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: Hydrocortisone is a corticosteroid that can cause fluid retention and increase blood pressure in some individuals. It is important for the PN to monitor the client's blood pressure and educate them about this potential side effect.
Choice B reason: Tiotropium bromide is a bronchodilator used to manage asthma and chronic obstructive pulmonary disease (COPD). While it is not commonly associated with increasing blood pressure, the PN should still be aware of any potential side effects and monitor the client's blood pressure.
Choice C reason: Ethinyl estradiol/norethindrone is a combination oral contraceptive that contains estrogen and progestin. Estrogen can cause blood vessels to constrict, leading to an increase in blood pressure. The PN should educate the client about this potential side effect and monitor their blood pressure regularly.
Choice D reason: Pseudoephedrine is a decongestant that can cause vasoconstriction and increase blood pressure. It is important for the PN to inform the client about this potential side effect and monitor their blood pressure closely.
Choice E reason: Albuterol sulfate is a bronchodilator used to relieve asthma symptoms. While it can cause some cardiovascular side effects, such as increased heart rate, it is not typically associated with a significant increase in blood pressure. The PN should still monitor the client's blood pressure and be aware of any potential side effects.

Choice A reason: Administering a prescribed analgesic is important for managing the client's pain and improving their comfort. However, before addressing the client's pain, it is crucial to ensure that appropriate infection control measures are in place. Herpes zoster (shingles) is a contagious condition, especially when there are draining lesions. The first priority is to prevent the spread of the infection to other clients and healthcare workers.
Choice B reason: Measuring the client's temperature is important for monitoring for signs of systemic infection, such as fever. While this is a necessary assessment, it is not the most immediate priority. Ensuring that appropriate isolation precautions are in place takes precedence to prevent the transmission of the infection.
Choice C reason: Initiating contact isolation precautions is the most critical action to take first. Herpes zoster can be spread through direct contact with the fluid from the lesions. Implementing contact isolation precautions, such as wearing gloves and gowns, and placing the client in a private room, helps to contain the infection and protect others. This is the first step in managing the client's condition and ensuring a safe environment for all.
Choice D reason: Applying cool, wet compresses to the lesions can help soothe the affected area and provide some relief from the pain and discomfort associated with herpes zoster. However, this is not the immediate priority. The first action should be to implement isolation precautions to prevent the spread of the infection. Once isolation measures are in place, the nurse can then focus on providing symptomatic relief.