A nurse is contributing to the plan of care for a client who has bulimia nervosa. Which of the following interventions should the nurse recommend?

The correct answer is Choice C.

Choice A rationale:

• While maintaining a distance of 3 feet can reduce the risk of direct contact transmission, it is not the most effective measure for contact isolation precautions.
• Contact isolation aims to prevent the spread of pathogens that can be transmitted through direct or indirect contact with the infected person or contaminated objects.
• A distance of 3 feet may not be sufficient to prevent transmission via droplets or fomites (inanimate objects that can harbor infectious agents).

Choice B rationale:

• Sterile gloves are not routinely required for contact isolation precautions.
• They are primarily used for sterile procedures or when there is a risk of exposure to blood or body fluids.
• For contact isolation, standard clean gloves are usually sufficient to protect against transmission via direct contact.

Choice C rationale:

• Leaving equipment that is used routinely in the client's room is a crucial part of contact isolation precautions.
• This practice prevents the spread of infection by minimizing the movement of potentially contaminated items outside of the isolation room.
• Equipment like stethoscopes, blood pressure cuffs, and thermometers should be dedicated to the client's use and not shared with other patients.

Choice D rationale:

• Negative-pressure airflow rooms are used for airborne isolation precautions, which are designed to prevent the spread of pathogens that can be transmitted through the air.
• Contact isolation does not specifically require a negative-pressure room, as the primary mode of transmission is through direct or indirect contact, not airborne particles.

c. Irregular, bulging veins

Deep-vein thrombosis (DVT) is a condition characterized by the formation of a blood clot in the deep veins, commonly in the lower extremities. When assessing a client with DVT, the nurse should expect to find irregular, bulging veins in the affected extremity. This is due to the obstruction of blood flow caused by the clot, leading to distension and visible changes in the appearance of the veins.

Explanation for the other options:

a. Absent dorsal pedal pulse: Absent dorsal pedal pulse is not a characteristic finding of DVT. It may be associated with peripheral arterial disease, which is a different condition involving impaired blood flow in the arteries.

b. Shiny, hairless skin: Shiny, hairless skin is not a typical finding in the affected extremity with DVT. In fact,

the skin in the area of the clot may appear red, warm to touch, and swollen.

d. Dull, aching pain: Dull, aching pain may be present in the affected extremity with DVT. However, it is important to note that some individuals with DVT may not experience any pain or may have minimal discomfort. Therefore, the absence of pain does not rule out the possibility of DVT.

In summary, irregular, bulging veins are an expected finding in the affected extremity of a client with deep- vein thrombosis (DVT). It is important for the nurse to recognize and report these signs promptly to facilitate appropriate management and prevention of complications associated with DVT.