A nurse is applying a condom catheter to a male client who is incontinent. Which of the following is an appropriate technique to use?

Rationale for correct choices

• Intake: The child shows multiple signs of dehydration: sunken eyes, weight loss of 0.5 kg in 24 hours, elevated hemoglobin and hematocrit (hemoconcentration), increased urine specific gravity, decreased urine output, tachycardia, and ongoing watery diarrhea. Using priority frameworks (ABCs and circulation), fluid volume deficit threatens circulation and organ perfusion. Addressing intake through fluid replacement is the immediate priority

• Temperature: After stabilizing fluid status, the nurse should address the child’s fever. The temperature increased to 38.8° C (101.8° F) on Day 2. Fever increases metabolic demand and insensible fluid loss, which can worsen dehydration. Managing temperature will help reduce metabolic stress and additional fluid loss while the infection is being treated.

Rationale for incorrect choices

• Hemoglobin: Although hemoglobin is elevated, this reflects hemoconcentration due to dehydration rather than a primary hematologic disorder. Correcting fluid volume will help normalize the value. It is not addressed before stabilizing intake.

• Heart rate: The elevated heart rate (116/min) is most likely secondary to fever and dehydration. Treating the underlying fluid deficit will improve the tachycardia. The heart rate itself is a symptom of the primary problem rather than the first independent focus.

• Sodium level: The sodium level is within normal limits (136 mEq/L). There is no evidence of severe electrolyte imbalance requiring immediate correction over fluid resuscitation.

• Saturation: Oxygen saturation remains between 95% and 98% on room air. There are no signs of respiratory distress or hypoxia. Airway and breathing are stable and do not require priority intervention.

• Respiration: Although the respiratory rate is mildly elevated, it is likely related to fever or metabolic compensation. There are no signs of respiratory compromise requiring immediate intervention.

• Infection: The child has a confirmed Escherichia coli infection; however, infection management (such as targeted treatment) follows stabilization of fluid status. Circulatory compromise from dehydration takes priority over treating the infection itself.

A. "The contraceptive effect will continue for 6 months following discontinuation of the medication.": The contraceptive effect of the transdermal patch does not persist after discontinuation. Fertility generally returns quickly, often within a few days to a month, so this statement is inaccurate and could lead to unintended pregnancy.

B. "Start the first patch on the seventh day of the menstrual cycle.": Standard instructions recommend applying the first patch on the first day of menstruation or on the first Sunday after menstruation begins. Starting on the seventh day could reduce contraceptive effectiveness and increase the risk of ovulation.

C. "Apply the patch to the lower abdomen.": The patch can be applied to the lower abdomen, buttocks, back, or upper arm, avoiding breasts. Correct placement ensures consistent absorption of hormones and optimal contraceptive effectiveness, making this an essential part of client teaching.

D. "Expect to have a headache during the first month.": While some clients may experience headaches as a side effect of estrogen-containing contraceptives, it is not a guaranteed or expected symptom. Teaching should focus on common, likely side effects rather than implying all clients will experience this.