A nurse is assisting in the care of a client. Nurses' Notes

2000:

The client presents to the emergency department and states, "I have been assaulted." The client was immediately placed in a treatment

room. 2015:

"The client states they were out with friends this evening and had "a little too much to drink." The client states that they fell asleep at their friend's house and when they woke up all of their clothes were off and their genitals were sore. The client states, "I think someone had sex with me, but I don't remember anything." The client reports a history of depression. The client is a full-time college student who lives with roommates. The client admits to drinking socially but denies illicit drug use and tobacco use.

Which of the following interventions should the nurse plan to implement? Select all that apply.

When collecting data from a child with pertussis (whooping cough), the nurse should expect the following manifestations:

1. Paroxysmal cough: The hallmark symptom of pertussis is a severe, uncontrollable cough that often occurs in bursts (paroxysms) followed by a characteristic "whooping" sound as the child inhales.
2. Posttussive vomiting: The coughing spells can be so severe that they may lead to vomiting.
3. Inspiratory whoop: As mentioned earlier, during the inhalation phase after a coughing episode, the child may make a distinctive whooping sound.
4. Cyanosis: The prolonged coughing episodes can sometimes cause the child's face to turn blue (cyanosis) due to inadequate oxygen intake.
5. Fatigue and exhaustion: The frequent and intense coughing episodes can be exhausting for the child, leading to fatigue and sleep disturbances.

Other possible manifestations of pertussis can include a mild fever, runny nose, and sneezing. However, these symptoms are less specific to pertussis and can be seen in other respiratory infections as well.

The manifestations listed in the question (beefy, red tongue; facial erythema; peeling of the hands and feet) are not typically associated with pertussis and may be indicative of other conditions or diseases. It is important to consult a healthcare provider for a proper evaluation and diagnosis.

A. Artificial flowers in the room: While artificial flowers can harbor dust and allergens, they are not a significant risk factor for infection in a neutropenic client with HIV. The primary concern is bacterial or fungal exposure, which is unlikely to be significantly affected by artificial flowers.Still, due to the need for a highly sterile environment for neutropenic patients, artificial flowers are typically avoided in clinical settings.

B. Room with negative airflow: A room with negative airflow is designed to prevent airborne pathogens from spreading outside the room. However, this measure is more relevant for clients with contagious respiratory infections (e.g., tuberculosis).

C. Meal tray with hard-boiled eggs: Hard-boiled eggs are generally safe for most clients. However, in a neutropenic client, the risk lies more in raw or undercooked eggs due to potential bacterial contamination (e.g., Salmonella). Hard-boiled eggs are fully cooked and less likely to pose a significant risk.

D. Meal tray with ice cream and fresh fruit: This choice presents a higher risk. Neutropenic clients should avoid fresh fruits (especially unwashed) due to potential bacterial and fungal contamination. Ice cream, although pasteurized, can also harbor bacteria if not handled properly.