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: Clarify that these precautions are mandated by law.
While it's important to acknowledge the legal requirements for Contact Precautions, this approach alone may not adequately address the family's emotional concerns and fears. It could potentially increase their anxiety if they feel forced to visit without understanding the reasons behind the precautions.
Choice B: Emphasize the importance of their visit to the patient.
While family support is crucial for the patient's well-being, emphasizing the importance of their visit without addressing their fears could inadvertently pressure them to visit without feeling comfortable or confident in their ability to protect themselves.
Choice C: Assure the family that they will not contract the infection.
It's not always possible to guarantee that the family won't contract the infection. Making such assurances could create a false sense of security and potentially lead to lapses in infection control practices.
Choice D: Demonstrate to the family how to prevent the spread of the disease.
Empowering the family through education and demonstration is the most effective approach. It addresses their concerns directly, promotes understanding, and instills confidence in their ability to protect themselves while visiting.
Key elements of this demonstration include:
Proper hand hygiene techniques
Use of personal protective equipment (PPE) such as gloves and gowns Safe handling of potentially contaminated items
Maintaining a safe distance from the patient when appropriate Understanding the modes of transmission for the specific disease
By providing clear guidance and allowing for practice, the nurse can help the family feel more comfortable and confident in their ability to visit safely.
Additional considerations:
Addressing the family's emotional concerns: Acknowledge their fears and provide reassurance in a compassionate and understanding manner.
Tailoring education to the family's level of understanding: Use simple language and visual aids as needed.
Encouraging questions and open communication: Create a supportive environment where the family feels comfortable asking questions and expressing their concerns.
Collaborating with other healthcare professionals: Involve infection control specialists or other relevant team members to provide additional support and expertise.

Choice A rationale:
A serum sodium level of 134 mEq/L (134 mmol/L) is mildly low, but this level of hyponatremia is not typically associated with significant cognitive impairment.
Symptoms of hyponatremia, such as confusion, lethargy, and seizures, usually occur when sodium levels are 125 mEq/L or lower.
However, it's important to monitor this patient for any changes in cognitive status as hyponatremia can worsen and lead to more severe symptoms.
Choice C rationale:
A patient who underwent an open cholecystectomy two days ago may experience some cognitive impairment due to the effects of anesthesia and pain medications.
However, this type of impairment is usually temporary and resolves within a few days.
It's important to assess for cognitive impairment in this patient, but it is not the most urgent priority.
Choice D rationale:
A 32-year-old patient with a 20-pack-year history of smoking is at risk for cognitive impairment due to the long-term effects of smoking on the brain.
However, this risk is typically not as immediate as the risk of cognitive impairment following a stroke.
It's important to educate this patient about the risks of smoking and encourage smoking cessation, but it is not the most urgent priority in terms of cognitive assessment.
Choice B rationale:
An 88-year-old patient who had a hemorrhagic stroke three days ago is at the highest risk for cognitive impairment among the given options.
Hemorrhagic stroke involves bleeding in the brain, which can damage brain tissue and lead to cognitive deficits.
The risk of cognitive impairment is particularly high in older adults, as they may have less cognitive reserve to compensate for the damage caused by the stroke.
Early assessment and intervention for cognitive impairment are crucial for optimizing recovery and quality of life in stroke patients.
Prompt evaluation for cognitive impairment is essential to identify any deficits and initiate appropriate interventions to support the patient's cognitive function and recovery.