A charge nurse is teaching a newly licensed nurse about health care-associated infections (HAIs). Which of the following should the nurse include in the teaching as examples of HAIS?

A. Clean drinking water is crucial for preventing waterborne diseases, which are transmitted through contaminated water sources (indirect transmission). It does not directly address diseases transmitted from person to person (direct transmission).
B. Proper sanitation practices, such as hand hygiene, proper disposal of waste, and sanitation of living environments, can prevent the spread of diseases transmitted through direct contact (e.g., fecal-oral route, respiratory droplets). Effective sanitation reduces the contamination of surfaces and objects that can harbor infectious agents, thereby interrupting direct transmission routes.
C. Pest control primarily targets diseases transmitted by vectors (such as mosquitoes, ticks, rodents) and is important for preventing diseases like malaria, dengue fever, and Lyme disease. While vector control is essential for preventing these diseases, it does not directly address diseases transmitted directly from person to person.
D. Isolation involves separating individuals who are infected or suspected of being infected from others to prevent the spread of disease. Isolation measures are crucial for controlling diseases that are highly contagious and spread through direct contact (e.g., airborne transmission, close personal contact). By isolating infected individuals, the nurse can effectively prevent direct transmission within the community.

A. Episodes of confusion could indicate various issues, such as metabolic disturbances, disease progression affecting the central nervous system, or medication side effects. However, confusion alone would not typically lead to an increase in morphine dosage. Therefore, this is not a likely explanation for why the client needed more morphine for pain relief.
B. Tolerance occurs when the body adapts to the effects of a medication over time, requiring higher doses to achieve the same therapeutic effect. This is a common phenomenon with opioids like morphine when used long-term for pain management. If the client's pain relief diminished despite increasing the dose, tolerance to morphine could indeed be the reason why higher doses were needed.
C. Addiction is a psychological and physiological dependence on a substance characterized by compulsive drug-seeking behavior and use despite harmful consequences. Addiction is not typically the reason why a client with terminal cancer would require an increased dose of morphine for pain relief. In this context, the focus is on managing pain rather than addiction.
D. If the client has not been adhering to the prescribed dosing schedule or has missed doses, it could result in inadequate pain control. This might necessitate an increase in morphine dosage to achieve adequate pain relief. However, this scenario would require further assessment to confirm.