A nurse is reinforcing teaching about activities of daily living with a client who had a stroke. Which of the following statements should the nurse include?

Rationale:

A. Erythema toxicum: This is a common and benign rash seen in newborns. It is not infectious, poses no public health risk, and does not require mandatory reporting.

B. Bacterial vaginosis: Although it is a vaginal infection, bacterial vaginosis is not classified as a reportable condition. It does not pose the same level of public health concern as sexually transmitted infections like gonorrhea.

C. Molluscum contagiosum: Molluscum contagiosum is a viral skin infection that is generally self-limiting and not considered a reportable disease. It does not require public health intervention in most cases.

D. Gonorrhea: Gonorrhea is a nationally notifiable disease in many countries, including the United States, due to its infectious nature and potential for serious complications. Public health reporting is required to track, treat, and prevent its spread.

Rationale:

• Ask the client for a list of close contacts: The client exhibits classic symptoms of active tuberculosis (TB), including weight loss, night sweats, hemoptysis (bloody cough), and chest tightness. Identifying close contacts is crucial for contact tracing and limiting disease spread.
• Obtain a sputum culture: A sputum culture is essential for diagnosing pulmonary TB. This test confirms the presence of Mycobacterium tuberculosis and guides further treatment decisions.
• Place the client in a negative-pressure room: Clients suspected of having TB should be placed in a negative-pressure isolation room to prevent airborne transmission to others, especially in healthcare settings.
• Use airborne precautions: Airborne precautions, including the use of an N95 respirator, are required for suspected or confirmed TB due to its airborne transmission risk.
• Obtain blood cultures: Blood cultures are not the priority in TB diagnosis unless sepsis is suspected. TB is primarily diagnosed through respiratory samples, not blood.
• Recommend ABGs be drawn: Arterial blood gases (ABGs) are typically unnecessary in TB unless there is respiratory compromise requiring ventilatory support or oxygenation monitoring, which is not indicated here.
• Request a glucocorticoid prescription from the provider: Glucocorticoids are not standard treatment for TB and may suppress immune response. They may be used in specific TB complications like meningitis or pericarditis, but not in general pulmonary TB management.