A charge nurse is preparing to admit four new clients to the unit. Which of the following clients should the nurse assign to a private room?

Rationale:

A. Cerebrospinal fluid electrophoresis: CSF electrophoresis is used to detect oligoclonal bands, which are indicative of multiple sclerosis (MS). The client’s presentation—fatigue, intermittent muscle weakness, tremors, double vision, and gait disturbances—suggests a demyelinating disorder, making this test appropriate.

B. Paracentesis: Paracentesis is used to evaluate ascites, which is not indicated in this client. There are no signs of abdominal fluid accumulation or liver disease that would warrant this procedure.

C. Bone marrow biopsy: Bone marrow biopsy is used for hematologic disorders such as anemia, leukemia, or other blood dyscrasias. The client’s symptoms do not indicate a primary bone marrow pathology.

D. MRI of brain: MRI is the diagnostic imaging of choice for detecting lesions in the central nervous system consistent with multiple sclerosis. It helps visualize demyelination and correlate it with clinical symptoms.

E. X-ray of abdomen: Abdominal X-ray is not indicated, as the client does not present with abdominal pain, obstruction, or gastrointestinal issues requiring imaging.

A. "Empty the drainage bag every 12 hours.": Urine should be emptied regularly, but not on a fixed 12-hour schedule. The focus is on preventing backflow and maintaining sterility, so the bag should be emptied when it is two-thirds full or as needed, rather than strictly every 12 hours.

B. "Irrigate the indwelling urinary catheter once per shift.": Routine irrigation is not recommended for preventing catheter-associated urinary tract infections (CAUTIs) and can introduce pathogens or cause trauma. Irrigation should only be performed if specifically indicated for obstruction or provider order.

C. "Apply a topical antimicrobial ointment as part of routine catheter care.": Routine application of antimicrobial ointment is not recommended and does not prevent CAUTIs. Proper hygiene and sterile technique are more effective in infection prevention than topical agents.

D. "Keep the drainage bag below the level of the bladder.": Maintaining the drainage bag below the bladder prevents backflow of urine, which is a major risk factor for introducing bacteria into the urinary tract. This simple intervention is a key measure in reducing catheter-associated urinary tract infections.