A patient with congestive heart failure (CHF) complains of worsening cough with frothy secretions. The nurse notes the patient is sitting in the tripod position and appears to be air hungry. A chest x-ray is ordered. Which of the following x-ray findings most likely explains the patient’s acute symptoms?

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?

The patient's heart rate is 28 bpm and the systolic blood pressure is 80 mmHg. One dose of atropine 0.5 mg IV push has been administered with no response. The patient is unstable, but conscious. Which next intervention is appropriate?