A nurse is teaching a client who has burns to the upper body about positioning to prevent contractures. Which of the following information should the nurse include?

A. The client is alert and oriented: While alertness is important for overall safety, it does not confirm that the client can safely swallow without risk of aspiration. Mental status alone is not sufficient to determine readiness for oral intake after an EGD.

B. The client's gag reflex is active: An active gag reflex indicates that the client’s protective airway mechanisms are intact, reducing the risk of aspiration. This is the key criterion for safely resuming oral intake following anesthesia or sedation for an EGD.

C. The client's oxygen saturation is 95%: Oxygen saturation within normal limits shows adequate oxygenation but does not ensure safe swallowing. A client can have normal oxygen levels and still be at risk for aspiration if the gag reflex is absent or impaired.

D. The client's vital signs are stable: Stable vital signs suggest cardiovascular and hemodynamic stability but do not confirm that the client can safely tolerate oral intake. Assessment of swallowing and airway protection is the priority before resuming food or fluids.

A. "Keep your elbow in a flexed position.": Maintaining the elbow in flexion can promote contracture formation after burns. The joint should be positioned in extension, or a neutral alignment, to prevent tightening of the skin and underlying tissues.

B. "Remain in a side-lying position.": Lying on the side does not specifically prevent contractures in the upper body and may cause pressure on burned areas. Proper positioning should focus on extending the affected joints and minimizing flexion.

C. "Wear splints on your wrists.": Splints help maintain joints in a functional position and prevent contractures, particularly after burns to the hands, wrists, or forearms. Regular use of splints supports tissue healing in an extended position and improves long-term mobility.

D. "Place a firm pillow under your head.": Placing a pillow under the head does not prevent contractures in the upper extremities. Head positioning should ensure comfort and airway alignment, but joint positioning is more critical for contracture prevention.