To improve the oxygenation of a client with acute respiratory distress syndrome (ARDS) who is receiving mechanical ventilation, the nurse should place the client in which position?

Choice A reason: Medicating the patient for pain is not the most appropriate immediate action in this situation. While pain management is important, the primary concern should be addressing the significant changes in heart rate and blood pressure, which may indicate a more serious underlying issue.

Choice B reason: Allowing the patient to rest quietly is not the appropriate response to the noted changes in vital signs. The increase in heart rate and drop in blood pressure are signs that require immediate investigation and intervention, rather than passive observation.

Choice C reason: Assessing the patient for bleeding is the most appropriate action. The increase in heart rate and decrease in blood pressure following an angioplasty procedure are concerning for potential bleeding or hemorrhage, especially if the patient has an intra-arterial line. Quick assessment and intervention are crucial to address any bleeding and stabilize the patient's condition.

Choice D reason: Documenting the findings in the chart is necessary, but it should not be the immediate priority. The nurse must first assess and address the potential cause of the changes in vital signs, such as bleeding, before documenting the events.

Choice A reason: Hypokalemia, or low potassium levels, is not typically expected in clients with extensive burn injuries. In fact, during the acute phase of burn injury, hyperkalemia is more common due to the release of potassium from damaged cells and the impairment of kidney function.

Choice B reason: Metabolic alkalosis is not a common finding in clients with extensive burns. Instead, metabolic acidosis is more likely due to the increased production of lactic acid from tissue hypoxia and impaired perfusion. Burn injuries can lead to significant fluid and electrolyte shifts, but metabolic alkalosis is not the usual result.

Choice C reason: Low hemoglobin can occur in burn patients due to fluid shifts and the loss of red blood cells from the injury itself. However, it is not the most characteristic laboratory finding associated with extensive burns compared to hyperkalemia.

Choice D reason: Hyperkalemia is the expected laboratory result in clients with extensive burn injuries. Burns cause massive cell destruction, leading to the release of intracellular potassium into the bloodstream. Additionally, impaired kidney function in the acute phase can further contribute to elevated potassium levels, making hyperkalemia a common and critical concern in burn patients.