A nurse is providing oral care for a client who had has impaired upper extremity strength. Which of the following actions should the nurse take?

Provide the client with an electric toothbrush.

Give the client an alcohol-based mouth wash.

Give the client lemon-glycerin mouth swabs.

Provide the client with a spool of dental floss.

Answer and Explanation

The Correct Answer is A

A. Provide the client with an electric toothbrush: An electric toothbrush is an appropriate option for a client with impaired upper extremity strength. It requires less physical effort to use compared to a manual toothbrush, making it easier for the client to maintain oral hygiene effectively. The powered brushing action can help ensure more thorough cleaning of the teeth and gums.

B. Give the client an alcohol-based mouth wash: Alcohol-based mouthwashes can be irritating to the oral mucosa, especially in clients who may have dry mouth or other oral health issues. Instead, a non-alcoholic mouthwash or rinse should be considered to promote comfort and effective oral care.

C. Give the client lemon-glycerin mouth swabs: Lemon-glycerin swabs are not recommended for oral care, as they can be irritating and may cause dryness in the mouth. Additionally, lemon can be acidic and potentially harm the enamel of the teeth. It is better to use products designed for sensitive oral care.

D. Provide the client with a spool of dental floss: While dental floss is important for maintaining oral hygiene, using it requires manual dexterity and strength that may be difficult for a client with impaired upper extremity strength. Instead, alternatives such as floss holders or interdental brushes could be suggested, but the initial focus should be on ensuring the client can effectively brush their teeth.

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Correct Answer is B

Explanation

A. "If you wear gloves, you do not have to wash your hands.": Hand hygiene must still be performed even when gloves are worn. Gloves can become contaminated, and not washing hands after removing them can lead to the spread of pathogens. It is crucial to wash hands before putting on gloves and after removing them to ensure proper infection control.

B. "Rub all surfaces of your hands with an alcohol rub for 20 to 30 seconds.": This emphasizes the importance of thoroughly applying an alcohol-based hand rub to all areas of the hands, including the back, between fingers, and under nails. Using the rub for 20 to 30 seconds allows for effective disinfection, reducing the risk of transmitting infections.

C. "Use an alcohol rub when your hands are visibly soiled.": When hands are visibly soiled, soap and water should be used instead of an alcohol rub. Alcohol-based hand rubs do not effectively clean dirt or organic matter, which makes proper handwashing essential in such cases to ensure all contaminants are removed.

D. "If you don't have an infection, your hands won't infect others.": It is possible for hands to carry microorganisms that can cause infections even if the person does not have an active infection. Regular hand hygiene practices are necessary to prevent the transmission of pathogens to others, highlighting the importance of maintaining clean hands regardless of one's health status.

A. A 60 year old patient who is on a mechanical ventilator B. A 65 year old patient who is vegetarian and obese C. A 45 year old patient who smokes a pack of cigarettes a day D. A 70 year old patient who has a normal WBC count

Correct Answer is A

Explanation

A. A 60 year old patient who is on a mechanical ventilator: This patient is at the highest risk for healthcare-acquired infections (HAIs) due to the use of mechanical ventilation. Ventilated patients are susceptible to ventilator-associated pneumonia and other respiratory infections, making them more vulnerable to HAIs.

B. A 65 year old patient who is vegetarian and obese: While obesity can increase the risk for certain complications, being vegetarian does not inherently increase the risk for HAIs. This patient may have some risk factors, but they are not as significant as those associated with mechanical ventilation.

C. A 45 year old patient who smokes a pack of cigarettes a day: Smoking is a risk factor for various health issues, including respiratory infections, but it does not specifically correlate with a higher risk of HAIs in a hospitalized setting compared to a patient on a mechanical ventilator.

D. A 70 year old patient who has a normal WBC count: Although older age can increase the risk for infections, a normal white blood cell count indicates a functioning immune response. Without additional risk factors, this patient would not be considered the most at risk for developing HAIs compared to a ventilated patient.

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