A client with renal calculi is experiencing hematuria and reports severe flank pain.
Which intervention should the nurse implement first?

Choice A rationale:

Nosocomial transmission in the medical area. Rationale: Nosocomial transmission refers to infections that are acquired in healthcare settings. While it's essential for healthcare professionals to be aware of this risk, the client's presentation of diarrhea in a hurricane disaster area is more likely due to environmental factors rather than hospital-acquired infection.

Choice B rationale:

Food contamination from floodwaters. Rationale: In the aftermath of a hurricane, floodwaters can carry contaminants and pathogens, leading to food contamination. This is a significant concern, and the nurse should educate the client about the potential risks associated with consuming food exposed to floodwaters. However, the primary source of contamination for diarrhea is typically waterborne pathogens, which is addressed in choice C.

Choice C rationale:

Drinking water contaminated by sewage. Rationale: During natural disasters like hurricanes, sewage systems can become compromised, leading to the contamination of drinking water sources. This contamination poses a significant risk for diarrheal illnesses, as sewage often contains harmful pathogens. Therefore, the nurse should consider this as the most probable source of the client's exposure.

Choice D rationale:

Close living quarters at evacuation centers. Rationale: Close living quarters in evacuation centers can contribute to the spread of infectious diseases, including diarrheal illnesses. However, in this scenario, the client's chief complaint is diarrhea, and the nurse should prioritize investigating potential sources of waterborne contamination, as this aligns more closely with the client's symptoms.

The correct answers are Choices B, C, D, and E.

Choice A rationale: Dentures should remain in place to preserve facial structure and dignity. Removing them may cause facial collapse, distressing the family during viewing and violating postmortem presentation standards.

Choice B rationale: Gently closing the eyes prevents ocular drying and maintains a peaceful appearance. If eyelids resist closure, moistened cotton balls may be used temporarily to assist with natural positioning.

Choice C rationale: Placing a small pillow under the head elevates it, preventing blood pooling and facial discoloration due to livor mortis. It supports a natural, respectful presentation for family viewing.

Choice D rationale: Applying a body shroud ensures hygienic containment and visual dignity. It’s standard practice before transport and aligns with institutional protocols for respectful postmortem care.

Choice E rationale: Removing resuscitation equipment reduces trauma triggers for the family, restores environmental calm, and supports emotional closure. It also complies with facility standards for postmortem room preparation.