A nurse in the emergency department is assessing a newly admitted client who is experiencing drooling and hoarseness following a burn injury. Which of the following actions should the nurse take first?
Obtain a blood specimen for ABG analysis.
Apply 100% humidified oxygen.
Obtain a baseline ECG.
Insert an 18-gauge IV catheter.
The Correct Answer is B
A. Obtain a blood specimen for ABG analysis. Important, but not the first action.
B. In a client with burn injuries experiencing signs of airway compromise (drooling, hoarseness), the first action should be to ensure adequate oxygenation. Applying 100% humidified oxygen can help manage potential airway edema.
C. Obtain a baseline ECG. Necessary for monitoring but secondary to securing the airway.
D. Insert an 18-gauge IV catheter. Essential for fluid resuscitation and medication administration, but after ensuring adequate oxygenation.
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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Mastitis is a breast infection that can occur in breastfeeding women. It causes inflammation, pain, redness, and sometimes fever and pus in the affected breast. One of the risk factors for mastitis is nipple trauma, such as cracks or fissures, that can allow bacteria to enter the breast tissue.
Correct Answer is D
Explanation
A: Feeling light-headed upon standing is a common side effect of many psychotropic medications, indicating orthostatic hypotension but not necessarily requiring immediate provider intervention unless it persists or worsens.
B: Mumbling quietly could be related to the client’s schizophrenia rather than a direct effect of the medication.
C: Photosensitivity can be a side effect of some antipsychotic medications, but it is less concerning than neurological symptoms and usually manageable with lifestyle adjustments.
D: A shuffling gait can indicate the development of parkinsonism, a serious side effect of antipsychotic medications, which involves motor impairments mimicking symptoms of Parkinson's disease. This is significant and should be reported to the provider immediately for potential medication adjustment.
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