A nurse is caring for several clients in the morning prior to surgery. Which medications taken by the clients necessitate a consultation with the primary health care provider regarding their administration? (Select all that apply.)

Choice A rationale:
Wearing a respirator when handling urine output is not routinely recommended for MRSA infections. While airborne transmission of MRSA is possible, it is primarily spread through direct contact with infected skin or surfaces. Respirators are typically reserved for situations where there is a high risk of aerosolization, such as during certain medical procedures.
The use of a respirator can be cumbersome and uncomfortable, and it may not provide significant additional protection in this context.

It's important to prioritize hand hygiene and contact precautions over respirator use for routine care of patients with MRSA infections.
Choice B rationale:
Limiting visitors strictly to immediate family members only is not necessary for MRSA infection control. Visitors can be educated on proper hand hygiene and contact precautions to minimize the risk of transmission.
Restricting visitors can have negative psychosocial impacts on the patient, such as isolation and decreased social support. It's important to balance infection control measures with the patient's overall well-being.
Choice C rationale:
Washing hands only after removing gloves post-care is inadequate for MRSA infection control. Hands should be washed thoroughly with soap and water or an alcohol-based hand sanitizer:
Before and after entering the patient's room
Before and after any contact with the patient or their surroundings After removing gloves
After using the toilet Before eating or drinking.

Choice D rationale:
Vancomycin is an antibiotic that is effective against MRSA infections. It is often the first-line treatment for these infections.
Preparing to administer vancomycin as prescribed by the healthcare provider is the most appropriate action to take to address the patient's MRSA infection.
Prompt initiation of appropriate antibiotic therapy is essential to controlling the infection and preventing complications.

Choice A rationale:
Skin and mucous membranes are the most effective and crucial barriers to infection. They provide a continuous physical barrier that prevents pathogens from entering the body. Here's a detailed explanation of their protective mechanisms:
1. Physical Barrier:
Skin: The outermost layer of skin, the epidermis, is composed of tightly packed cells that are difficult for pathogens to penetrate. It's also covered in a layer of sebum, an oily substance that helps to repel water and microorganisms.
Mucous membranes: These moist linings cover the openings of the body, such as the nose, mouth, eyes, and digestive, respiratory, and urogenital tracts. They produce mucus, a sticky substance that traps pathogens and prevents them from entering the body. Mucus also contains enzymes and antibodies that can kill certain pathogens.
2. Chemical Barrier:
Skin and mucous membranes secrete a variety of substances that have antimicrobial properties. These include: Sebum: Contains fatty acids that can kill bacteria and fungi.
Sweat: Contains salt and lysozyme, an enzyme that can break down bacterial cell walls. Saliva: Contains enzymes that can break down food and kill bacteria.
Gastric acid: The highly acidic environment of the stomach kills most pathogens that are ingested.
3. Immune Barrier:
Skin and mucous membranes are home to a diverse community of microbes, known as the microbiome. These microbes play an important role in protecting against infection by competing with pathogens for resources and space.
Mucous membranes contain specialized immune cells, such as M cells and dendritic cells, that can recognize pathogens and initiate an immune response.
In contrast, the other choices are less effective barriers to infection:
Choice B: Gastrointestinal secretions, such as gastric acid, do play a role in preventing infection, but they are not as effective as skin and mucous membranes. Pathogens can still enter the body through the digestive tract, even in the presence of gastric acid.
Choice C: Colonization by host bacteria can actually help to protect against infection by competing with pathogens. However, it is not a primary barrier to infection.
Choice D: Inflammatory processes are a response to infection, not a barrier to it. They occur after pathogens have already entered the body.