A nurse is caring for a client who has dehydration and reports muscle cramps and constipation. Which of the following laboratory values should the nurse expect?

Rationale

A. Perform hand hygiene with at least 4 to 5 mL of hand sanitizer when leaving the client's room: Alcohol-based hand sanitizer is ineffective against C. difficile spores, which require mechanical friction with soap and water for removal. Handwashing is the required method when caring for clients with confirmed C. difficile.

B. Provide a mask for the client when they are outside their room: The client has influenza, which requires droplet precautions to prevent respiratory particle spread during coughing or talking. Wearing a mask when outside the room reduces the risk of transmitting the virus to others in the hallway or waiting areas.

C. Place the client in a room with positive air flow: Positive airflow rooms push air out into the hallway and are not appropriate for infections spread by respiratory droplets or for infections requiring contact precautions. The client with influenza and C. difficile should be placed in a standard private room using droplet plus contact precautions.

D. Don a gown when entering the client's room: C. difficile is spread through contact with spores shed in stool, and gowns protect clothing from contamination. The presence of ongoing diarrhea increases the risk of spore dispersal in the environment. Wearing a gown helps prevent the spread of infection during direct and indirect contact.

E. When removing personal protective equipment, remove gloves first: Gloves have the highest level of contamination because they come into direct contact with infectious materials such as stool and respiratory secretions. Removing gloves first prevents the transfer of pathogens to clean PPE surfaces or the nurse’s skin during removal.

Rationale

A. "Your provider wants you to take this medication.": This response focuses on the provider’s wishes rather than the client’s concerns and may make the client feel dismissed. It does not support shared decision-making or encourage the client to express what is worrying them about treatment. Such a statement can create resistance instead of promoting understanding.

B. "Would you like to discuss other treatment options with your provider?": This response acknowledges the client’s autonomy and validates their concerns about monitoring. It opens the door to exploring alternatives, such as DOACs, which require less monitoring, while still keeping the provider involved.

C. "Why don't you want to undergo monitoring?": Asking “why” can feel accusatory or confrontational, which may make the client defensive. Although understanding the reason is important, this phrasing is not therapeutic and can shut down communication. A more open and neutral statement would be needed to explore the client's concerns effectively.

D. "Regular monitoring is not difficult and will ensure that you remain healthy.": This response minimizes the client’s feelings and assumes they will find the monitoring easy. It offers reassurance without addressing the client’s specific concerns or allowing them to express their viewpoint. It does not promote meaningful dialogue about their hesitation.