A nurse is preparing to perform tracheostomy care for a client.
In which order should the nurse take the following steps?

(Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Choice A rationale

Performing neurovascular checks every 2 hours ensures that the nurse can quickly identify signs of compromised circulation or nerve function in the affected extremity. This includes monitoring for changes in color, temperature, sensation, and movement, which are critical for preventing complications such as compartment syndrome.

Choice B rationale

Positioning the fractured arm below the level of the client's heart can increase swelling and impair circulation to the area. It is generally recommended to elevate the arm to reduce edema and promote better blood flow.

Choice C rationale

Immobilizing the client's fingers using a hand splint is not necessary unless there are additional injuries to the hand or fingers. The focus should be on the distal radius fracture and maintaining mobility in the fingers to prevent stiffness and promote circulation.

Choice D rationale

Using a hair dryer to blow hot air into the cast can cause skin burns and damage the cast material. Itching under the cast should be managed with safe methods such as blowing cool air or taking antihistamines if necessary.

Choice A rationale

Instilling a warm enema solution is not appropriate for treating malignant hyperthermia. The focus should be on cooling measures and medications.

Choice B rationale

Applying a cooling blanket is an appropriate action to help reduce the client's body temperature during malignant hyperthermia.

Choice C rationale

Administering meperidine IM is not indicated for malignant hyperthermia. The appropriate medications include dantrolene, cooling measures, and supportive care.

Choice D rationale

Ventilating the client with 100% oxygen, not 50%, is the appropriate action to ensure adequate oxygenation during malignant hyperthermia.