A nurse is caring for a client who has a white blood cell (WBC) count of 15,000/mm3. Which of the following actions should the nurse take?

Choice A reason: Watching a video game in the playroom is not a good activity for a child who requires airborne precautions, as it may expose the child and other children to the risk of infection. Airborne precautions are used for patients who have diseases that are transmitted by small droplets that can remain suspended in the air and travel over long distances, such as tuberculosis, chickenpox, or measles. The child should stay in a private room with negative air pressure, high-efficiency particulate air (HEPA) filtration, and respiratory protection for health care workers and visitors.

Choice B reason: Putting a large-piece puzzle together is a good activity for a child who requires airborne precautions, as it can be done in the child's room and does not involve close contact with others. It is also developmentally appropriate for a 4-year-old child, as it helps to develop fine motor skills, cognitive skills, and problem-solving skills. The nurse should provide the child with a variety of puzzles that are colorful, fun, and challenging, but not frustrating.

Choice C reason: Constructing a model airplane is not a good activity for a child who requires airborne precautions, as it may involve small pieces that can be easily lost, swallowed, or inhaled. It may also be too difficult or complex for a 4-year-old child, who may not have the attention span, dexterity, or patience to complete the task. The nurse should choose activities that are safe, simple, and suitable for the child's age and abilities.

Choice D reason: Pulling a wagon with toys in the hallway is not a good activity for a child who requires airborne precautions, as it may expose the child and other people to the risk of infection. The child should not leave the room unless it is necessary for diagnostic or therapeutic procedures. If the child has to leave the room, the nurse should ensure that the child wears a mask and follows the infection control guidelines. The nurse should also minimize the movement and transport of the child.

Choice A reason: This is the correct instruction for the nurse to include in the plan. Mumps is a viral infection that causes inflammation of the salivary glands. It is transmitted by respiratory droplets from coughing, sneezing, or talking. The nurse should initiate droplet precautions, which include wearing a surgical mask, gloves, and gown, and keeping the child in a private room or with other children who have mumps.

Choice B reason: This is not the correct instruction for the nurse to include in the plan. Airborne precautions are used for infections that are transmitted by small particles that can remain suspended in the air for long periods of time, such as tuberculosis, chickenpox, or measles. Mumps is not an airborne infection, and the nurse does not need to wear a respirator or place the child in a negative pressure room.

Choice C reason: This is not the correct instruction for the nurse to include in the plan. Contact precautions are used for infections that are transmitted by direct or indirect contact with the infected person or their environment, such as scabies, impetigo, or MRSA. Mumps is not a contact infection, and the nurse does not need to wear gloves and gown for all interactions with the child or use disposable equipment.

Choice D reason: This is not the correct instruction for the nurse to include in the plan. Standard precautions are the minimum level of infection control that should be used for all patients, regardless of their diagnosis or presumed infection status. They include hand hygiene, use of personal protective equipment, safe injection practices, and environmental cleaning. However, they are not sufficient for preventing the transmission of mumps, and the nurse should use additional precautions.