A nurse is attending a social event when another guest coughs weakly once, grasps his throat with his hands, and cannot talk. Which of the following actions should the nurse take?
Perform the Heimlich maneuver.
Slap the client on the back several times.
Assist the client to the floor and begin mouth-to-mouth resuscitation.
Observe the client before taking further action.
The Correct Answer is A
Choice A reason:
The Heimlich maneuver, also known as abdominal thrusts, is the recommended first aid technique for a conscious person who is choking. This maneuver helps to expel the object blocking the airway by using the air remaining in the lungs to force it out. The nurse should stand behind the person, place their arms around the person’s waist, make a fist with one hand, and place it just above the navel. The other hand should grasp the fist, and quick, upward thrusts should be performed until the object is expelled.
Choice B reason:
Slapping the client on the back several times is not the recommended first action for a conscious adult who is choking. While back blows can be effective, they are typically used in combination with abdominal thrusts and are more commonly recommended for infants. For adults, the Heimlich maneuver is preferred as the initial response.
Choice C reason:
Assisting the client to the floor and beginning mouth-to-mouth resuscitation is not appropriate for a conscious person who is choking. Mouth-to-mouth resuscitation, or rescue breathing, is used when a person is not breathing and is unresponsive. In this scenario, the client is conscious but unable to speak, indicating a blocked airway that requires the Heimlich maneuver.
Choice D reason:
Observing the client before taking further action is not advisable in a choking emergency. Immediate intervention is crucial to prevent the situation from worsening. If the person is unable to speak, cough, or breathe, the Heimlich maneuver should be performed without delay.
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Correct Answer is D
Explanation
Choice A: Leave the pad in place for at least 40 minutes
Leaving the aquathermia pad in place for at least 40 minutes is not recommended. The typical duration for applying an aquathermia pad is 20 to 40 minutes1. Prolonged exposure beyond this time can lead to complications such as burns or vasoconstriction, where blood vessels constrict instead of dilate, potentially increasing blood pressure and causing discomfort.
Choice B: Set the pad’s temperature to 42.2°C (108°F)
Setting the pad’s temperature to 42.2°C (108°F) is too high. The recommended temperature range for an aquathermia pad is generally between 40.5°C to 43°C (105°F to 109.4°F)3. Temperatures above this range can increase the risk of burns and skin damage. It is crucial to follow the manufacturer’s guidelines and institutional protocols to ensure safe and effective use of the pad.
Choice C: Use safety pins to keep the pad in place
Using safety pins to keep the pad in place is not safe. Safety pins can puncture the pad, causing leaks and potentially leading to electrical hazards. Instead, the pad should be secured with tape or a cloth cover to ensure it stays in place without causing damage.
Choice D: Stop the treatment if the client’s skin becomes red
Stopping the treatment if the client’s skin becomes red is the correct action. Redness of the skin can indicate the beginning of a burn or other skin damage. It is essential to monitor the client’s skin condition frequently during the application of heat therapy and to discontinue the treatment immediately if any signs of adverse reactions, such as redness or discomfort, are observed.
Correct Answer is B
Explanation
Choice A Reason:
Vesicles on the skin are more commonly associated with cutaneous anthrax, not inhalation anthrax. Cutaneous anthrax typically presents with a raised, itchy bump that develops into a painless sore with a black center.
Choice B Reason:
Respiratory failure is a severe and common symptom of inhalation anthrax. Inhalation anthrax begins with flu-like symptoms but can rapidly progress to severe respiratory distress, shock, and often death if not treated promptly.
Choice C Reason:
Flu-like symptoms are indeed an early sign of inhalation anthrax, but they are not specific enough to indicate exposure definitively. These symptoms include sore throat, mild fever, fatigue, and muscle aches.
Choice D Reason:
Coughing of blood can occur in the later stages of inhalation anthrax as the disease progresses and the respiratory system becomes severely compromised.