A nurse is reviewing the laboratory results of a client and finds both their iron and vitamin B12 levels are below the expected reference range. The nurse should monitor the client for which of the following conditions?

A) Check blood pressure for a client who is short of breath:
In a mass casualty incident, triage prioritizes addressing life-threatening conditions first. While shortness of breath may indicate a serious problem, assessing blood pressure would not be the most immediate action. The nurse should focus on airway, breathing, and circulation (the ABCs) before checking vital signs like blood pressure, as these could indicate the need for more urgent interventions.

B) Identify arterial bleeding by the presence of dark red blood:
Arterial bleeding is typically characterized by bright red blood that spurts or pulses with the heartbeat. Dark red blood is more indicative of venous bleeding. Recognizing arterial bleeding involves identifying the bright red, spurting blood, not dark red blood. It is essential to address major bleeding immediately by applying pressure or using a tourniquet as needed.

C) Open the airway of a client who has a cervical injury by using the jaw-thrust technique:
In clients with potential cervical spine injuries, the jaw-thrust technique is the recommended method to open the airway, as it does not involve tilting the head and neck, which could exacerbate a cervical injury. Ensuring the airway is patent is a priority in triage, and the jaw-thrust maneuver minimizes the risk of further injury to the spine.

D) Request the assistance of another staff member to log roll a client:
While log rolling is important for proper spinal alignment in clients with suspected spinal injuries, it is not the most urgent action during triage. In the context of a mass casualty incident, other immediate interventions, such as securing the airway and controlling bleeding, should take precedence before moving the patient unless the client’s condition requires repositioning to facilitate life-saving care.

A) Initiate droplet precautions: Respiratory syncytial virus (RSV) is primarily spread through contact with respiratory secretions, and droplet precautions are essential to prevent transmission. While RSV is commonly transmitted via direct contact or droplets, additional precautions like contact precautions may also be required, but droplet precautions should definitely be initiated as part of standard care to prevent the spread of the virus to others.

B) Monitor the preschooler’s urine for protein: Monitoring the urine for protein is not a standard action related to RSV. RSV is a respiratory virus, and its primary symptoms and complications involve the respiratory system, such as difficulty breathing, wheezing, or respiratory distress. There is no direct link between RSV and proteinuria, so this action is not necessary.

C) Administer fluconazole to the preschooler: Fluconazole is an antifungal medication, and it is not used to treat respiratory syncytial virus. RSV is a viral infection, so antiviral medications or supportive care like oxygen therapy, hydration, and possibly bronchodilators may be more appropriate. Fluconazole would not be appropriate for treating a viral infection like RSV.

D) Request an x-ray of the preschooler’s neck: An x-ray of the neck is generally not indicated for RSV unless there is a specific concern about airway obstruction or another condition like croup, which may present with symptoms similar to RSV. RSV primarily affects the lower respiratory tract, leading to symptoms like wheezing, cough, and difficulty breathing, not necessarily requiring a neck x-ray.