A nurse is reviewing the medical record for a client who is at 38 weeks of gestation, tested positive for group B streptococcus B-hemolytic, and is allergic to penicillin. The nurse should identify that which of the following medications is contraindicated for this client?

Answer: (D) Refrigerate the specimen until the time of transport to the laboratory

Rationale:

A) Collect 2 ml of sputum in an emesis basin: While it is important to collect an adequate volume of sputum, using an emesis basin is inappropriate for collecting a specimen for culture and sensitivity. Sputum must be collected in a sterile container to avoid contamination, ensuring the accuracy of the culture results.

B) Instruct the client to rinse with an antiseptic mouthwash prior to specimen collection: Using an antiseptic mouthwash before collecting a sputum specimen is not recommended, as it could contaminate the sample with antiseptic agents, potentially affecting the growth of microorganisms in the culture. The client should rinse with plain water instead.

C) Swab the oropharynx with a sterile swab: Swabbing the oropharynx is more appropriate for collecting a throat culture rather than a sputum specimen. Sputum collection requires the client to expectorate mucus from the lower respiratory tract, not from the oropharynx, to obtain an accurate sample for culture and sensitivity.

D) Refrigerate the specimen until the time of transport to the laboratory: Refrigerating the sputum specimen is crucial to preserve the integrity of the sample and inhibit the growth of contaminants before it is transported to the laboratory. This action helps ensure that the results of the culture and sensitivity test are accurate.

d. Increased joint stiffness due to loss of elasticity in joint cartilage.

Explanation:

The correct answer is d. Increased joint stiffness due to loss of elasticity in joint cartilage.

When teaching an older adult client about age-related changes, it is important for the nurse to provide accurate and relevant information. Joint stiffness is a commonly experienced age-related change that occurs due to the natural loss of elasticity in joint cartilage. As people age, their joints may become stiffer and less flexible, making movements and activities more challenging.

Option a is not the correct answer. Increased nail growth due to the buildup of calcium deposits is not an expected age-related change. Nail growth is primarily determined by factors such as genetics, overall health, and nutritional status, rather than calcium deposits.

Option b is not the correct answer. Increased perspiration due to overproduction by the sweat glands is not an expected age-related change. In fact, older adults may experience a decrease in the production of sweat, which can make them more susceptible to heat-related illnesses and dehydration.

Option c is not the correct answer. Increased cardiac output due to weakened heart walls is not an expected age-related change. With aging, the heart muscles may become stiffer and less efficient, leading to a decrease in cardiac output rather than an increase.

By focusing on the expected age-related change of increased joint stiffness due to loss of elasticity in joint cartilage, the nurse can provide accurate information and help the older adult client understand and manage this common aspect of the aging process.