Final answer:
After ensuring a patent airway and administering oxygen, a nurse should administer Lactated Ringer's solution to a patient with extensive full-thickness burns to manage shock and fluid loss, ensuring the patient's fluid balance takes top priority.
Step-by-step explanation:
In an emergency department, when a nurse is caring for a client with full-thickness burns over 20% of their total body surface area, the first and foremost treatment, after ensuring a patent airway and administering oxygen, is maintaining vital bodily functions, which includes managing shock and fluid loss. Thus, the nurse should be prepared to administer Lactated Ringer's solution first. Replacement of fluids is a crucial step to prevent hypovolemic shock due to massive fluid loss from the burn. This solution is isotonic and helps in maintaining fluid balance within the patient's body, making it essential for burn patients to ensure adequate circulation and prevent renal failure.
Giving intravenous fluids like Lactated Ringer's solution is fundamental because burns can lead to a massive loss of fluids, hence threatening dehydration and electrolyte imbalance. Tetanus toxoid vaccine and morphine sulfate for pain management are indeed important, but stabilizing the patient's fluid and electrolyte balance takes precedence to maintain body functions and prepare for the next stages of treatment. Intravenous antibiotics may also be administered later to prevent or treat infection due to the compromised skin barrier.