A nurse is preparing to admit a client who has a new diagnosis of methicillin-resistant Staphylococcus aureus (MRSA). The nurse should plan to place the client in which of the following types of transmission-based precautions?

Choice A Reason: Instruct the client to wear a hospital gown every day, even when out of bed

This intervention does not directly address the prevention of complications related to immobility. Wearing a hospital gown may be necessary for medical reasons, but it does not promote mobility or prevent complications such as pressure ulcers, muscle atrophy, or deep vein thrombosis (DVT). Encouraging the client to wear regular clothes when out of bed might actually promote a sense of normalcy and encourage more movement.

Choice B Reason: Have the client remain in bed for self-care activities

Keeping the client in bed for self-care activities is counterproductive in preventing complications of immobility. Prolonged bed rest can lead to muscle atrophy, decreased joint mobility, and increased risk of pressure ulcers and DVT. Encouraging the client to get out of bed and perform self-care activities while standing or sitting can help maintain muscle strength and joint flexibility.

Choice C Reason: Encourage the client to sit in the chair for all meals

Encouraging the client to sit in a chair for meals is an effective intervention to prevent complications of immobility. Sitting up helps improve digestion and respiratory function and reduces the risk of pressure ulcers by changing the pressure points on the body. It also promotes muscle activity and circulation, which are crucial in preventing DVT and maintaining overall physical health.

Choice D Reason: Elevate the head of the bed to 30° to 45° for medication administration

While elevating the head of the bed can be beneficial for certain medical conditions and for medication administration, it does not significantly contribute to preventing complications of immobility. This position can help with respiratory function and prevent aspiration during medication administration, but it does not promote overall mobility or prevent muscle atrophy and pressure ulcers.

Choice A Reason: Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain

This statement is not accurate. Cerebral edema in meningitis is not primarily caused by the flow of cerebrospinal fluid (CSF) from the intraventricular space to the interstitial area. Instead, it is more related to the inflammatory response triggered by the infection.

Choice B Reason: Cerebral edema is caused by osmotic cerebral edema

Osmotic cerebral edema occurs when there is an imbalance in the osmotic pressure, leading to fluid accumulation in the brain. However, this is not the primary mechanism in meningitis. The edema in meningitis is more related to the inflammatory response and the by-products of the pathogen.

Choice C Reason: Cerebral edema is caused by the by-products of the pathogen that causes the meningitis

This statement is the most accurate. In meningitis, the infection triggers an inflammatory response, leading to the release of various by-products such as cytokines and other inflammatory mediators. These substances increase the permeability of the blood-brain barrier, resulting in fluid leakage and cerebral edema.

Choice D Reason: Cerebral edema is caused by whole body inflammation which affects the brain the most

While systemic inflammation can contribute to cerebral edema, the primary cause in meningitis is the localized inflammatory response in the brain and meninges. The by-products of the pathogen and the resulting inflammation are the main factors leading to cerebral edema.