A client with an electrical burn is brought to the emergency department. The entrance wound is on the right hand and the exit wound is on the left foot. The client reports chest tightness and feels lightheaded. Which action should the nurse take?

Electrical burns require understanding the path of current through the body. Because electricity follows the path of least resistance, it often travels through the heart. This necessitates applying knowledge of cardiac rhythm disturbances and immediate diagnostic prioritization. Choice A rationale Checking pulses is important to assess for compartment syndrome or vascular damage in the right hand and left foot. However, it is secondary to assessing the heart, as electrical current can cause immediate, fatal cardiac arrest. Choice B rationale Irrigating wounds is part of standard burn care but is not the priority for electrical injuries. The surface wounds often mask extensive internal tissue damage. Addressing potential cardiac conduction issues must occur before performing local wound cleansing. Choice C rationale Electrical current passing between hands and feet frequently crosses the heart. This can cause immediate dysrhythmias or delayed cardiac irritability. Continuous telemetry is vital to monitor for life-threatening changes in the heart's electrical activity and rhythm. Choice D rationale While the client may experience pain, the report of chest tightness and lightheadedness suggests a cardiac or hemodynamic event. Administering opioids before stabilizing the cardiac status could mask symptoms or further complicate the clinical assessment process..