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Return of skin to previous position when the client's shin is palpated: This is a normal finding indicating no presence of edema. It suggests that skin turgor is within normal limits and does not point toward fluid overload in this context.

Oxygen saturation 93%: While slightly lower than ideal, this level alone is not specific to fluid overload and can be seen in many conditions. Without respiratory distress or other signs, it is not definitive for volume excess.

The client has gained 1 pound since yesterday: A 1-pound gain could indicate mild fluid retention, but in clients on hemodialysis, more significant weight changes are typically used to assess fluid accumulation. This gain is not a strong indicator of overload on its own.

Mitigating risk of infection: Infection is a major concern in burn clients, especially as the skin barrier is lost. However, in the early acute phase, before wounds become colonized, infection prevention is secondary to stabilizing perfusion and preventing hypovolemic shock.

Provide nutritional support: Nutritional needs increase significantly after burns due to the hypermetabolic state. Nonetheless, this is not the immediate priority in the early acute phase, where maintaining circulation takes precedence.

Assessing psychosocial coping: Psychological support is important, but in the early phase, physiological stability must be ensured first. Addressing coping and emotional needs becomes more central during the rehabilitation and recovery phases.

Cool and clammy skin: This may suggest hypovolemia or shock, which can occur in severe burns. However, it is not specific to electrical burns and is more commonly a systemic response in larger surface area injuries.

Purulent drainage from the burn site: This indicates a possible infection, which is a concern in any burn injury but typically develops later. In the early period, cardiac complications are more immediate and critical in electrical burns.

Muscle weakness: While this can occur from deep tissue injury, nerve damage, or compartment syndrome, it is a less urgent finding compared to arrhythmias. It does not directly point to the most life-threatening early complication of electrical burns.

Carbon monoxide poisoning: This condition often presents with symptoms such as headache, dizziness, nausea, and confusion. It does not typically cause hoarseness, drooling, or a brassy cough, which are signs of upper airway irritation or obstruction.

Pulmonary edema: While it causes respiratory distress and crackles, it is characterized more by dyspnea, frothy sputum, and hypoxia than by hoarseness or brassy cough. Drooling is also not a usual feature of pulmonary edema.

Bacterial pneumonia: Pneumonia generally presents with fever, productive cough, and adventitious breath sounds. It does not commonly cause hoarseness or drooling, which suggest upper airway involvement rather than lower respiratory infection.

Document the change and continue to monitor the client's respiratory rate: While documentation is important, delaying action in the presence of rapid deterioration in airway status can be life-threatening. This option does not address the urgency of the situation.

Encourage the client to cough and auscultate the lungs again: Coughing may be beneficial in clearing secretions, but the combination of facial burns, declining breath sounds, and low oxygen saturation indicates airway edema, not mucus obstruction.

Reposition the client in high-Fowler's position and reassess breath sounds: Elevating the head may ease breathing slightly, but it does not resolve the risk of impending airway closure. Airway management takes priority over repositioning.

Encouraging the client to eat bananas: Bananas are high in potassium and should be avoided in clients with hyperkalemia. Consuming potassium-rich foods can further elevate serum potassium levels, increasing the risk of cardiac complications.

Administering a potassium-sparing diuretic: Potassium-sparing diuretics, such as spironolactone, can exacerbate hyperkalemia by reducing potassium excretion. They are contraindicated in clients with elevated serum potassium levels, especially those with chronic renal failure.

Initiating an IV potassium infusion: Administering intravenous potassium would further increase serum potassium levels, posing a significant risk of life-threatening arrhythmias. This intervention is inappropriate for a client already experiencing hyperkalemia.

Auscultate the antecubital fossa using a Doppler stethoscope: The antecubital fossa is not the location of the AV graft. Doppler may help detect blood flow, but the graft site itself should be directly auscultated to assess for patency.

Check the brachial and radial pulses of the left arm simultaneously: While pulse checks assess general circulation, they do not specifically evaluate the flow through the AV graft itself, which is necessary for dialysis adequacy.

Measure the client's blood pressure to ensure it is higher in the left arm than the right: Blood pressure differences between arms are not a reliable or appropriate method to assess AV graft patency. Blood pressure should also never be measured on the graft arm.

Hypomagnesaemia: Magnesium is typically retained during AKI due to impaired renal excretion, making hypermagnesemia more likely. Hypomagnesemia is not expected in this phase.

Decreased creatinine level: Creatinine is a waste product cleared by the kidneys. In AKI, especially the oliguric phase, decreased urine output causes serum creatinine to rise, not fall.

Increased glomerular filtration rate (GFR): The GFR decreases significantly during the oliguric phase due to impaired kidney function. An increased GFR would be inconsistent with this phase of AKI.

Hyperkalemia: Elevated potassium levels can occur in ESRD and may cause cardiac dysrhythmias or muscle weakness, but they do not typically cause lung crackles, peripheral edema, or shortness of breath.

Hypoxemia: Low oxygen levels may lead to shortness of breath, but they are a symptom rather than a cause in this scenario. The presence of fluid overload signs suggests a more specific underlying issue.

Hypovolemia: Presents with symptoms such as decreased blood pressure, increased heart rate, poor skin turgor, and dry mucous membranes. The client's elevated blood pressure and lower extremity swelling are contradictory to the signs and symptoms of hypovolemia.