A nurse is discussing with a colleague who is relocating to a new state and needs to find a new job there. What is the best advice the nurse can give?

Choice A rationale:
This statement is accurate. Early Lyme disease (Stage I) is typically treated with oral antibiotics for 14 to 21 days. This is often effective in clearing the infection and preventing further complications.
Choice B rationale:
This statement is also accurate. A red rash that may resemble a bull's eye is a common early symptom of Lyme disease. It often appears at the site of the tick bite, typically within 3 to 30 days after the bite.
Choice C rationale:
This statement is incorrect. While Lyme disease can be serious if not treated, it is rarely fatal. Most people who are treated for Lyme disease recover fully. However, if left untreated, it can lead to chronic health problems, such as arthritis, neurological problems, and heart issues.
Choice D rationale:
This statement is accurate. Taking precautions against tick bites is essential for preventing Lyme disease. Ticks are most active during the warmer months, so it's crucial to be vigilant about tick prevention during the spring, summer, and fall.

Rationale for Choice A:
While it's important for the primary healthcare provider to be informed about the CD4+ results, it's not the first action the nurse should take. The priority is to implement appropriate infection control measures to protect the patient, other patients, and healthcare staff.
CD4+ cell count is a crucial indicator of the patient's immune status. A count of 180/mm is significantly low, suggesting a weakened immune system and increased vulnerability to infections. However, informing the provider alone doesn't directly address the immediate need for infection control.
Rationale for Choice B:
Airborne Precautions are specifically used for patients with known or suspected airborne infections, such as tuberculosis, measles, or varicella. These precautions involve the use of negative pressure rooms and N95 respirators.
In this case, the patient's TB skin test was negative, indicating no evidence of active tuberculosis infection. Implementing Airborne Precautions unnecessarily could lead to excessive resource utilization and potential stigmatization of the patient.
Rationale for Choice C:
Droplet Precautions are used for patients with infections that can be spread through large respiratory droplets, such as influenza, pertussis, or meningococcal meningitis. These precautions involve the use of masks and eye protection.
While the patient's symptoms of fever, night sweats, and severe cough could be consistent with a droplet-spread infection, there's no definitive evidence to support this at the present time. Initiating Droplet Precautions without a clear indication could also lead to unnecessary resource use and potential anxiety for the patient.
Rationale for Choice D:
Standard Precautions are the foundation of infection control and should be used for all patients, regardless of their known or suspected infection status. These precautions include hand hygiene, use of personal protective equipment (PPE) when indicated, and safe handling of sharps and bodily fluids.

By implementing Standard Precautions, the nurse can effectively minimize the risk of transmission of pathogens, protecting both the patient and other individuals in the healthcare setting. This is the most appropriate first action to ensure a safe and appropriate level of care.