A nurse at a long-term care facility is assisting with teaching staff about infection control practices. Which of the following examples should the nurse include as an infection control hazard?

A staff member places a midstream urine sample in a specimen refrigerator after-collecting it.

A staff member wipes a countertop with chlorhexidine solution to clean the area following a blood spill.

A nurse uses alcohol-based antiseptic to clean his hands after talking with a client who has varicella zoster.

A nurse pours sterile 0.9% sodium chloride irrigation solution on an open pressure wound prior to collecting a specimen for culture

Answer and Explanation

The Correct Answer is C

A. A staff member places a midstream urine sample in a specimen refrigerator after collecting it: This action is appropriate as long as the specimen is labeled correctly and stored at the correct temperature. Proper handling of specimens is essential for accurate testing and does not represent an infection control hazard.

B. A staff member wipes a countertop with chlorhexidine solution to clean the area following a blood spill: This action is appropriate for cleaning a contaminated surface. Chlorhexidine is an effective disinfectant for blood spills. Therefore, this action does not represent an infection control hazard.

C. A nurse uses alcohol-based antiseptic to clean his hands after talking with a client who has varicella zoster: While alcohol-based antiseptics are effective for most pathogens, varicella zoster is primarily spread through direct contact and airborne transmission. It is recommended to wash hands with soap and water after caring for a patient with varicella zoster, especially if hands are visibly soiled. This action may not adequately control the infection hazard.

D. A nurse pours sterile 0.9% sodium chloride irrigation solution on an open pressure wound prior to collecting a specimen for culture: This action is appropriate as long as sterile technique is maintained. Using sterile saline for irrigation is standard practice to minimize the risk of introducing pathogens before specimen collection. Therefore, this action does not represent an infection control hazard.

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Correct Answer is A

Explanation

A. Use of the Braden scale for clients who are immobile.

The Braden Scale is a widely used tool for assessing the risk of pressure ulcer development. It includes various factors such as sensory perception, moisture, activity, mobility, nutrition, and friction/shear. For clients who are immobile, the Braden Scale helps identify their risk for skin breakdown and guides the implementation of preventive measures.

B. Daily weighing of clients who have heart failure:

Daily weighing of clients with heart failure is important for monitoring fluid status, but it is not specifically focused on decreasing the risk of skin breakdown. Skin breakdown is more closely related to factors such as immobility, pressure, and friction.

C. Documentation of PAINAD scale for clients who have dementia:

The PAINAD scale is used to assess pain in clients with advanced dementia. While managing pain is important for overall well-being, it is not a direct measure for decreasing the risk of skin breakdown. Skin breakdown prevention is more related to factors like pressure relief and moisture management.

D. Implementation of incentive spirometry for clients who are postoperative:

Incentive spirometry is primarily aimed at promoting lung expansion and preventing respiratory complications after surgery. While postoperative care is essential, it does not directly address the risk of skin breakdown. Skin breakdown prevention involves interventions related to pressure relief, repositioning, and skin care.

A. Administer the medication twice daily. B. Administer the medication as needed for pain. C. Administer the medication 2 hr after meals. D. Administer a loading dose of 100 mg PO E. Administer the medication with a snack

Correct Answer is E

Explanation

Administer the medication twice daily.

Incorrect. The prescription specifies TID (three times daily), not twice daily.

Administer the medication as needed for pain.

Incorrect. The prescription provides specific dosing instructions (100 mg now, then 50 mg TID with food), and it is not meant for administration as needed.

Administer the medication 2 hr after meals.

Incorrect. The prescription specifies that indomethacin should be taken with food, so administering it 2 hours after meals is not in accordance with the instructions.

Administer a loading dose of 100 mg PO.

Incorrect. The initial dose of 100 mg is not considered a loading dose but rather the first dose in the prescribed regimen.

Administer the medication with a snack.

Correct. The prescription indicates that indomethacin should be taken with food. Administering

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