A nurse is teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle? (Select All that Apply)

A. Functional incontinence: Functional incontinence occurs when a person has difficulty reaching the toilet due to physical or cognitive impairments, such as mobility issues or dementia. Kegel exercises, which focus on strengthening the pelvic floor muscles, would not directly address the underlying causes of functional incontinence.

B. Stress incontinence: Stress incontinence is characterized by the involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, laughing, or exercising. Kegel exercises are specifically designed to strengthen the pelvic floor muscles, which can help support the bladder and reduce the occurrence of stress incontinence.

C. Urinary retention: Urinary retention refers to the inability to empty the bladder completely. While Kegel exercises may help improve bladder control, they are not typically used to address urinary retention, which often requires other interventions such as medications, catheterization, or surgery.

D. Fecal incontinence: Fecal incontinence involves the involuntary leakage of stool. Kegel exercises are not effective for addressing fecal incontinence, as they primarily target the pelvic floor muscles involved in urinary control, not bowel control. Treatment for fecal incontinence may include dietary modifications, medications, pelvic floor rehabilitation, or surgical interventions, depending on the underlying cause.

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.