A nurse is caring for a client who has had an allogeneic hematopoietic stem-cell transplant. Which of the following infection-control precautions should the nurse use while caring for this client?

A. The client's daughter, who is the primary caregiver: While the daughter may be involved in the client's care and decision-making process, the client themselves should provide informed consent if they have decision-making capacity. Informed consent cannot be provided by a caregiver unless legally authorized to do so.

B. The client: The client is alert, oriented, and has advance directives. In this scenario, the client possesses decision-making capacity and is capable of providing informed consent for the procedure. As long as the client is competent and able to understand the nature, risks, benefits, and alternatives of the procedure, they are the appropriate person to sign the informed consent document.

C. The client's partner: Unless legally designated as the client's healthcare proxy or legally authorized to provide consent on the client's behalf, the partner should not sign the informed consent document. The client themselves should provide consent if they have decision-making capacity.

D. The client's son, who has a durable power of attorney: While a durable power of attorney grants legal authority to make healthcare decisions on behalf of the client if they lack decision-making capacity, it does not negate the client's ability to provide informed consent if they are competent to do so. If the client is alert, oriented, and capable of understanding the procedure, they should sign the informed consent document themselves.

A) Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic that promotes sodium and water excretion, leading to decreased blood volume and decreased potassium excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.

B) Spironolactone: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased sodium reabsorption and increased potassium retention. This mechanism of action can predispose clients to hyperkalemia due to potassium retention. Additionally, spironolactone can cause hyponatremia by promoting the excretion of sodium and water. Therefore, clients receiving spironolactone are at risk for both hyperkalemia and hyponatremia.

C) Furosemide: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle, promoting sodium, chloride, potassium, and water excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.

D) Metolazone: Metolazone is a thiazide-like diuretic that acts similarly to hydrochlorothiazide by promoting sodium and water excretion. Like hydrochlorothiazide, it can cause hypokalemia due to increased potassium excretion but does not typically lead to hyperkalemia.