A 62-year-old client has extensive blister injuries to the back and both legs caused by exposure to toxic chemicals at work and is admitted to the ED. Which of these ordered interventions will you perform first?

Correct Answer: B

Rationale: The correct answer is B: Irrigate the back and legs with 4 L of sterile normal saline. This intervention is priority as it aims to remove the toxic chemicals from the client's skin, preventing further damage and absorption. Immediate decontamination is crucial in chemical exposure cases to minimize systemic effects. Choice A focuses on fluid resuscitation but is secondary to decontamination. Choice C, obtaining blood for lab tests, can wait until after decontamination. Choice D, documenting the burn surface area, is important but not as urgent as decontamination in this scenario. Prioritizing decontamination will help prevent further harm and improve the client's outcomes.

Correct Answer: B

Rationale: Certainly! The correct answer is B: Parasitic fungi. Dermatophytoses, commonly known as ringworm, are fungal infections that affect the skin, hair, and nails. These infections are caused by a group of fungi known as dermatophytes. They thrive on keratinized tissues such as skin, hair, and nails. Itch mites (A) are responsible for scabies, not dermatophytoses. Reactivated virus (C) refers to conditions like shingles, unrelated to dermatophytoses. Pediculosis (D) is caused by lice infestation, not fungal infections like dermatophytoses.

Correct Answer: A

Rationale: Step 1: Fluid resuscitation aims to restore intravascular volume to improve circulation and organ perfusion. Step 2: Intravascular volume restoration helps to maintain blood pressure and tissue oxygenation. Step 3: Weight gain is not the primary goal of fluid resuscitation. Step 4: Fluid resuscitation does not directly reduce bleeding but helps stabilize the patient's condition. Step 5: Normalizing breathing is not a direct goal of fluid resuscitation. Therefore, the correct answer is A, as it aligns with the primary goal of fluid resuscitation.

Correct Answer: D

Rationale: The correct answer is D: Infection. Following debridement, there is an increased risk of infection due to the open wound and potential exposure of underlying tissues. Infection can lead to serious complications such as delayed healing, sepsis, and tissue damage. The nurse must closely monitor for signs of infection like redness, swelling, warmth, and purulent drainage. Incorrect choices: A: Bleeding - While bleeding can occur post-debridement, it is a common and expected complication that can usually be managed with pressure and hemostatic agents. B: Pain control - Pain is also a common post-debridement complication, but can be managed with analgesics and other pain management strategies. C: Loss of fluids - Although fluid loss can occur during debridement, it is not typically a major concern post-procedure as long as the client is adequately hydrated.

Correct Answer: B;C

Rationale: The correct answers are B (Mohs' surgery) and C (Surgical excision). Mohs' surgery is used for precise removal of skin cancer layers, ensuring minimal damage to surrounding healthy tissue. Surgical excision involves removing the entire tumor along with a margin of healthy tissue to prevent cancer spread. Shave biopsy (A) is not ideal for melanoma as it may not provide accurate depth information. Localized radiation (D) is not typically used as initial treatment for melanoma, but rather for advanced cases or as adjuvant therapy.