A child is brought to the emergency department from a house fire. She has singed eyebrows and sounds hoarse. After applying oxygen, which action by the nurse takes priority?
A.
Assemble intubation equipment.
B.
Gently cleanse any burn wounds.
C.
Place child on a cardiac monitor.
D.
Prepare to give pain medication.
ANS: A
All actions are appropriate for this child; however, airway patency is always the priority. This child has manifestations that cause the nurse to consider an inhalation injury. Swelling can occur rapidly, cutting off the airway. The nurse applies oxygen and ensures intubation supplies are nearby. If needed, the nurse delegates this activity. The child should be placed on a cardiac monitor, but because this is not related to airway, this is not the priority. Pain medication will be an important intervention, as is burn care, but, again, they are not the priority over airway.
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