Which interventions does the nurse include in the plan of care for the 2-day-old infant who requires phototherapy for hyperbilirubinemia? Select all that apply.

The 20-year-old healthy soccer player is brought to the emergency department after collapsing at the end of a summer soccer game. The patient is lethargic and confused about the event. Upon assessment, the nurse notes flushed, dry skin that is warm to the touch. The oral mucosa is dry, as well. Vitals are as follows: temperature 40.7°C, heart rate 122 bpm, respiratory rate 20, and blood pressure 116/64 mmHg. Which order does the nurse carry out first?  

The patient is admitted to the intensive care unit after starting antibiotics and experiencing a severe drug reaction and erythema multiforme syndrome. The patient has severe mucocutaneous bullae over 42% of the body surface area. The nurse anticipates which diagnosis for this patient?