A nurse is admitting a client who has pertussis. Which of the following types of transmission-based precautions should the nurse initiate?

A) A client who has had a cerebrovascular accident:
Clients who have had a cerebrovascular accident (stroke) often suffer from dysphagia (difficulty swallowing) due to impaired muscle control or sensory deficits. This makes them more susceptible to aspiration, as food or liquid can enter the airway instead of the esophagus.

B) A client who has had radiation therapy for head and neck cancer:
Radiation therapy in the head and neck area can cause damage to tissues, leading to mucositis, fibrosis, and reduced salivary flow, all of which can impair swallowing function. This increases the risk of aspiration because the normal mechanisms that protect the airway during swallowing may be compromised.

C) A client who is 4 hr postoperative following a leg amputation with general anesthesia:
General anesthesia can depress the gag and cough reflexes and impair coordination of the muscles involved in swallowing, making it more difficult for the client to protect their airway. This increased risk of aspiration is particularly relevant in the immediate postoperative period when the effects of anesthesia may still be present.

D) A client who has lactose intolerance:
Lactose intolerance primarily affects the digestive system and does not directly impact the mechanics of swallowing or increase the risk of aspiration. This condition leads to gastrointestinal symptoms such as bloating, diarrhea, and abdominal pain when consuming lactose-containing foods, but it does not increase the risk of food or liquid entering the airway during eating.

E) A client who has had prolonged diarrhea:
Prolonged diarrhea can lead to dehydration and electrolyte imbalances, but it does not directly affect the swallowing mechanism or increase the risk of aspiration. The primary concern with prolonged diarrhea is fluid and electrolyte management rather than an increased risk of aspiration during eating.

A. Disenfranchised grief:
Disenfranchised grief occurs when the loss experienced by an individual is not openly acknowledged or socially supported. This type of grief may occur when the relationship with the deceased is not recognized or valued by others, such as in the case of a non-traditional relationship. In this scenario, the client's grief is acknowledged but persists beyond what is considered a typical mourning period, suggesting a different type of grief.

B. Anticipatory grief:
Anticipatory grief occurs when individuals experience feelings of loss before the actual loss or death occurs. This often happens in situations where death is expected due to a terminal illness. Since the client's partner has already died, anticipatory grief does not apply in this case.

C. Prolonged grief:
This is the correct answer. Prolonged grief, also known as complicated grief, occurs when the grieving process persists over an extended period, beyond what is considered typical or socially acceptable. Individuals experiencing prolonged grief may have difficulty accepting the reality of the loss and may continue to experience intense emotions related to the loss for an extended period, often interfering with their daily functioning.

D. Uncomplicated grief:
Uncomplicated grief refers to a normal and typical response to loss that typically resolves over time. While grief is a natural response to loss, uncomplicated grief does not persist for an extended period or significantly impair the individual's ability to function in their daily life. In this scenario, the client's continued inability to accept the loss suggests that the grief may be more complex than uncomplicated grief.