A nurse is evaluating an 8-month-old infant's pain level following the administration of hydrocodone. Which of the following pain scales would the nurse use?

A) Wear sterile gloves to remove the dressing: For a wet-to-dry dressing change, clean gloves are typically used when removing the dressing, as the procedure does not require a sterile technique unless the wound is being directly cleaned or treated with sterile instruments. Wearing sterile gloves for removal is unnecessary and could increase the risk of contamination when handling non-sterile dressing material.

B) Remove the tape by pulling from the center of the dressing: Tape should be removed by pulling it gently from the edges rather than from the center. Pulling from the center may cause unnecessary trauma to the surrounding skin or disrupt the wound's healing process. Gently pulling from the edges helps reduce the risk of skin irritation and minimizes discomfort for the patient.

C) Moisten dressing before removal: The dressing should be moistened before application, not before removal. Wetting the dressing before removing it may actually cause further trauma to the wound, and it might be difficult to remove the wet-to-dry dressing cleanly. The dressing should be removed first, and then a new dressing should be moistened if needed.

D) Clean the wound from the center to the outer edges: When cleaning a wound, the nurse should always clean from the center of the wound to the outer edges in a circular motion. This helps prevent the spread of bacteria from the outer contaminated areas into the clean tissue. By cleaning from the center outward, the nurse reduces the risk of introducing new bacteria into the wound site.

Airborne precautions (Anticipated): Tuberculosis is an airborne disease, requiring negative pressure isolation, N95 respirators, and airborne precautions to prevent transmission.

Rifampin (Anticipated): A key first-line TB medication that inhibits bacterial RNA synthesis. It is part of the standard RIPE (Rifampin, Isoniazid, Pyrazinamide, Ethambutol) regimen.

Contact precautions (Contraindicated): TB does not spread via direct contact, so contact precautions (gloves, gowns) are unnecessary unless the client has open wounds with drainage.

Isoniazid (Anticipated): A primary anti-TB drug that inhibits mycolic acid synthesis, crucial for treating active and latent TB infections.

Monthly TB skin test for 1 year (Contraindicated): Once TB is diagnosed, routine Mantoux tests are unnecessary, as they will likely remain positive due to prior exposure.

Pyrazinamide (Anticipated): A bactericidal TB medication used in the intensive phase of treatment to shorten therapy duration.

Ethambutol (Anticipated): Used to prevent drug resistance in TB treatment. Regular eye exams are needed due to the risk of optic neuritis.