The emergency department nurse provides care for a 50-year-old male patient with septic shock. The nurse recalls that the renin- angiotensin system is activated during which stage of shock?

In a patient receiving mechanical ventilation, a high respiratory rate can indicate increased work of breathing and potential airway obstruction. COPD patients, in particular, may have excessive mucus production and airway inflammation, leading to mucus plugging and compromised airway clearance. Suctioning may be necessary to remove excessive secretions and maintain a patent airway.
A. The pulse oximeter shows a SpO2 of 90% in (option A) is incorrect because While a SpO2 of 90% is suboptimal and may require intervention, it does not specifically indicate the need for suctioning. Other interventions, such as adjusting oxygen delivery or ventilation settings, may be more appropriate.
B. The patient has not been suctioned for the last 6 hours in (option B) is incorrect because The duration since the last suctioning episode alone does not necessarily indicate the need for suctioning. The need for suctioning should be based on the patient's clinical presentation, such as signs of airway obstruction or excessive secretions.
D. The lungs have occasional audible expiratory wheezes in (option D) which is incorrect because Occasional audible expiratory wheezes may be common in patients with COPD and may not specifically indicate the need for suctioning. Wheezing is more commonly associated with narrowing of the airways, and suctioning is typically performed to clear secretions or maintain airway patency.
C. Therefore, in a COPD patient receiving mechanical ventilation, a high respiratory rate (C) is the assessment information that would indicate the need for suctioning to help remove excessive secretions and ensure a patent airway

In the initial 24 hours after burn injury, fluid resuscitation is a critical priority in the management of burn patients. Burn injuries can lead to significant fluid loss, both locally at the burn site and systemically due to increased capillary permeability. Fluid resuscitation aims to restore and maintain adequate intravascular volume, ensuring sufficient tissue perfusion and organ function.
The Parkland Formula is commonly used to guide fluid resuscitation in burn patients. It involves calculating the total volume of fluid needed in the first 24 hours, with a portion given in the initial hours after injury and the remainder given over the remaining hours.
A. Sterile dressing changes (option A) are incorrect because they are important in wound care management for burn patients to prevent infection. However, fluid resuscitation takes precedence within the first 24 hours.
B. Emotional support (option B) is incorrect because it is an essential aspect of burn care, as burn injuries can have a significant psychological impact. While emotional support is crucial for the patient's overall well-being, it may not be the highest priority within the first 24 hours compared to addressing the physiological needs of fluid resuscitation.
D. Range-of-motion exercises (option D) are incorrect because they are important for preventing contractures and maintaining joint mobility in burn patients. However, they are typically initiated after the initial fluid resuscitation phase and wound stabilization.
Therefore, the priority the nurse anticipates within the first 24 hours for a 31-year-old male patient with burn injuries is fluid resuscitation.