubing as instructed by the medical supply company to prevent

The correct answer is choice D. Sit with the client to provide a sense of security.

A client who is experiencing a panic attack has a very high level of anxiety and a diminished ability to focus.

The nurse should stay with the client and remain calm and reassuring during the panic attack. This can help the client feel safe and supported, and reduce the intensity of the anxiety.

Choice A is wrong because atomoxetine is not an anti-anxiety medication, but a selective norepinephrine reuptake inhibitor (SNRI) used to treat attention deficit hyperactivity disorder (ADHD). It has no effect on reducing anxiety and can cause side effects such as insomnia, nausea, and increased blood pressure.

Choice B is wrong because encouraging the client to watch television is not a therapeutic intervention for a panic attack.

Watching television can increase the stimuli in the client’s environment, which can worsen the anxiety.

The nurse should maintain an environment with low stimulation for the client experiencing a panic attack. Dim lighting, few people, and minimal distractions can assist the nurse to decrease the client’s level of anxiety.

Choice C is wrong because teaching the client how to meditate is not appropriate during a panic attack.

Meditation is a relaxation technique that can be helpful for preventing or reducing anxiety, but it requires concentration and focus, which are impaired in a panic attack. The nurse should teach the client how to meditate when the client is calm and receptive, not when the client is in crisis.