A nurse in a community clinic is caring for a client who has erythema migrans. The nurse should implement which of the following precautions?

Contact

Droplet

Airborne

Standard

Answer and Explanation

The Correct Answer is D

Rationale:

A. Contact: Contact precautions are used for infections transmitted by direct or indirect contact with the client or their environment, such as MRSA or C. difficile. Erythema migrans, associated with Lyme disease, is not spread through contact.

B. Droplet: Droplet precautions are for infections transmitted through large respiratory droplets, such as influenza or pertussis. Lyme disease does not spread via respiratory secretions, so droplet precautions are unnecessary.

C. Airborne: Airborne precautions apply to infections transmitted via small particles that remain suspended in the air, such as tuberculosis or measles. Lyme disease is not airborne, so this precaution is not required.

D. Standard: Standard precautions are appropriate for Lyme disease, including erythema migrans. These precautions involve routine hand hygiene, use of gloves when in contact with body fluids, and proper handling of contaminated materials, which are sufficient since the disease is transmitted via tick bites, not person-to-person.

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Correct Answer is A

Explanation

Rationale:

A. Uses the TPN IV tubing to administer the client's next dose of antibiotics: TPN lines should never be used for administering other medications or fluids because this increases the risk of contamination, infection, and incompatibility reactions. TPN requires dedicated IV access to maintain sterility and prevent complications such as sepsis.

B. Plans for a check of the client's fingerstick glucose level every 6 hr: Monitoring blood glucose regularly is essential during TPN administration because high dextrose concentrations can cause hyperglycemia. Checking every 4–6 hours aligns with safe monitoring practices and does not require intervention.

C. Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved: Slowly titrating the TPN rate helps the client adjust to the high glucose content and reduces the risk of hyperglycemia or fluid overload. This demonstrates safe and appropriate administration practice.

D. Schedules a bag and tubing change for 24 hr after the start of the infusion: Changing the TPN solution and tubing every 24 hours is consistent with infection control guidelines. This action maintains sterility and prevents microbial growth, reflecting proper technique.

A. Place an ice pack directly on the skin of the affected joints. B. Limit dietary intake of phosphorus. C. Place a large pillow under the knees when sleeping D. Take a hot shower every day.

Correct Answer is D

Explanation

Rationale:

A. Place an ice pack directly on the skin of the affected joints: Ice should never be applied directly to the skin as it can cause frostbite or skin damage. It should be wrapped in a cloth or towel before use. While cold therapy can reduce inflammation and numb pain, safety precautions are essential.

B. Limit dietary intake of phosphorus: Phosphorus restriction is not relevant for osteoarthritis management. Dietary modifications for osteoarthritis focus more on maintaining a healthy weight and anti-inflammatory nutrients rather than phosphorus intake.

C. Place a large pillow under the knees when sleeping: Placing a large pillow under the knees can hyperflex the joints and increase strain on the knees and hips. Proper positioning involves keeping joints in a neutral or slightly extended position to reduce discomfort and prevent contractures.

D. Take a hot shower every day: Heat therapy helps relax muscles, relieve stiffness, and improve joint mobility in clients with osteoarthritis. Warm showers or moist heat applications are effective nonpharmacological interventions for managing pain and promoting comfort.

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A nurse in a community clinic is caring for a client who has erythema migrans. The nurse should implement which of the following precautions?

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