A nurse is caring for a male client who has a spinal cord injury. Which of the following techniques should the nurse use when providing perineal care?

Use water with no soap to prevent skin irritation.

Discard the washcloth after cleansing the urethral meatus.

Don sterile gloves to prevent infection.

Wash the penis from the scrotum to the tip using a spiral motion.

Answer and Explanation

The Correct Answer is B

A. While avoiding harsh soap is important, using water alone may not adequately clean the area.

B. After cleaning the urethral meatus, the nurse should discard the washcloth or use a different part of it to prevent the spread of bacteria.

C. Clean gloves are typically sufficient unless the procedure involves a sterile environment.

D. The penis should be cleaned from the tip to the base (proximal to distal) to reduce the risk of introducing bacteria.

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Correct Answer is []

Explanation

Potential condition: Systemic lupus erythematosus

Based on the provided information, the client is most likely experiencing Systemic Lupus Erythematosus (SLE). This is suggested by the presence of a macular rash on the cheeks, joint discomfort, fever, and elevated erythrocyte sedimentation rate (ESR).

Actions to Take

Anticipate administering prescribed immunosuppressant medication: This helps manage the autoimmune response and reduce inflammation.
Encourage client to avoid direct sunlight: Sun exposure can exacerbate lupus symptoms and trigger flares.

Parameters to Monitor

Vital signs every 4 hr: Monitoring vital signs helps track the client's overall condition and detect any changes that may indicate complications.
Erythrocyte sedimentation rate: Monitoring ESR helps assess the level of inflammation and the effectiveness of treatment.

A. A nurse experiences insulting comments directed at them by another nurse. B. A nurse submits a complaint about another department's handoff reporting. C. A nurse expresses concern that another shift works fewer holiday hours. D. A nurse has a personal difficulty with caring for clients who have HIV.

Correct Answer is A

Explanation

A. Interpersonal conflict occurs when there is a disagreement or negative interaction between two individuals. Insulting comments directed at a nurse by another nurse clearly represent an interpersonal conflict.

B. A complaint about handoff reporting is an issue between departments and may involve interdepartmental or communication problems, not interpersonal conflict.

C. A concern about holiday hours is a work scheduling issue and may relate to workload fairness rather than interpersonal conflict.

D. A personal difficulty with caring for clients who have HIV is an intrapersonal conflict, as it reflects the nurse’s internal struggle, not a conflict between two individuals.

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A nurse is caring for a male client who has a spinal cord injury. Which of the following techniques should the nurse use when providing perineal care?

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Correct Answer is []

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Correct Answer is A

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