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 nurse is assessing the patient 4 hours after a cholecystectomy and notes the skin around the umbilicus to be blue. The nurse contacts the provider to report which positive sign?

The unresponsive patient was pulled from a frozen lake. A regular heart rhythm is noted on the monitor with a rate of 28 bpm. Upon assessment, there is no palpable pulse. The first responders report which rhythm to the receiving hospital?