A nurse is checking the apical pulse of a client who is taking several cardiovascular medications. Which of the following actions should the nurse take?

Choice A reason: Droplet precautions are necessary when dealing with infectious agents that are spread through large droplets expelled during coughing, sneezing, or talking. However, leukemia itself is not an infectious disease but a type of cancer affecting the blood and bone marrow. Therefore, droplet precautions are not typically required for leukemia patients unless they have a concurrent infection that warrants such measures.

Choice B reason: A protective environment refers to room designs that minimize the risk of infection in immunocompromised patients, such as those with leukemia. This includes HEPA filtration, positive air pressure rooms, and rigorous infection control practices. Given that patients with leukemia have compromised immune systems, a protective environment is crucial to protect them from infections, which can be life-threatening due to their reduced ability to fight off diseases.

Choice C reason: Airborne precautions are used for diseases that are transmitted through tiny droplets that remain suspended in the air and can be inhaled by others. Diseases like tuberculosis, measles, and chickenpox require airborne precautions. Leukemia does not require airborne precautions unless the patient has a coexisting airborne infection.

Choice D reason: Contact precautions are used for infections that are spread by direct contact with the patient or the patient's environment. While leukemia patients may be more susceptible to infections due to their compromised immune systems, contact precautions are not specifically required for leukemia itself but may be necessary if the patient has a concurrent contact-transmissible infection.

Choice A reason: Wearing gloves when measuring a client's blood pressure is not typically necessary unless there is a risk of exposure to bodily fluids or if the client has an infectious disease. The use of gloves is based on the type of contact and potential for exposure, not routine tasks like BP measurement.

Choice B reason: Wearing gloves for all client contact is not necessary and is not consistent with standard precautions. Gloves should be used when there is potential contact with blood, body fluids, secretions, excretions, contaminated items, or mucous membranes.

Choice C reason: Gloves are not a substitute for hand hygiene. The primary reason for wearing gloves is to provide a barrier against infection, not to reduce handwashing. Hand hygiene is still required before donning gloves and after removing them, regardless of whether the gloves are soiled or not.

Choice D reason: Wearing gloves and a gown when bathing a client with open skin lesions is correct because it protects both the healthcare worker and the client from the risk of infection. Open skin lesions can be a source of infection, and PPE is necessary to prevent the transmission of pathogens.