A nurse is providing teaching to a client who has stress incontinence. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Rationale:
A. Having no vesicles prevents the spread of transmission: HSV-2 can be transmitted even when no visible lesions are present through asymptomatic viral shedding. The client should use barrier protection, such as condoms, during all sexual activity to reduce transmission.

B. Antibiotics are the primary treatment for this infection: HSV-2 is a viral infection, and antibiotics are ineffective against viruses. The mainstay of treatment involves antiviral medications such as acyclovir, valacyclovir, or famciclovir.

C. It is a latent infection that may reactivate periodically: HSV-2 remains dormant in nerve ganglia after the initial infection and can reactivate intermittently, leading to recurrent outbreaks triggered by stress, illness, or immunosuppression.

D. It is recommended any partners receive a vaccine to prevent this infection: There is currently no vaccine available to prevent HSV-2 infection. Prevention relies on consistent condom use, abstaining during outbreaks, and open communication with sexual partners about infection status.

Rationale:
A. Initiate fibrinolytic therapy: Fibrinolytic therapy, such as tissue plasminogen activator (tPA), is most effective when administered within a 3- to 4.5-hour window from the onset of ischemic stroke symptoms. Early administration can dissolve the clot, restore cerebral blood flow, and improve neurological outcomes.

B. Place the client in a supine position: Clients with ischemic stroke are usually positioned with the head of the bed elevated 15–30 degrees unless contraindicated. Supine positioning can increase intracranial pressure and risk aspiration, which may worsen neurological status.

C. Prepare the client for a chest x-ray: A chest x-ray is not a priority in acute ischemic stroke management. Immediate neuroimaging, typically a CT scan, is required to differentiate ischemic from hemorrhagic stroke before initiating fibrinolytic therapy.

D. Insert an indwelling urinary catheter: Inserting a catheter is not indicated as an initial intervention for acute stroke unless the client is unable to void or requires strict output monitoring. Priority actions focus on neuroprotection and reperfusion therapy.