A nurse is caring for a school-age child who is 2 hr postoperative following cardiac catheterization.

The nurse observes blood on the child’s dressing.

Which of the following actions should the nurse take?

The correct answer is b. “I can visit my nephew who has chickenpox 5 days after the sores have crusted.”

Choice A rationale:

• Statement:“I should take antibiotics when I have a virus.”
• Rationale:This statement is incorrect.Antibiotics are medications that fight bacteria,not viruses.Taking antibiotics when you have a virus will not help you get better and can actually lead to antibiotic resistance.

Choice B rationale:

• Statement:“I can visit my nephew who has chickenpox 5 days after the sores have crusted.”
• Rationale:This statement is correct.Chickenpox is a highly contagious virus that is spread through the air by coughing and sneezing.However,a person with chickenpox is no longer contagious once all of the sores have crusted over.This typically happens about 5 days after the rash first appears.

Choice C rationale:

• Statement:“I should wash my hands for 10 seconds with hot water after working in the garden.”
• Rationale:This statement is partially correct.Handwashing is an important way to prevent the spread of infection.However,the water does not need to be hot.Warm or cold water is just as effective.It is also important to wash your hands for at least 20 seconds,not 10 seconds.

Choice D rationale:

• Statement:“I can clean my cat’s litter box during my pregnancy.”
• Rationale:This statement is incorrect.Cat feces can contain a parasite called Toxoplasma gondii,which can cause a serious infection called toxoplasmosis.Toxoplasmosis can be harmful to a developing baby.It is best to avoid cleaning cat litter boxes during pregnancy.If you must clean the litter box,wear gloves and wash your hands thoroughly afterwards.

. Taking a hot shower in the morning can help decrease stiffness and improve joint mobility for people with rheumatoid arthritis. This is one of the self-management strategies that can reduce pain and disability.

Choice A is wrong because applying cold packs directly on the skin of the affected joints can cause vasoconstriction and increase inflammation.

Cold therapy should be used with caution and with a barrier between the skin and the ice pack.

Choice B is wrong because biological response modifiers are not used to prevent infection, but to reduce inflammation and slow down joint damage in rheumatoid arthritis.

These medications can actually increase the risk of infection by suppressing the immune system.

Choice D is wrong because clustering physical activities during the day can cause fatigue and joint stress for people with rheumatoid arthritis.

It is better to pace activities throughout the day and take frequent breaks to rest the joints.

Normal ranges for rheumatoid arthritis are based on the disease activity score (DAS), which measures the number of swollen and tender joints, the level of inflammation in the blood, and the patient’s global assessment of health. A DAS below 2.6 indicates remission, a DAS between 2.6 and 3.2 indicates low disease activity, a DAS between 3.2 and 5.1 indicates moderate disease activity, and a DAS above 5.1 indicates high disease activity.