A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

Choice A reason: Vesicles on the skin are not typical of inhalation anthrax; instead, they are more associated with cutaneous anthrax, which presents as papules that progress to vesicles and then black eschars.

Choice B reason: Respiratory failure can occur later in the course of inhalation anthrax, but it is not an early finding. It usually develops after the initial phase of nonspecific symptoms when the illness progresses to severe respiratory distress and shock.

Choice C reason: Sloughing of skin is not characteristic of inhalation anthrax. Similar to vesicles, skin sloughing may be associated with severe cutaneous infections or other dermatologic conditions, not the respiratory form of anthrax.

Choice D reason: Flu-like symptoms, such as fever, cough, malaise, muscle aches, and mild chest discomfort, are the initial and most indicative early findings of inhalation anthrax. These nonspecific symptoms often appear within several days after exposure before progressing to severe respiratory compromise.

Choice A Reason: This is correct. The nurse should remove both of the elastic bandages from the leg, as they can impair blood flow and increase tissue damage. The nurse should also elevate the leg and keep it immobile to reduce venom absorption.

Choice B Reason: This is incorrect. The nurse should not discharge the client, as they may develop serious complications from the snake bite, such as swelling, bleeding, infection, or shock. The client should be monitored closely and treated accordingly.

Choice C Reason: This is incorrect. The nurse should not obtain a prescription for the appropriate anti-venom, as this is not within their scope of practice. The nurse should notify the physician and provide supportive care until the physician arrives and decides whether to administer anti-venom or not.

Choice D Reason: This is incorrect. The nurse should not obtain a prescription for pain medication, as this may mask the symptoms of venom toxicity or cause adverse reactions with anti-venom. The nurse should use non- pharmacological methods to relieve pain, such as ice packs or distraction.