A nurse is preparing to administer a measles, mumps, and rubella (MMR) immunization. Which of the following client characteristics is a contraindication to administration?

Rationale:

A. "Rest in supine position for 30 minutes after a meal.": Lying flat after a meal increases the risk of aspiration particularly in stroke clients who may have impaired swallowing. A more upright position should be encouraged during and after meals to reduce this risk.

B. "Dress the affected side first.": Dressing the affected side first promotes independence and makes the task easier by minimizing the need for fine motor coordination on the impaired side. It also reduces frustration and helps establish a safe, consistent dressing routine.

C. "Use the arm on your affected side to brush your hair.": Stroke often leads to muscle weakness or paralysis on one side, making it difficult or unsafe to perform tasks with the affected limb. Initially, clients should use their stronger arm while the affected side is supported and rehabilitated gradually.

D. "Use a straw when you drink liquids.": Using a straw can increase the risk of aspiration in clients with post-stroke dysphagia by promoting rapid fluid intake. It is generally contraindicated until a swallowing assessment confirms that it is safe.

Rationale:

A. Search for the medication on the National Library of Medicine's MedlinePlus website: This action allows the nurse to independently access a reliable, evidence-based source to gather essential information about the medication, including its purpose, dosage, side effects, and precautions. It promotes safe and informed medication administration.

B. Ask the charge nurse to explain the purpose of the medication: While consulting experienced colleagues is acceptable, relying solely on another person without verifying the medication through a formal, credible source may lead to misinformation. Independent verification is a safer and more accountable approach.

C. Ask the client to state the indication for the medication: Clients may not always have accurate knowledge of their medications or may misunderstand the reason for their use. Relying on client input does not ensure medication safety and is not a substitute for clinical validation.

D. Allow the client to self-administer the prepared medication: Allowing a client to self-administer a medication that the nurse does not understand is unsafe and violates standards of medication administration. Nurses are responsible for knowing what they administer and ensuring it is appropriate for the client's condition.