The nurse is providing discharge education to a patient diagnosed with immune thrombocytopenic purpura. Which statement by the patient indicates a need for further teaching?

The patient complains of severe fatigue and joint pain. Upon assessment, the nurse notes the patient’s skin is bronzed. Which of the following physical assessments is most important?

Following an explosion at a factory, the patient is brought by ambulance to the emergency department. The patient has soot on the face and around the mouth and is coughing up black sputum. He verbalizes severe pain in his leg and his voice is noted to be a hoarse whisper. Further assessment reveals full thickness burns to the arms and hands and partial thickness burns to the legs. Shrapnel appears to have been embedded in the patient’s thigh. While moving the leg to assess the inner thigh, a piece of shrapnel shifts and the patient begins bleeding profusely from the wound. The patient cries out in pain and requests pain relief. Which action does the nurse take first?