A nurse is teaching a client about foods that are included on a clear liquid diet. Which of the following food choices made by the client indicates the need for further teaching?

A. Prime the blood tubing with dextrose 5% in water:
Priming the blood tubing with dextrose 5% in water is not appropriate for a blood transfusion. Blood tubing should be primed with normal saline, not dextrose solutions, to prevent hemolysis of the blood components.
B. Check vital signs before transfusion:
Before initiating a blood transfusion, it's essential to assess the client's vital signs, including temperature, pulse, respiratory rate, and blood pressure. Monitoring vital signs before, during, and after the transfusion helps identify any adverse reactions promptly.
C. Insert an IV with a 13-gauge needle:
Using a 13-gauge needle for IV insertion is not appropriate for a blood transfusion. Typically, a smaller gauge needle, such as 18 or 20 gauge, is used for venous access during a blood transfusion to minimize discomfort and reduce the risk of hemolysis.
D. Transfuse the blood product within 5 hr after removing it from refrigeration:
Blood products should be transfused within a specific timeframe after removal from refrigeration to minimize the risk of bacterial growth and subsequent infection. Typically, this timeframe is within 4 hours for packed red blood cells and within 24 hours for platelets. Adhering to the recommended timeframe ensures the safety and efficacy of the transfusion.
E. Check the expiration date of the blood product with a second nurse:
Verifying the expiration date of the blood product with a second nurse or healthcare provider is a crucial step to ensure patient safety and prevent the administration of expired blood products. This double-check process helps mitigate the risk of administering outdated or expired blood components.

A) Contact: While contact precautions are important for preventing the transmission of infections, they primarily apply to clients with known or suspected infections that can spread through direct or indirect contact with the client or their environment. Protective isolation goes beyond contact precautions and involves comprehensive measures to protect immunocompromised clients from all potential sources of infection.

B) Airborne: Airborne precautions are necessary for clients with infections that spread through the airborne route, such as tuberculosis or measles. While respiratory infections can pose a significant risk to immunocompromised clients, the focus of care for clients after hematopoietic stem-cell transplant is on preventing all types of infections, not just airborne ones.

C) Droplet: Droplet precautions are used for infections transmitted through respiratory droplets expelled when a person coughs, sneezes, or talks, such as influenza or pertussis. While respiratory infections are a concern for immunocompromised clients, the broader approach of protective isolation is more appropriate for clients after hematopoietic stem-cell transplant, as it encompasses all potential routes of infection transmission, not just droplet spread.

D) Protective: Clients who have undergone allogeneic hematopoietic stem-cell transplant are profoundly immunocompromised due to the destruction of their immune system and are highly susceptible to infections. Protective isolation, also known as reverse isolation, is necessary to minimize the risk of infection in these clients. This includes implementing strict infection control measures such as wearing gowns, gloves, masks, and sometimes goggles to prevent exposure to pathogens. Additionally, maintaining a clean environment and limiting visitors and healthcare personnel who may carry infectious agents are essential components of protective isolation.