A nurse in a provider's office is collecting data from a client who has candidiasis.
Which of the following findings should the nurse expect?

Choice A rationale:

Bradycardia (slow heart rate) is not typically associated with a perforated appendix. Instead, tachycardia (increased heart rate) is a more common finding due to the body's response to infection and inflammation. Therefore, choice A is not the correct answer.

Choice B rationale:

An elevated temperature (fever) is a common manifestation of appendicitis, especially when it progresses to perforation. This is because infection and inflammation in the abdominal cavity can lead to fever as the body's immune response. While it is a concern, it is not specifically indicative of a perforated appendix. Therefore, choice B is not the correct answer.

Choice C rationale:

Lethargy may be seen in a child with appendicitis, especially if they are experiencing pain and discomfort. However, it is not a specific indicator of a perforated appendix. Lethargy can result from various factors, including pain and illness, but it does not directly correlate with perforation. Therefore, choice C is not the correct answer.

Choice D rationale:

Decreased abdominal girth is a concerning sign that can be indicative of a perforated appendix. When the appendix perforates, it can release infected material into the abdominal cavity, leading to inflammation and the formation of an abscess. This can cause the abdomen to become distended initially, but as the infection spreads and fluid accumulates in the abdominal cavity, the abdomen may appear swollen and then gradually decrease in girth as the abscess forms. Therefore, choice D is the correct answer as it reflects a significant and specific manifestation of a perforated appendix that requires prompt reporting to the healthcare provider.

Choice A rationale:

Hydrogen peroxide. Hydrogen peroxide is not the recommended solution for disinfecting surfaces following a blood spill. While it can be used to clean wounds and may have some disinfectant properties, it is not as effective as bleach in destroying bloodborne pathogens.

Choice B rationale:

Bleach. Bleach is the appropriate choice for disinfecting surfaces contaminated with blood. A 10% bleach solution (1 part bleach to 9 parts water) is effective at killing bloodborne pathogens such as HIV and hepatitis B and C viruses. It should be used in healthcare settings to ensure proper disinfection after a blood spill.

Choice C rationale:

Isopropyl alcohol. Isopropyl alcohol is an effective disinfectant for some purposes, but it may not be as effective as bleach against bloodborne pathogens. It is commonly used for cleaning and disinfecting skin before medical procedures but is not the recommended choice for disinfecting surfaces following a blood spill.

Choice D rationale:

Chlorhexidine. Chlorhexidine is an antiseptic solution often used for skin disinfection before surgical procedures or invasive medical interventions. It is not typically used for disinfecting surfaces contaminated with blood.