A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?

Place a large-bore IV catheter in an upper extremity.

Administer packed RBCs.

Obtain a specimen for ABG analysis.

Insert an indwelling urinary catheter.

Answer and Explanation

The Correct Answer is A

A. Place a large-bore IV catheter in an upper extremity: Establishing rapid IV access with a large-bore catheter is the priority in a client with abdominal trauma because it allows for immediate fluid resuscitation and administration of blood products if hemorrhage is present. Prompt vascular access is essential for stabilizing circulation and preventing shock.

B. Administer packed RBCs: Blood transfusion is critical for treating hypovolemia, but it cannot occur until IV access is established. Administering RBCs without a patent, large-bore line is unsafe and impractical in an emergency setting.

C. Obtain a specimen for ABG analysis: While ABG analysis provides valuable information on oxygenation and acid-base status, it is not the immediate priority. Ensuring vascular access and hemodynamic stability takes precedence in acute trauma care.

D. Insert an indwelling urinary catheter: Urinary catheterization is important for monitoring output and assessing renal perfusion, but it is secondary to establishing IV access and stabilizing the client’s circulatory status.

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Correct Answer is C

Explanation

A. Offer the client saltine crackers between meals: Dry foods like saltine crackers can worsen the discomfort associated with xerostomia and may irritate oral mucosa. They are not recommended for managing dry mouth.

B. Instruct the client on the use of esophageal speech: Esophageal speech is a technique used after laryngectomy, not for managing xerostomia. It does not address the underlying issue of dry mouth caused by radiation therapy.

C. Provide humidification of the room air: Humidifying the room adds moisture to the environment, helping relieve dryness in the oral cavity and throat. This intervention is appropriate for managing xerostomia and improving comfort for clients post-radiation therapy.

D. Suggest rinsing his mouth with an alcohol-based mouthwash: Alcohol-based mouthwashes can further dry and irritate the oral mucosa, worsening xerostomia. Clients should be advised to use non-alcoholic, moisturizing rinses instead.

A. Apply a tourniquet below the venipuncture site. B. Elevate the client's arm prior to insertion. C. Choose a vein that is palpable and straight. D. Select a site on the client's dominant arm.

Correct Answer is C

Explanation

A. Apply a tourniquet below the venipuncture site: The tourniquet should be applied above the intended insertion site to impede venous return and distend the vein. Placing it below the site would not promote vein filling and can hinder successful cannulation.

B. Elevate the client's arm prior to insertion: Lowering the arm below heart level promotes venous filling by gravity, making veins easier to visualize and palpate. Elevating the arm can cause veins to collapse and make insertion more difficult.

C. Choose a vein that is palpable and straight: A straight, resilient vein that can be palpated is less likely to roll and allows smoother catheter advancement. This reduces infiltration risk and increases the likelihood of a successful IV start.

D. Select a site on the client's dominant arm: The non-dominant arm is preferred to promote comfort and reduce interference with daily activities. Using the dominant arm can limit mobility and increase the risk of dislodgement.

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A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?

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