A nurse is caring for a client who has influenza and isolation precautions in place. Which of the following actions should the nurse take to prevent the spread of infection?
Administer metronidazole.
Don protective eyewear before entering the room.
Place the client in a negative airflow room.
Wear a mask when working within 3 feet of the client.
The Correct Answer is D
A. Administer metronidazole:
Metronidazole is an antibiotic medication used to treat bacterial infections, particularly those caused by anaerobic bacteria and certain parasites. It is not effective against viral infections like influenza. Administering metronidazole would not prevent the spread of influenza.
B. Don protective eyewear before entering the room:
Protective eyewear is typically worn when there is a risk of exposure to bodily fluids or other potentially infectious materials that could splash or splatter into the eyes. While protective eyewear is an important infection control measure in certain situations, it is not specifically indicated for preventing the spread of influenza, which primarily spreads through respiratory droplets.
C. Place the client in a negative airflow room:
Negative airflow rooms are designed to prevent airborne transmission of infectious agents by maintaining negative air pressure, which prevents contaminated air from flowing out of the room and into adjacent areas. While negative airflow rooms may be used for certain infectious diseases, such as tuberculosis, they are not typically indicated for influenza, which primarily spreads through respiratory droplets. Moreover, negative airflow rooms are often limited in availability and may not be necessary for every client with influenza.
D. Wear a mask when working within 3 feet of the client.
Influenza is primarily spread through respiratory droplets when an infected person coughs, sneezes, or talks. Wearing a mask when working within close proximity (within 3 feet) of the client helps prevent the nurse from inhaling respiratory droplets containing the influenza virus, reducing the risk of transmission. Masks act as a barrier that helps trap respiratory secretions and prevent them from reaching the nurse's mouth and nose.
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Related Questions
Correct Answer is C
Explanation
A. Level of orientation:
The level of orientation refers to the client's cognitive status and ability to understand their surroundings. While important for overall assessment and care planning, it is not typically included in anthropometric assessment, which focuses specifically on physical measurements and characteristics of the body.
B. Respiratory rate:
Respiratory rate is a vital sign that reflects the client's respiratory status and is important for assessing oxygenation and ventilation. However, it is not part of anthropometric assessment, which primarily focuses on physical measurements related to body size, shape, and composition.
C. Weight
Anthropometric assessment involves the measurement of various body dimensions, such as height, weight, and body composition. Weight is a crucial component of anthropometric assessment as it provides information about the client's nutritional status, growth patterns, and overall health. Monitoring changes in weight over time can help identify trends and assess the effectiveness of interventions aimed at improving nutritional status or managing health conditions.
D. Current pain level:
Pain level is important for assessing the client's comfort and managing pain effectively, but it is not included in anthropometric assessment. Anthropometric assessment focuses on objective measurements of body dimensions and characteristics rather than subjective experiences such as pain.
Correct Answer is D
Explanation
A. Apply the pouch while the skin barrier is still damp.
Applying the pouch while the skin barrier is damp can lead to poor adhesion and potential leaks. It’s essential to ensure the skin is completely dry before attaching the pouch.
B. Change the pouch once every 24 hr.: The frequency of pouch changes depends on individual client needs, stoma output, and the type of pouching system used. Changing the pouch every 24 hours may be unnecessary for some clients and could potentially cause skin irritation or damage.
C. Rub the peristomal skin dry after cleaning: Rubbing the peristomal skin dry after cleaning can cause irritation and damage to the skin. Instead, the nurse should gently pat the skin dry using a soft cloth or towel to avoid causing friction or trauma to the delicate skin surrounding the stoma.
D. Ensure the pouch is 0.32 cm (1/8 in) larger than the stoma:a allows for a better fit and helps prevent the edges of the stoma from coming into contact with stool, which can cause irritation and breakdown of the skin. A proper fit also helps ensure a secure seal and prevents leakage.
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