A client is admitted for blunt force chest trauma following a motor vehicle collision. A nasogastric (NG) tube was inserted in the emergency department and chest x-ray results indicate that the tip of the NG tube is in the left chest. Which priority action(s) should the nurse implement? Select all that apply.

Rationale:
A. Both the sun and radiation can damage the skin because it has a rapid renewal rate:
The skin’s high cellular turnover makes it vulnerable to damage from both UV radiation and radiation therapy. Clients with fair skin are especially prone to radiation dermatitis due to lower melanin protection.

B. Ionizing energy of RT penetrates to the target tumor and does not affect the skin like sun rays: Although radiation targets deeper tissues, the skin at the entry site can still be affected. Radiation can cause localized skin damage, including dryness, erythema, or peeling.

C. Shielding helps to localize the entrance of RT and protects other sensitive areas:
Radiation therapy uses shielding and precise targeting to minimize exposure to surrounding tissues. However, the entry site of the beam still receives some exposure, making localized protection and care essential.

D. Special gels can be prescribed for local application to promote healing and comfort:
Topical agents like hydrophilic creams or corticosteroid gels may be recommended to soothe irritated skin and promote healing during radiation therapy. These help manage symptoms like dryness and inflammation.

E. Application of cold compresses after treatment decreases the skin's sensitivity: Cold compresses are not typically recommended after radiation, as they may constrict blood flow and delay healing. Instead, gentle skincare routines and prescribed topical treatments are preferred.

Rationale:

A. Arrange for an unlicensed assistive personnel to assist the PN during the procedure:
The issue is not lack of assistance, but incorrect positioning. Adding support staff doesn’t correct the improper technique for lumbar puncture preparation.

B. Acknowledge that the PN has positioned the client safely and correctly: For a lumbar puncture, the client should be in a lateral recumbent position with knees on both legs, not just the left, pulled up to the chest and the neck flexed.

C. Assume care of the client and assign the PN to the care of a different client: This approach is punitive and misses a teaching opportunity. It’s more effective to correct the error and provide guidance for future practice.

D. Demonstrate to the PN how to position the client more effectively for the procedure:
This promotes safe care while supporting the PN’s learning. Demonstrating the correct positioning ensures immediate correction and improves future practice.