A public health nurse is preparing for a mass casualty incident. Which of the following tasks should the nurse complete during the planning phase of disaster management?

A. A client who has depression and anxiety with an established plan of care: A medical-surgical nurse can safely care for a client with stable mental health conditions when a clear, established plan of care is in place. This client does not require constant psychiatric interventions, making it appropriate for assignment.

B. A client who is trying to engage in self-harm and does not understand why they cannot leave the facility: This client is high-risk and requires a nurse with specialized mental health training to implement safety measures and therapeutic interventions. Assigning this client to a medical-surgical nurse could compromise safety.

C. A client who is being discharged and needs information on substance abuse counseling: Discharge teaching and counseling for substance abuse require specialized knowledge and therapeutic communication skills typical of mental health nurses. A medical-surgical nurse may not have the expertise to provide adequate education and support.

D. A client who has been placed in restraints and requires documentation every 15 min: Clients in restraints require frequent monitoring, crisis intervention, and mental health expertise. This high-acuity situation is not appropriate for a nurse without psychiatric training.

A. Obtain a brain natriuretic peptide (BNP) test: BNP is a marker of heart failure and is indicated given the client’s new-onset dyspnea, crackles, and S3/S4 heart sounds. Measuring BNP helps assess for possible acute decompensated heart failure following surgery.

B. Obtain a complete blood count: A CBC helps identify infection, anemia, or other hematologic changes that could contribute to dyspnea, tachypnea, or hypoxia in the postoperative client. The client’s fever and tachycardia warrant this assessment.

C. Request respiratory therapy for intubation: Intubation is not immediately indicated as the client is still alert, maintaining oxygen saturation of 92% on supplemental oxygen. Less invasive diagnostics and interventions are prioritized first.

D. Obtain a STAT MRI: MRI is not the first-line diagnostic tool for acute dyspnea and postoperative cardiopulmonary assessment. It is not indicated in emergent evaluation of pulmonary or cardiac complications.

E. Obtain ABGs: Arterial blood gases are important to assess oxygenation, ventilation, and acid-base status given the client’s tachypnea, hypoxemia, and sudden respiratory distress.

F. Prepare the client for cardiac catheterization: Cardiac catheterization is invasive and not the immediate priority. Initial noninvasive assessment should guide the need for further intervention.

G. Obtain a chest x-ray: A chest x-ray is indicated to assess for pulmonary edema, pleural effusion, or other cardiopulmonary complications in a postoperative client presenting with dyspnea, crackles, and hypoxia.