What should a nurse do if a client with smoke inhalation has an ABG indicating low arterial oxygenation?

In the case of a client with smoke inhalation showing low arterial oxygenation as indicated by arterial blood gas (ABG) results, the priority is to ensure adequate oxygenation and ventilation. When arterial oxygen levels are low, it suggests that the lungs are not effectively oxygenating the blood, which is a critical concern that needs immediate intervention.

Assisting in intubating the client and beginning mechanical ventilation is appropriate because it provides a secure airway and ensures that the client can receive sufficient oxygen. In cases of severe respiratory distress or where there is evidence that the patient cannot maintain adequate ventilation on their own, mechanical ventilation becomes necessary to support the client's breathing and improve oxygenation. Intubation allows for closer control of oxygen delivery, particularly in situations where smoke inhalation could lead to airway swelling or damage, complicating spontaneous breathing.

While continuing to administer humidified oxygen, monitoring closely, or merely increasing the amount of humidified oxygen are important supportive measures, they may not be sufficient if the client is critically hypoxic or unable to breathe effectively. Interventions promoting immediate and invasive support, such as intubation and mechanical ventilation, directly address the underlying issue of inadequate oxygenation much more rapidly than non-invasive methods alone.