Find patient data about a client below.

After the nurse assesses the client, the physician writes orders. The nurse reviews the orders. Which 2 orders should the nurse complete first?

When a primigravida client confides in the practical nurse (PN) about being in an abusive relationship, the primary concern is the safety and well-being of the client and her unborn child. Providing contact information for a women's shelter is the most appropriate response in this situation. Women's shelters provide a safe haven for individuals experiencing domestic violence and can offer immediate assistance, including shelter, counseling, legal support, and other resources.

Let's evaluate why the other options are incorrect:

B. Safety plan to keep in a purse at all times:

While a safety plan is essential for individuals experiencing domestic violence, providing a safety plan alone may not address the immediate danger the client is facing. It is crucial to prioritize the client's safety by connecting her with a women's shelter where she can receive comprehensive support.

C. Visit summary documenting the report of abuse:

While it is important to document any reports of abuse, providing a visit summary alone does not address the urgent need for the client's safety. Documentation can be helpful for future reference, but immediate action should be taken to ensure the client's well-being.

D. Paperwork needed to file a restraining order:

Filing a restraining order is a legal step that may be necessary in cases of domestic violence, but it should be pursued after ensuring the client's immediate safety. Providing paperwork alone does not address the client's immediate need for a safe environment. Connecting the client with a women's shelter is a more appropriate course of action to ensure her safety and well-being.

The level of hypoxemia that the child may have experienced during the submersion depends on several factors, but the most important ones are:

• The **temperature of water**: Cold water can induce a diving reflex, which lowers the heart rate and oxygen consumption, and may protect the brain from hypoxic injury¹². Cold water can also cause laryngospasm, which prevents water aspiration but also impairs gas exchange.
• The **amount of time the child was submerged**: The longer the submersion, the more severe the hypoxemia and the higher the risk of brain damage and death. The survival rate decreases significantly after 5 minutes of submersion³.

The other factors are less relevant or not directly related to the level of hypoxemia:

• The **weight of the child**: This may affect the buoyancy and the ability to float or swim, but not the oxygen consumption or gas exchange during submersion¹.
• The **oxygen concentration of the ambient air**: This may affect the pre-submersion oxygen saturation, but not the rate of oxygen depletion or gas exchange during submersion¹.
• The **witnessing of the fall into the pool**: This may affect the time to rescue and resuscitation, but not the level of hypoxemia during submersion.