A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. Which of the following actions should the nurse take first?

Choice A rationale:

Enclosing the dressing in a single clear plastic bag and discarding it in the bedside trash receptacle is not the appropriate method for disposing of a dressing saturated with blood and purulent drainage. Blood and purulent drainage are considered potentially infectious materials, and they should be handled as biohazardous waste to prevent the spread of infection.

Choice B rationale:

This is the correct choice. When dealing with potentially infectious materials such as blood and purulent drainage, it's essential to dispose of them in a biohazardous waste container. This specialized container is designed to contain potentially infectious materials and prevent their spread, thereby protecting both healthcare workers and the environment.

Choice C rationale:

Discarding the dressing in the bedside trash receptacle is not the recommended approach for disposing of materials that are contaminated with blood and purulent drainage. Simply discarding it in the regular trash increases the risk of infection transmission and is not compliant with proper infection control practices.

Choice D rationale:

Double-bagging the dressing in clear bags and labeling it "biohazard" is a good practice to ensure proper containment. However, it's not the most comprehensive method of disposal. Placing the dressing in a dedicated biohazardous waste container is a more secure and standardized method for disposing of potentially infectious materials.

Choice A rationale:

Pneumonia is not likely to be the correct answer. Pneumonia is often characterized by productive cough, fever, chest pain, and increased tactile fremitus due to consolidation of lung tissue. The presence of barrel chest, decreased tactile fremitus, and hyperresonant percussion sounds is not consistent with pneumonia.

Choice B rationale:

Atelectasis is not the most likely option. Atelectasis refers to collapsed or partially collapsed lung tissue, which can lead to decreased breath sounds, dullness to percussion, and decreased tactile fremitus. The symptoms mentioned in the scenario, such as prolonged expiration, wheezes, and barrel chest, are not indicative of atelectasis.

Choice C rationale:

Pleural effusion is not the most suitable choice. Pleural effusion usually presents with decreased breath sounds, dullness to percussion, and decreased tactile fremitus over the affected area due to fluid accumulation in the pleural space. The hyperresonant percussion sounds and the presence of wheezes and rhonchi do not align with pleural effusion.

Choice D rationale:

Emphysema is the most likely disorder based on the given symptoms. Barrel chest (increased anterior-posterior chest diameter), limited lung expansion, decreased tactile fremitus, hyperresonant percussion sounds, prolonged expiration, wheezes, and rhonchi are characteristic findings of emphysema. This condition involves damage to the alveoli and their supporting structures, leading to air trapping, reduced lung elasticity, and obstructed airflow. The patient's use of accessory muscles to breathe further suggests a chronic obstructive pulmonary disease (COPD) like emphysema.