A nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates the medication is having the desired effect?

Tuberculosis is a highly contagious airborne infection caused by Mycobacterium tuberculosis. It spreads through airborne droplet nuclei that remain suspended in the air and can be inhaled by others. Infection control requires strict airborne precautions to prevent transmission to healthcare workers and other patients. Proper use of personal protective equipment is essential during routine care to reduce exposure risk.

Rationale:
A. Shoe protectors are not required for tuberculosis isolation because the organism is not transmitted through contact with footwear or contaminated floors. TB spreads through airborne particles rather than environmental surface contamination. Therefore, shoe covers do not provide meaningful protection.

B. An N95 respirator is required because it filters airborne particles and protects the nurse from inhaling droplet nuclei containing Mycobacterium tuberculosis. It is specifically designed for airborne precautions and must be properly fitted to ensure effectiveness. This is the appropriate PPE for routine care of a client with active tuberculosis.

C. A surgical mask is not sufficient protection against airborne pathogens like tuberculosis because it does not filter small aerosolized particles effectively. Surgical masks are intended for droplet precautions, not airborne isolation. A surgical mask does not provide adequate protection for healthcare workers in this situation.

D. Sterile gloves are not required for routine care of a client with tuberculosis unless sterile procedures are being performed. While gloves are used for contact with body fluids, they do not protect against airborne transmission. The primary protective equipment needed is respiratory protection rather than sterile hand protection.

Postoperative clients are at increased risk for venous thromboembolism due to immobility, vascular injury, and hypercoagulable states associated with surgery. Calf pain in this context is concerning for deep vein thrombosis (DVT), which can potentially progress to pulmonary embolism if the clot dislodges. Early recognition and monitoring for systemic complications are essential to prevent life-threatening outcomes. Nursing care focuses on avoiding actions that dislodge a clot and monitoring for respiratory compromise.

Rationale:
A. Instructing the client to massage the calf gently is contraindicated because it may dislodge a thrombus if a deep vein thrombosis is present. This increases the risk of embolization to the lungs, leading to a pulmonary embolism. Massage is therefore avoided in clients with suspected or confirmed DVT.

B. Maintaining the leg in a dependent position is not recommended because it can increase venous stasis and worsen swelling in the affected extremity. The appropriate positioning for suspected DVT is elevation to promote venous return. A dependent position may exacerbate symptoms and increase discomfort.

C. Monitoring the client's pulse oximetry is appropriate because a complication of DVT is pulmonary embolism, which can impair oxygen exchange. A drop in oxygen saturation may be an early indicator of embolic migration to the lungs. Continuous or frequent monitoring allows early detection of respiratory compromise and prompt intervention.

D. Applying a cold compress to the calf is not an appropriate intervention for suspected DVT because it does not address the underlying clot and may cause vasoconstriction without benefit. The priority is to avoid interventions that could dislodge the clot and instead monitor for complications. Warmth, not cold, is sometimes used for comfort, but only under provider guidance and not in acute suspicion of thrombosis.