A nurse is assisting with triaging clients after a mass casualty event. Which of the following clients should the nurse attend to first?

Choice A reason: The correct answer is a because auscultating the lung fields allows the nurse to determine the areas of congestion and plan the most effective positioning and techniques for chest percussion, vibration, and postural drainage.

Choice B reason: Providing mouth care is important for client comfort but is not the first step in preparing for chest physiotherapy.

Choice C reason: Cupping hands and tapping on the client’s chest repeatedly is part of the chest percussion technique but should be done after assessing the lung fields to target the appropriate areas.

Choice D reason: Positioning the client so that the lung area to be drained is above the trachea is part of postural drainage but should be planned based on the findings from auscultation.

Choice A reason: A low-sodium diet is essential for clients with acute glomerulonephritis to prevent fluid retention and reduce the workload on the kidneys. This dietary modification helps manage edema and hypertension, common complications of the condition. By limiting sodium intake, the body retains less water, which helps control swelling and blood pressure, making it a crucial intervention in the plan of care.

Choice B reason: Encouraging increased fluid intake is not recommended for clients with acute glomerulonephritis. Excessive fluid intake can lead to fluid overload, worsening edema and hypertension. The kidneys are already compromised in their ability to excrete fluid efficiently, so increasing fluid intake would exacerbate these issues. Instead, fluid intake should be carefully monitored and potentially restricted to prevent further strain on the kidneys.

Choice C reason: Obtaining weekly weight is not specific enough to monitor the acute phase of glomerulonephritis. Daily weights are more appropriate to closely monitor fluid balance and detect changes in edema. Daily weight measurements can help in assessing the effectiveness of interventions such as a low-sodium diet or diuretics and provide timely information for adjusting the plan of care.

Choice D reason: Encouraging frequent ambulation, while generally beneficial for overall health, is not a specific intervention for managing acute glomerulonephritis. The primary focus should be on dietary modifications and monitoring fluid balance to manage symptoms and prevent complications. Ambulation should be encouraged based on the client's overall condition and ability but is not a direct intervention for glomerulonephritis.