A nurse in an emergency department is receiving report on a group of clients. Which of the following clients should the nurse assess first?

Indicated:

Encourage high-calorie finger food: The client has experienced weight loss and decreased appetite, which can occur with depression. Offering high-calorie, easy-to-eat foods helps maintain adequate nutrition and prevents further weight loss.

Advise client to rise slowly from a sitting position: Trazodone can cause orthostatic hypotension due to its alpha-adrenergic blocking effects. Advising the client to rise slowly reduces the risk of dizziness or falls when standing.

Advise client to notify the provider if pregnant: Trazodone is contraindicated in pregnancy due to potential risks to the fetus. The client should inform the provider if pregnancy occurs or is suspected.

Encourage a regular sleep-wake schedule
Maintaining a consistent bedtime and wake time improves sleep hygiene, supports trazodone’s effectiveness for insomnia, and helps regulate mood and energy levels.

Not Indicated:

Instruct client to avoid foods that have been fermented or aged: This dietary restriction is necessary for clients taking monoamine oxidase inhibitors (MAOIs), not trazodone. Trazodone does not require tyramine restriction, so this intervention is unnecessary.

Encourage naps during the day when the client is tired: Daytime napping can disrupt nighttime sleep and worsen insomnia. The focus should be on promoting a consistent sleep routine rather than allowing extra daytime sleep.

Encourage client to sleep until later in the morning: Sleeping late can interfere with the circadian rhythm and reduce sleep quality. A consistent wake-up time is more beneficial for improving sleep patterns and mood.

A. Varicella (chickenpox) requires airborne and contact precautions, not droplet precautions, due to its high transmissibility.

B. Aspirin should never be given to children with viral infections because it increases the risk of Reye’s syndrome, a life-threatening condition causing liver failure and encephalopathy.

C. The herpes zoster vaccine (Zostavax or Shingrix) is for adults to prevent shingles, not for children with active varicella infection.

D. Children with varicella are contagious from 1–2 days before the rash appears until all vesicles have crusted over (usually 5–7 days). They should be isolated from susceptible individuals during this period.