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

A. Light-headedness when standing up:
Elevated potassium levels (hyperkalemia) can lead to muscle weakness or paralysis, cardiac dysrhythmias, and even cardiac arrest. Light-headedness when standing up is more commonly associated with orthostatic hypotension or volume depletion rather than electrolyte imbalances like hyperkalemia.

B. Weak quadriceps muscles:
Weakness in the quadriceps muscles is not typically associated with the electrolyte imbalances presented in the scenario. Hyperkalemia can cause muscle weakness, but it is not specific to the quadriceps.

C. Decreased deep tendon reflexes:
Decreased deep tendon reflexes are not typically associated with the electrolyte imbalances presented in the scenario. Hyperkalemia can lead to hyperreflexia or absent reflexes, but it is not specific to decreased deep tendon reflexes.

D. Tingling of extremities:
This is the correct answer. Hypocalcemia, indicated by the low calcium level in the scenario, can manifest with symptoms such as tingling or numbness of the extremities, muscle cramps, and tetany. Calcium plays a crucial role in nerve transmission, and low levels can lead to sensory disturbances like tingling in the extremities.

A) Asking the client to cough while inserting the NG tube:
This action is not necessary and may not be appropriate during the insertion of an NG tube. Coughing can increase the risk of gagging and aspiration during the procedure.

B) Wearing sterile gloves to insert the NG tube:
While the nurse should maintain appropriate hand hygiene, wearing sterile gloves is not typically necessary for the insertion of an NG tube. Clean gloves are sufficient for this procedure.

C) Placing the client into a left lateral position before inserting the NG tube:
Positioning the client in a high Fowler's position (sitting upright) or semi-Fowler's position is generally preferred for NG tube insertion to facilitate tube passage into the esophagus and reduce the risk of aspiration. Placing the client in a left lateral position is not typically done for NG tube insertion.

D) Determining the length of the NG tube to be inserted prior to the procedure:
This is the correct action. Before inserting the NG tube, the nurse should measure the distance from the tip of the client's nose to the earlobe and then from the earlobe to the xiphoid process or the mark on the NG tube corresponding to the desired insertion length. This helps ensure that the tube is inserted to the appropriate depth and reaches the desired location within the gastrointestinal tract.