A nurse inserts an indwelling urinary catheter for a client who is preoperative. Three days later, the client develops a urinary tract infection. The nurse should identify that the client has which of the following types of infections?
Systemic
Health care-associated
Endogenous
Exogenous
The Correct Answer is B
Choice A reason: A systemic infection would affect the entire body or multiple systems, not just the urinary tract. While a urinary tract infection can become systemic if it leads to sepsis, the scenario provided does not specify such progression.
Choice B reason: A health care-associated infection (HAI) is an infection that a patient acquires while receiving treatment for another condition within a healthcare setting. Since the infection occurred after the insertion of a urinary catheter in a hospital, it is considered an HAI.
Choice C reason: An endogenous infection originates from the host's own microbial flora. The scenario does not provide enough information to determine if the infection was caused by the client's own flora or by external sources.
Choice D reason: An exogenous infection comes from outside the body. While the urinary tract infection could be exogenous, the scenario suggests it is more likely to be health care-associated due to the timing and context of the catheter insertion.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Offering a beverage is a hospitable gesture but not the first step in taking a health history. The priority is to establish communication and trust.
Choice B reason: Confirming insurance coverage is important but not the initial step in the health history process. The focus should first be on the patient's immediate needs and concerns.
Choice C reason: Establishing a rapport with the patient is the first and most crucial step in taking a health history. It involves creating a comfortable and trusting environment for the patient to share personal health information.
Choice D reason: Asking the patient to disrobe and put on a gown may be necessary for a physical examination but is not the first step in taking a health history. The nurse should first establish a rapport with the patient.
Correct Answer is D
Explanation
Choice A reason: Gloves are typically removed first because they are likely to be the most contaminated. They should be removed carefully to avoid contaminating the hands, using the glove-in-glove or beak method.
Choice B reason: The gown should be removed after the gloves because it may also be contaminated. The nurse should reach up to the shoulders and carefully pull the gown forward and away from the body, touching only the inside of the gown.
Choice C reason: Eyewear is removed after the gown. The nurse should handle the eyewear by the arms, avoiding touching the front part that has been exposed to contaminants.
Choice D reason: The mask should be removed last because it protects the mucous membranes of the mouth and nose from infectious droplets. It should be taken off by handling the ties or elastic bands from behind the head and pulling it away from the face without touching the front of the mask.
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