A client with diabetes mellitus is admitted with an infected foot pressure injury. During a routine assessment, the practical nurse (PN) notes a pattern of deep, rapid respirations and a fruity breath odor. Which action should the PN take first?

Choice A reason: Placing the client in the left lateral recumbent position with the right leg supported in proper alignment is not the best choice for reducing swelling and promoting comfort in a client with a fractured right tibia and fibula. While supporting the leg in proper alignment is important, the left lateral recumbent position does not provide optimal elevation of the affected limb. Elevation is crucial to reduce swelling and promote venous return, which can help decrease edema and discomfort.
Choice B reason: Placing the client in the dorsal recumbent position with the right leg elevated on two pillows is the most appropriate choice. This position allows the right leg to be elevated above the level of the heart, which helps reduce swelling by promoting venous return and lymphatic drainage. Elevation also decreases the hydrostatic pressure in the lower extremity, which can help minimize edema and improve comfort. This position ensures that the leg is properly supported and aligned, which is essential for optimal healing.
Choice C reason: Placing the client in the supine position with a footboard and a trochanter roll to the right leg is not the best choice for reducing swelling. While using a footboard and a trochanter roll can help maintain proper alignment and prevent external rotation of the leg, it does not provide the necessary elevation to reduce swelling. Elevation is a key component in managing edema and promoting comfort in clients with fractures.
Choice D reason: Placing the client in the right lateral position with a pillow between the legs is not an appropriate choice for reducing swelling in a client with a fractured right tibia and fibula. The right lateral position does not allow for proper elevation of the affected limb, which is essential for reducing swelling and promoting venous return. Additionally, this position may place pressure on the injured leg, causing discomfort and potentially compromising the healing process.

Choice A reason: A sore throat is a common and expected concern after an endoscopy. During the procedure, an endoscope is passed through the mouth and down the throat to examine the upper gastrointestinal tract, which can cause irritation and discomfort in the throat. This is typically temporary and can be managed with soothing remedies such as warm saltwater gargles or throat lozenges. The practical nurse should reassure the client that a sore throat is a normal side effect and provide appropriate comfort measures.
Choice B reason: Clay-colored stools are not typically associated with an endoscopy. This finding is more indicative of a problem with bile flow, possibly related to liver or gallbladder conditions. The presence of clay-colored stools suggests that bile is not reaching the intestines, which can occur in conditions such as biliary obstruction. While it is an important symptom to report, it is not directly related to the endoscopic procedure.
Choice C reason: Pain in the mid-abdominal area is not a common post-endoscopy concern. While some mild discomfort or bloating can occur due to the air introduced into the stomach during the procedure, severe or persistent mid-abdominal pain is not expected and should be evaluated further. This symptom could indicate a complication such as perforation, which is rare but serious.
Choice D reason: White, chalky emesis is not a typical concern after an endoscopy. This type of emesis may be related to the ingestion of barium, a contrast material used in certain radiologic studies, but it is not associated with an endoscopic examination. If a client experiences white, chalky emesis, further investigation is needed to determine the cause, but it is not a normal post-endoscopy symptom.