The practical nurse (PN) is caring for a client that has just arrived in the emergency department with 2nd degree thermal burns to the right thigh, lower leg and foot, and reports severe pain in the right leg. Which priority action should the PN take while caring for this patient?
Anticipate rehydration of 1000 mL/6 hr. with normal saline.
Remove clothing, cover burned area with cool damp cloth.
Completely flush burned area with water or sterile saline.
Collect data, vital signs, blood gases, height and weight.
The Correct Answer is B
The priority action for the practical nurse (PN) to take while caring for a client that has just arrived in the emergency department with 2nd degree thermal burns to the right thigh, lower leg and foot, and reports severe pain in the right leg is to remove clothing and cover the burned area with a cool damp cloth. This will help to cool the burn and reduce pain.
Anticipating rehydration of 1000 mL/6 hr. with normal saline (Option A) is an important intervention for burn patients, but it is not the first priority. Completely flushing the burned area with water or sterile saline (Option C) may be appropriate in some cases, but it is not the first intervention that should be implemented. Collecting data such as vital signs, blood gases, height and weight (Option D) is also important, but it is not the first priority.
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Related Questions
Correct Answer is B
Explanation
The greatest priority for the practical nurse to monitor during the administration of epidural anesthesia is maternal blood pressure (BP). Epidural anesthesia can cause maternal hypotension due to vasodilation and decreased venous return, which can result in decreased fetal perfusion and oxygenation. Therefore, it is important for the practical nurse to monitor maternal BP frequently and promptly report any significant changes to the healthcare provider. Options A, C, and D are also important assessments, but they are not the priority in this scenario.
Therefore, options A, C, and D are not answers because they are not the priority assessment during the administration of epidural anesthesia.
Correct Answer is A
Explanation
Explanation: Acute otitis media is a common childhood illness that refers to an infection of the middle ear. It occurs when the Eustachian tube, which connects the middle ear to the back of the throat, becomes blocked and fluid accumulates in the middle ear. This fluid provides a breeding ground for bacteria, leading to infection and inflammation. Symptoms of acute otitis media can include ear pain, fever, irritability, and difficulty hearing. It is important for the PN to provide accurate information to the mother and to explain the treatment plan, which may include antibiotics and pain relief measures, as prescribed by the healthcare provider.
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