A nurse is providing safe sex education to a group of adolescents.Which of the following statements should the nurse include in the education? (Select all that apply.)

Choice A rationale

Administering an IV infusion like Lactated Ringer's addresses potential hypovolemia or shock but is not the immediate priority for a client with pulmonary embolism (PE). PE primarily causes an obstruction of pulmonary blood flow, leading to ventilation-perfusion (V/Q) mismatch and resulting in hypoxemia, which must be addressed first.

Choice B rationale

IV morphine can alleviate the pleuritic chest pain and anxiety associated with a pulmonary embolism by depressing the central nervous system and reducing myocardial oxygen demand. However, managing pain is a secondary intervention to the life-threatening impairment of oxygenation.

Choice C rationale

Initiating cardiac monitoring is vital for detecting potential complications such as dysrhythmias or right heart strain secondary to increased pulmonary vascular resistance. Nevertheless, the immediate threat to life is profound hypoxemia due to the massive V/Q mismatch, making oxygen delivery paramount.

Choice D rationale

Beginning oxygen therapy is the priority intervention because a pulmonary embolism obstructs blood flow to the alveoli, causing a severe ventilation-perfusion (V/Q) mismatch and hypoxemia. Supplemental oxygen directly increases the PaO_2 and SaO_2, which are essential for maintaining adequate tissue oxygenation and preventing organ damage.

Choice A rationale

Applying cold packs, or cryotherapy, is primarily indicated for acute soft tissue injuries to induce vasoconstriction, thereby decreasing local blood flow, metabolism, and inflammation, which reduces pain and swelling. For chronic or recurring lower back pain prevention, heat is often more effective, as it promotes vasodilation, increasing blood flow to relax muscles and reduce stiffness, making cold less suitable as a frequent preventative strategy.

Choice B rationale

Prolonged static postures, like sitting, increase intradiscal pressure and muscle tension in the lumbar region, leading to muscle fatigue and reduced blood flow to the supporting structures, which exacerbates back pain. Regular movement and changing positions is crucial to maintain flexibility, promote circulation, and distribute mechanical stress across different structures, minimizing sustained strain on the spinal ligaments and discs.

Choice C rationale

Sleeping on a mattress that is too soft fails to provide adequate support for the spine's natural curvature (lumbar lordosis), allowing the trunk to sink, which can lead to spinal misalignment and increased strain on the back muscles and ligaments. A medium-firm mattress is generally recommended to maintain proper spinal alignment during sleep, which reduces mechanical stress and prevents morning stiffness and pain.

Choice D rationale

Asking for help when moving clients ensures the nurse can use proper body mechanics, which involves keeping the load close to the body, maintaining a wide base of support, and lifting with the legs, not the back. This principle minimizes the mechanical stress and sheer forces applied to the intervertebral discs and paraspinal muscles, significantly lowering the risk of acute muscle strains or chronic cumulative trauma to the lumbar spine.

Choice E rationale

Partial sit-ups with the knees bent strengthen the abdominal and oblique muscles, which are key components of the body's core musculature. A strong core acts as a stabilizer for the lumbar spine, increasing intra-abdominal pressure to support the vertebral column and reducing the load and mechanical strain on the lower back structures during movement and daily activities, thereby preventing injury recurrence.