The practical nurse (PN) is caring for a client who has a fractured right tibia and fibula. To reduce swelling and promote comfort, the PN should place the client in which position?

Choice A reason: A respiratory rate of 28 breaths per minute indicates tachypnea, which can be a response to pain, anxiety, or hypovolemia. While it is important to monitor and manage respiratory status, this finding alone is not as critical as urine output when assessing the client's overall condition and fluid balance. Tachypnea should be reported, but it is not the most urgent parameter in this scenario.
Choice B reason: A blood pressure of 110/90 mm Hg is within a range that might be acceptable for some individuals, though the pulse pressure is narrow. In the context of a client receiving blood and fluid replacement, it is important to monitor blood pressure closely to ensure adequate perfusion. However, this reading does not immediately suggest a severe complication or shock, and other parameters might take precedence for immediate reporting.
Choice C reason: Urine output of 20 mL in the last hour is significantly low, indicating potential renal hypoperfusion or early signs of shock. Adequate urine output is a crucial indicator of renal perfusion and overall fluid status. Oliguria (reduced urine output) in this context suggests that the client's organs may not be receiving sufficient blood flow, which is a critical condition that requires prompt intervention. This finding should be reported immediately to the charge nurse to ensure timely and appropriate management.
Choice D reason: A pain score of 8 out of 10 indicates severe pain, which needs to be managed effectively to ensure the client's comfort and prevent further physiological stress. While addressing pain is important, it does not directly indicate a life-threatening condition compared to low urine output. Pain management should be part of the overall care plan, but reporting the critically low urine output takes priority in this situation.

Choice A reason: While monitoring serum electrolytes is important, especially if the client is experiencing side effects such as vomiting or diarrhea, it is not the priority follow-up assessment. Chemotherapy can impact electrolytes, but blood cell counts are a more immediate concern.
Choice B reason: Assessing nutritional status is important for overall health and recovery, but it is not the most critical follow-up assessment. Nutritional assessments can be addressed once more urgent concerns, such as blood cell counts, are evaluated.
Choice C reason: Hydration status is important, particularly if the client is experiencing side effects that lead to dehydration. However, hydration can usually be managed once the more critical assessment of blood cell counts has been completed.
Choice D reason: Blood cell counts are the priority follow-up assessment for a client who received chemotherapy. Chemotherapy can significantly impact the production of blood cells, leading to conditions such as anemia, neutropenia, or thrombocytopenia. Monitoring blood cell counts helps to identify these complications early and allows for appropriate interventions to be initiated.