A nurse is assisting the provider with a lumbar puncture for a client who has manifestations of meningitis.

Into which of the following positions should the nurse assist the client?

Provide the client with written information about advance directives: It is important for the nurse to educate the client about advance directives, their purpose, and how they can make informed decisions about their healthcare.

Instruct the client that an advance directive is a legal document and must be honored by care providers: The nurse should explain to the client that an advance directive is a legally binding document that guides healthcare decisions, and it must be respected and followed by healthcare providers.

Communicate advance directives status via the medical record and shift report: The nurse should ensure that the client's advance directives status is accurately documented in the medical record and communicated to other members of the healthcare team during shift handoffs. This helps ensure that the client's wishes are known and respected by all involved in their care.

Initiate a power of attorney for a healthcare document: The nurse can assist the client in initiating a power of attorney for a healthcare document if the client wishes to appoint someone as their healthcare proxy or agent. This document designates someone to make medical decisions on behalf of the client if they become unable to do so.

The other options listed are not appropriate or accurate in relation to the responsibilities of the nurse regarding advance directives:

• Document that the provider discussed do-not-resuscitate status with the client: While discussing do-not-resuscitate (DNR) status may be part of the advance care planning process, it is not directly related to advance directives as a whole.
• Inform the client that an advance directive discontinues further care: This statement is incorrect and misleading. An advance directive does not automatically discontinue care but rather guides the provision of care according to the client's wishes.

Isolate children who have varicella until the vesicles have formed crusts.

Isolating children who have varicella, also known as chickenpox, until the vesicles (blisters) have formed crusts is an important infection control measure. Varicella is highly contagious, and the fluid-filled vesicles can easily spread the virus to others. Keeping the child isolated until the vesicles have crusted over helps prevent the spread of the disease.

Children who have erythema infectious, commonly known as fifth disease in (option A) is incorrect because they, do not require short-term antibiotic therapy. Fifth disease is a viral infection caused by parvovirus B19 and is usually a self-limiting condition that resolves on its own without specific treatment.

Administration of childhood immunizations, such as the MMR (measles, mumps, rubella) vaccine in (option C) is incorrect because it, does not prevent exanthem subitem, also known as roseola infantum. Roseola infantum is usually a mild viral illness that primarily affects infants and young children. It is caused by human herpesvirus 6 (HHV-6) or human herpesvirus 7 (HHV-7) and is characterized by high fever followed by a rash.

Restricting fluids for children who have pertussis (whooping cough) in (option D) is not appropriate. In fact, it is important to encourage adequate fluid intake to prevent dehydration, especially in children who may have difficulty eating or drinking due to persistent coughing spells. Pertussis is a bacterial infection, and treatment typically involves antibiotics and supportive care.