A nurse is caring for a client who has acute pulmonary edema. Which of the following is the priority nursing intervention?

Insert an indwelling urinary catheter.

Administer an IV diuretic.

Initiate oxygen via face mask.

Request an analysis of ABGs.

Answer and Explanation

The Correct Answer is C

A. Insert an indwelling urinary catheter: This may be necessary to monitor fluid output after diuretic therapy, but it is not the immediate priority when oxygenation is compromised due to fluid in the lungs.
B. Administer an IV diuretic: Diuretics help reduce fluid overload, which is key in managing pulmonary edema, but oxygenation must be addressed first to stabilize the client and prevent hypoxia.
C. Initiate oxygen via face mask: The most urgent concern in acute pulmonary edema is impaired gas exchange. Administering oxygen immediately helps improve oxygenation and is the priority intervention to address life-threatening hypoxia.
D. Request an analysis of ABGs: While ABG results are important to assess respiratory function and guide further treatment, drawing labs takes time. Oxygen administration should not be delayed in order to obtain lab values.

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Correct Answer is A

Explanation

A. Place locks at the tops of exterior doors: Clients with Alzheimer’s disease are at high risk for wandering. Installing locks out of the client’s line of sight, such as at the tops of doors, enhances safety by reducing the chance of unsupervised exit.
B. Wear clothing with zippers instead of buttons: While simplifying clothing is helpful, Velcro or elastic waistbands are typically easier for clients with cognitive decline than zippers, which can still be difficult to manage.
C. Encourage physical activity prior to bedtime: Physical activity should be scheduled earlier in the day. Stimulating activity near bedtime may worsen sleep disturbances or contribute to sundowning in clients with Alzheimer’s disease.
D. Replace the carpet with hardwood floors: Removing carpet can increase the risk of slipping and falling. Soft flooring like carpet may actually provide better traction and cushion in the event of a fall.

A. Remove the safety inspection sticker before plugging in the IV pump. B. Grasp the IV pump cord when unplugging it from the electrical outlet. C. Ensure that the electric outlet has two prongs for the IV pump. D. Check the cords of the IV pump for fraying.

Correct Answer is D

Explanation

A. Remove the safety inspection sticker before plugging in the IV pump: The safety inspection sticker should remain on the device to confirm that it has been tested and is safe to use. Removing it eliminates proof of its inspection status and compliance.
B. Grasp the IV pump cord when unplugging it from the electrical outlet: Pulling the cord rather than the plug can damage the internal wiring and increase the risk of electrical shock or equipment failure. The plug should be grasped firmly at the base.
C. Ensure that the electric outlet has two prongs for the IV pump: Medical equipment, including IV pumps, should be plugged into a three-pronged grounded outlet to ensure safe operation and reduce the risk of electrical shock or fire.
D. Check the cords of the IV pump for fraying: Inspecting the cords for damage before use is a standard safety measure. Frayed or damaged cords pose a serious electrical hazard and the device should not be used until repaired or replaced.

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A nurse is caring for a client who has acute pulmonary edema. Which of the following is the priority nursing intervention?

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