A nurse is caring for a client who is at 36 weeks of gestation and is undergoing a nonstress test (NST). The test is nonreactive. Which of the following interventions should the nurse suggest based on the findings?

A. Weight loss: Nicotine withdrawal typically leads to increased appetite and potential weight gain rather than weight loss. The absence of nicotine alters metabolism and hunger signals, often causing individuals to consume more food, especially carbohydrates, as a substitute for smoking.
B. Insomnia: Disruptions in sleep patterns are a common symptom of nicotine withdrawal. Nicotine is a stimulant that affects neurotransmitters, and its sudden absence can cause difficulty falling asleep, frequent nighttime awakenings, and restless sleep. Sleep disturbances can persist for several weeks after smoking cessation.
C. Diarrhea: Nicotine withdrawal is more commonly linked to constipation rather than diarrhea. Nicotine stimulates gut motility, and when discontinued, bowel movements may slow down, leading to temporary constipation rather than increased bowel activity.
D. Diaphoresis: While withdrawal can trigger irritability and autonomic symptoms such as mild sweating, excessive sweating is not a primary sign. More common symptoms include mood swings, restlessness, headaches, increased cravings, and difficulty concentrating as the body adjusts to the absence of nicotine.

Rationale for Correct Choices:

• N95 respirator. The client’s presentation of a cough, fatigue, night sweats, weight loss, and positive sputum culture for M. tuberculosis strongly suggests active tuberculosis (TB). Tuberculosis is transmitted through airborne particles, and an N95 respirator is required to protect healthcare workers from inhaling these particles. The N95 mask is specifically designed to filter out small particles, including the Mycobacterium tuberculosis bacteria.
• Gloves. Gloves should be worn when caring for patients with suspected or confirmed TB to prevent contact transmission. While TB is primarily transmitted via airborne particles, gloves are still necessary to protect healthcare workers from coming into contact with bodily fluids such as sputum or any other potentially contaminated materials.

Rationale for Incorrect Options:

• Face shield. A face shield is not required as primary protection for TB. While face shields can protect against splashes and droplets, TB is primarily transmitted via airborne particles, for which an N95 respirator is more appropriate.
• Surgical mask. A surgical mask is not sufficient for protecting healthcare workers against tuberculosis because it does not filter out small airborne particles like the N95 respirator does. Surgical masks are primarily intended for droplet precautions, but tuberculosis is spread through airborne transmission, necessitating an N95 mask for adequate protection.

• Gown. A gown is not required in this situation unless the patient has other symptoms or conditions that increase the risk of contamination, such as excessive wound drainage or the potential for body fluid splashes. For TB transmission, the primary concern is airborne transmission, and appropriate PPE focuses on respiratory protection (N95) and gloves for contact precautions.