A nurse in an antepartum clinic is reviewing the medical records of four clients.

 Which of the following infectious conditions should the nurse report to the Centers for Disease Control and Prevention? 

. Engage the family in informal conversation. The first step in caring for a client with dementia is to establish a relationship of trust and comfort with the client and their family. Engaging the family in informal conversation can help the nurse gain insight into the family's needs and concerns, as well as provide an opportunity to establish rapport. Encouraging the family to join a support group, providing information about respite care, and educating the family regarding the progression of dementia are important steps in caring for a client with dementia, but they should follow the initial step of engaging the family in informal conversation.

Explanation: Heroin is a central nervous system depressant that can cause various physiological effects on the body. Dilated pupils are a common sign of heroin use, along with a decrease in blood pressure, respiratory rate, and heart rate. The pupils will appear larger than usual because heroin depresses the parasympathetic nervous system, which controls the size of the pupils.

Tachypnea, or rapid breathing, is not typically associated with heroin use, as it is a central nervous system depressant. Euphoria, or a feeling of intense pleasure or happiness, is a common effect of heroin use, but it is not the most reliable sign of heroin use, as other drugs can also produce this effect. Nystagmus, an involuntary movement of the eyes, is not a common sign of heroin use. Dilated pupils are a reliable sign of heroin use and should be documented in the client's medical record. It is important for the nurse to assess for other signs of drug use and to provide appropriate care and support to the client, which may include referrals for substance abuse treatment. The nurse should also follow agency policies and procedures for reporting drug use and abuse to appropriate authorities.

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