A patient with extensive electrical bum injuries is admitted to the emergency department. Which of these prescribed interventions would the nurse implement first?

A. Apply dressings to burned areas: Wound care is important to reduce infection risk and protect damaged tissue, but in electrical burns, internal injuries may be more severe than external findings. Covering the wounds does not address immediate life-threatening complications such as cardiac dysrhythmias. B. Assess for pain at contact points: Pain assessment is a routine component of burn care; however, electrical injuries may cause deep tissue damage with minimal external pain initially. Life-threatening cardiac complications take precedence over pain evaluation in the primary survey. C. Place on a cardiac monitor: Electrical burns can disrupt myocardial conduction pathways, predisposing the patient to lethal dysrhythmias such as ventricular fibrillation. Continuous cardiac monitoring allows early detection and rapid intervention for arrhythmias, which are a leading cause of mortality in electrical injuries. Immediate monitoring is critical upon arrival. D. Start two large bore IVs: Establishing large-bore IV access is essential for fluid resuscitation and medication administration. However, dysrhythmias can occur immediately after electrical exposure, making cardiac monitoring the first priority to detect and treat potentially fatal conduction abnormalities.