A client with extensive electrical burn injuries is admitted to the emergency department. Which prescribed intervention should the nurse implement first?

A. Place on cardiac monitor: Electrical burns can cause life-threatening cardiac arrhythmias due to the direct effect of electrical current on the myocardium. Ventricular fibrillation or other dysrhythmias may occur immediately, even if external injuries appear minor. Continuous cardiac monitoring is the highest priority intervention to detect and respond to acute arrhythmias. B. Assess oral temperature: While monitoring for fever is important in burn patients to detect infection, it is not an immediate priority during initial assessment of electrical burns. Temperature changes develop later and do not pose immediate life-threatening risk compared to potential cardiac events. C. Assess for pain at contact points: Electrical burns can cause deep tissue injury at entry and exit points, making pain assessment important for identifying tissue damage. However, pain assessment is secondary to monitoring for acute cardiac complications that can occur immediately after electrical exposure. D. Check a potassium level: Electrical burns may cause muscle breakdown (rhabdomyolysis) and subsequent hyperkalemia, which can lead to arrhythmias. While assessing potassium is important, placing the client on a cardiac monitor takes precedence because arrhythmias can occur immediately and unpredictably, before lab results are available.