The nurse completes teaching the client with a deep partial thickness burn about silver sulfadiazine.
Which client statements indicate that the teaching was effective? Select all that apply.

Chronic pancreatitis involves long-term inflammation of the pancreas leading to permanent structural damage and functional impairment. Knowledge of pancreatic enzyme dynamics, calcium sequestration during fat necrosis, and the resulting endocrine dysfunction is essential to identify clinical manifestations and laboratory abnormalities.

Choice A rationale

Chronic inflammation causes cellular destruction and leakage of enzymes into the bloodstream. During acute exacerbations of chronic pancreatitis, serum amylase levels rise above the normal range of 23 to 85 U/L due to pancreatic ductal obstruction.

Choice B rationale

Fat necrosis leads to the release of free fatty acids, which bind with ionized calcium in a process called saponification. This results in hypocalcemia, where serum calcium levels fall below the normal 9.0 to 10.5 mg/dL.

Choice C rationale

Serum lipase is highly specific to the pancreas and increases during inflammatory episodes. Lipase levels remain elevated longer than amylase, exceeding the normal reference range of 0 to 160 U/L as pancreatic acinar cells undergo damage.

Choice D rationale

Chronic pancreatitis often leads to the destruction of insulin-producing beta cells in the islets of Langerhans. This typically results in secondary diabetes mellitus and hyperglycemia, rather than decreased serum glucose levels below the normal 70 to 99 mg/dL.

Choice E rationale

Hypocalcemia is the expected finding due to calcium binding in necrotic fat. Elevated serum calcium is not consistent with pancreatitis; in fact, hypercalcemia is sometimes a causative factor for pancreatitis rather than a clinical manifestation of the disease.

Following major orthopedic surgery, a client presenting with sudden shortness of breath and tachycardia is highly suspicious for a pulmonary embolism. Knowledge of venous thromboembolism complications, diagnostic imaging protocols, and immediate stabilization techniques is necessary to prevent cardiovascular collapse and ensure respiratory support.

Choice A rationale: Computed tomography pulmonary angiography is the gold standard for diagnosing a pulmonary embolism. It allows for direct visualization of the pulmonary vasculature to identify arterial obstructions, which is essential for confirming the suspected condition in a post-operative patient.

Choice B rationale: A flat supine position can worsen respiratory distress by increasing the work of breathing and reducing lung expansion. Clients experiencing shortness of breath should be placed in a high-Fowler position to optimize ventilation and improve oxygenation.

Choice C rationale: Laboratory testing, including a complete blood count and coagulation studies, provides a baseline for the client's hematological status. These values are critical for planning the safe administration of therapeutic anticoagulation and monitoring for potential bleeding risks.

Choice D rationale: Obtaining venous access is a priority intervention to allow for the rapid administration of emergency medications or intravenous fluids. In the event of hemodynamic instability or the need for IV anticoagulants, established access is life-saving.

Choice E rationale: Continuous cardiac monitoring is necessary to track the client's heart rate and rhythm. Pulmonary embolism can cause right heart strain and dysrhythmias; monitoring allows the nurse to detect early signs of cardiac decompensation or worsening tachycardia.

Choice F rationale: Continuous oxygen saturation monitoring provides real-time data on the client’s respiratory status. Since pulmonary embolism impairs gas exchange, tracking saturation levels is vital to ensure that oxygen therapy is maintaining adequate systemic tissue perfusion.

Choice G rationale: Nurses cannot independently increase medication dosages, as this constitutes prescribing. Any changes to anticoagulant therapy, such as apixaban, must be ordered by a provider based on weight-based protocols and the severity of the thrombotic event.

Choice H rationale: Supplemental oxygen should be applied immediately to address the client's shortness of breath and potential hypoxemia. Increasing the concentration of inspired oxygen helps compensate for the ventilation-perfusion mismatch caused by the obstruction in the pulmonary arteries.