A client is brought to the emergency department by emergency medical responders. For each provider order, click to specify if the nurse anticipates or does not anticipate the prescription.

Inhalation injury is a life-threatening condition due to airway edema, bronchospasm, and impaired gas exchange from thermal and chemical damage. Key clinical findings in this client include hoarseness, wheezing, singed facial hair, soot around the mouth and nares, hypoxia, and altered mental status. Management prioritizes airway protection, oxygenation, bronchodilation, and early identification of respiratory deterioration. Rationale: • Position client with HOB elevated to 45 degrees: Elevating the head of the bed improves lung expansion and reduces airway edema in clients with inhalation injury. It also promotes better ventilation and reduces the risk of aspiration, especially in a drowsy client with impaired airway protection. This positioning supports respiratory effort and oxygenation. It is an appropriate supportive intervention in burn and smoke inhalation management. • Albuterol via nebulization: Albuterol is a bronchodilator that helps relieve bronchospasm caused by smoke inhalation and airway irritation. The client has inspiratory and expiratory wheezes, indicating bronchoconstriction. Nebulized albuterol improves airflow and reduces respiratory distress. It is commonly used in inhalation injuries to improve ventilation. • STAT arterial blood gases: ABGs are essential to assess the severity of respiratory compromise in inhalation injury. They help evaluate oxygenation, ventilation, and acid-base status, which may be rapidly deteriorating in this client. Given hypoxia and altered mental status, immediate ABGs are necessary to guide oxygen therapy and potential intubation decisions. This is a critical diagnostic priority. • Oxygen therapy to maintain oxygen saturations: The client is already hypoxic and requires ongoing high-flow oxygen to maintain adequate oxygenation. Smoke inhalation can lead to carbon monoxide exposure and impaired oxygen delivery despite normal pulse oximetry readings in some cases. Oxygen therapy is essential to prevent tissue hypoxia and organ damage. Maintaining adequate oxygen saturation is a continuous priority. • Immediate intubation and mechanical ventilation: This order is strongly anticipated due to signs of impending airway compromise, including hoarseness, soot in airway openings, wheezing, drowsiness, and facial burn indicators. Airway edema from inhalation injury can progress rapidly and lead to complete obstruction. Early intubation is often performed before airway swelling worsens. This intervention protects the airway and ensures adequate ventilation.