A client with osteomyelitis from a compound fracture of the left tibia has an open draining wound and is admitted with a possible methicillin-resistant Staphylococcus aureus (MRSA) infection. What intervention(s) should the nurse include in the plan of care? Select all that apply.
Use standard precautions and wear a mask.
Explain the purpose of a low bacteria diet.
Institute contact precautions for staff and visitors.
Send wound drainage for culture and sensitivity.
Monitor the client's white blood cell count.
Correct Answer : A,C,D,E
Choice A reason: Standard precautions, including the use of masks, are essential to prevent the spread of MRSA, which can be transmitted through respiratory droplets.
Choice B reason: A low bacteria diet is not typically required for MRSA or osteomyelitis management and does not directly impact the treatment or prevention of infection spread.
Choice C reason: Contact precautions are critical for preventing MRSA transmission, as it can be spread by direct contact with the infected wound or contaminated surfaces.
Choice D reason: Sending wound drainage for culture and sensitivity is crucial to identify the specific strain of MRSA and determine the most effective antibiotic treatment.
Choice E reason: Monitoring the white blood cell count is important to assess the body's response to infection and the effectiveness of treatment.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Application of heat and cold therapy can help manage symptoms but does not encompass the broader aspects of health promotion and teaching.
Choice B reason: Avoidance of foods containing purine is more specific to conditions like gout rather than rheumatoid arthritis, and while diet is important, it does not fully represent health promotion and teaching.
Choice C reason: Immobilization of affected joints is not a health promotion strategy and can actually worsen symptoms over time. Active and passive range-of-motion exercises are recommended instead.
Choice D reason: Prevention through nutrition and exercise is the most comprehensive approach that aligns with health promotion and teaching for clients with rheumatoid arthritis. It includes educating clients on a balanced diet and physical activity to manage symptoms and improve overall health.
Correct Answer is A
Explanation
Choice A reason: Knowing the type and amount of drugs ingested is critical for immediate medical intervention and treatment.
Choice B reason: While important, the timing of the last dose for bipolar disorder is less urgent than the details of the suicide attempt.
Choice C reason: Past suicide attempts are relevant for a psychiatric evaluation but are not the immediate concern in an acute overdose situation.
Choice D reason: The location of the suicide note is less critical than the medical information needed to treat the client's overdose.
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