A nurse in an assisted living facility is collecting data from an older adult client who fell in their room and hit their head on the dresser. Which of the following findings is the nurse's priority?

Choice A reason:
Resuming exercise in 10 days post-tympanoplasty may not be advisable. Postoperative care typically includes avoiding strenuous activities for at least 2 weeks to prevent pressure changes in the ear that can disrupt healing. Exercise can increase blood pressure and may lead to bleeding or other complications in the surgical site. Normal physical activity can usually be resumed gradually as per the surgeon's advice and based on the patient's recovery progress.

Choice B reason:
Planning to shampoo hair in 1 week post-tympanoplasty is not recommended. The standard postoperative instruction is to keep the ear dry for 4-6 weeks to prevent infection and allow proper healing of the eardrum. Water entering the ear canal can introduce bacteria and cause infections, which can compromise the surgical repair. Patients are usually advised to take baths instead of showers and to use a shower cap or apply petroleum jelly-covered cotton balls in the ears when bathing to prevent water from entering the ear canal.

Choice C reason:
Drinking fluids through a straw is not specifically contraindicated after tympanoplasty. However, it is essential to avoid activities that can create negative pressure within the ear, such as sucking on a straw, which could potentially dislodge the graft or packing material used during surgery. Patients are generally advised to swallow normally and to avoid actions that significantly alter ear pressure until cleared by the healthcare provider.

Choice D reason:
Closing the mouth when sneezing is incorrect advice post-tympanoplasty. Patients should be instructed to sneeze with their mouth open to avoid creating excessive pressure in the ear canal, which can disrupt the healing process. Sneezing with a closed mouth can force air and pressure through the Eustachian tube into the middle ear, potentially damaging the surgical repair. Open-mouth sneezing helps to minimize this risk.

Choice A reason:
Discarding soiled wound care supplies in a trash receptacle outside the client's room is a necessary action to prevent the spread of infection within the healthcare facility. It is important to ensure that these materials are disposed of properly to maintain a clean environment and reduce the risk of contaminating other areas.

Choice B reason:
Instructing visitors to perform hand hygiene is crucial in preventing the spread of infection. However, the CDC recommends washing hands for at least 20 seconds to effectively remove germs, not just 5 seconds. Proper hand hygiene practices are essential in a healthcare setting, especially when dealing with infectious wounds.

Choice C reason:
Administering antibiotic therapy before culturing the client's wound is not the recommended practice. Culturing should be done prior to the administration of antibiotics to accurately identify the causative organisms and determine the most effective antibiotic treatment.

Choice D reason:
Placing the client in a private room with a private bathroom is the most appropriate action listed. It helps to isolate the client and prevent the spread of infection to other patients. This measure is in line with infection control protocols and provides a controlled environment for the client's care.