A client presents to the emergency department after prolonged ...

[Starlight]

A client presents to the emergency department after prolonged exposure to the cold. The client is difficult to arouse and speech is incoherent. Which action should the nurse take first?
 
  a. Reposition the client into a prone position.
  b. Administer warmed intravenous fluids to the client.
  c. Wrap the client's extremities in warm blankets.
  d. Initiate extracorporeal rewarming via hemodialysis.

Question 2

While at a public park, a nurse encounters a person immediately after a bee sting. The person's lips are swollen, and wheezes are audible. Which action should the nurse take first?
 
  a. Elevate the site and notify the person's next of kin.
  b. Remove the stinger with tweezers and encourage rest.
  c. Administer diphenhydramine (Benadryl) and apply ice.
  d. Administer an EpiPen from the first aid kit and call 911.

[SVictor]

Answer to Question 1

ANS: B
Moderate hypothermia manifests with muscle weakness, increased loss of coordination, acute confusion, apathy, incoherence, stupor, and impaired clotting. Moderate hypothermia should be treated by core rewarming methods, which include administration of warm IV fluids, heated oxygen, and heated peritoneal, pleural, gastric, or bladder lavage, and by positioning the client in a supine position to prevent orthostatic changes. The client's trunk should be warmed prior to the extremities to prevent peripheral vasodilation. Extracorporeal warming with cardiopulmonary bypass or hemodialysis is a treatment for severe hypothermia.

Answer to Question 2

ANS: D
The client's swollen lips indicate that anaphylaxis may be developing, and this is a medical emergency. 911 should be called immediately, and the client transported to the emergency department as quickly as possible. If an EpiPen is available, it should be administered at the first sign of an anaphylactic reaction. The other answers do not provide adequate interventions to treat airway obstruction due to anaphylaxis.