A nurse is initiating bladder retraining for a client who has urge urinary incontinence. Which of the following instructions should the nurse give the client?

Rationale:

A. "You should expect your blisters to last up to three weeks.": Herpes zoster lesions typically last 7 to 10 days, with crusting and healing often occurring within 2 weeks. While some cases may extend slightly longer, stating "up to three weeks" may overgeneralize and mislead.

B. "Antiviral medications are most effective if taken within the first 72 hours of symptoms.": Antiviral drugs like acyclovir or valacyclovir are most effective when initiated within 72 hours of symptom onset. Early treatment reduces severity, duration, and the risk of complications such as postherpetic neuralgia.

C. "People who have had chicken pox are at a decreased risk for herpes zoster.": Herpes zoster occurs due to reactivation of the varicella-zoster virus, which remains dormant after chickenpox. Therefore, individuals who have had chickenpox are actually at increased risk.

D. "Severe pain after the blisters are gone is less common in older adults.": Older adults are more likely to experience postherpetic neuralgia, a complication involving persistent nerve pain after lesions resolve. The risk and severity of this pain increase with age, not decrease.

Rationale:

A. Change gloves after contact with infectious material: Gloves must be changed after contact with infectious material to prevent cross-contamination. C. difficile spores can survive on surfaces and be transferred if gloves are not properly changed between tasks or patients.

B. Wear an N95 respirator when providing care: An N95 respirator is not required for C. difficile, as it is transmitted via the fecal-oral route through spores, not by airborne particles. Standard and contact precautions not airborne are appropriate for this infection.

C. Wear a gown when providing care: Wearing a gown is essential when caring for a client with C. difficile, as the spores can contaminate clothing and surfaces. Contact precautions require both gloves and gowns for direct care.

D. Remove the thermometer from client's room for use on another client: Equipment used for a client with C. difficile should remain dedicated to that client to prevent environmental contamination. Sharing items between patients increases the risk of spreading spores.

E. Wash hands with an alcohol-based cleaner: Alcohol-based hand sanitizers are ineffective against C. difficile spores. Hands should be washed with soap and water, which is the only effective method for removing these resilient organisms.