A nurse manager is receiving report and is faced with the following situations that require interventions. Which of the following should the nurse manager address first?

Explanation:

A. Report the infection to the local health department:

Reporting certain communicable diseases to local health departments is a crucial step in public health surveillance and control. However, reporting typically occurs at the healthcare facility or laboratory where the diagnosis is made, rather than by individual healthcare providers like nurses. While reporting chlamydia to the health department is important for tracking and managing the spread of the infection in the community, it is not the immediate responsibility of the nurse caring for the client with chlamydia.

B. Initiate contact precautions:

Contact precautions are measures taken to prevent the spread of infectious agents that are spread by direct or indirect contact with the client or their environment. Chlamydia is primarily transmitted through sexual contact and is not spread by casual contact or airborne transmission. Therefore, there is no indication for initiating contact precautions when caring for a client with chlamydia. Standard precautions, such as hand hygiene and appropriate use of personal protective equipment, are typically sufficient.

C. Instruct the client to use condoms until the treatment is complete:

When a client is diagnosed with chlamydia, it is essential to educate them about the importance of preventing the transmission of the infection to sexual partners and reducing the risk of reinfection. Instructing the client to use condoms consistently and correctly until the completion of treatment is a crucial step in preventing the spread of chlamydia. Condoms provide a barrier method of protection that can significantly reduce the risk of transmission of chlamydia and other sexually transmitted infections.

D. Apply an antiviral cream to the lesions:

Chlamydia does not typically cause visible lesions. It is caused by a bacterium, Chlamydia trachomatis, rather than a virus, so antiviral creams would not be effective in treating it. Chlamydia is treated with antibiotics, such as azithromycin or doxycycline, to eradicate the bacterial infection. Therefore, applying an antiviral cream would be an incorrect action and ineffective in treating chlamydia.

a. Store opened bottles of normal saline in a refrigerator for up to 48 hours:

Incorrect. Once opened, bottles of normal saline should generally be used within a short time frame (typically 24 hours) and should not be stored for extended periods to prevent contamination. This practice could lead to infection risks and is not recommended as a cost-containment measure.

b. Wait to dispose of sharps containers until they are completely full:

Incorrect. Overfilling sharps containers increases the risk of needle-stick injuries and potential exposure to bloodborne pathogens. Sharps containers should be disposed of when they are about three-quarters full to maintain safety.

c. Use clean gloves rather than sterile gloves for colostomy care:

Correct. For colostomy care, clean gloves are generally sufficient as it is a clean procedure, not a sterile one. Using clean gloves instead of sterile gloves reduces costs without compromising patient safety.

d. Return unused supplies from the bedside to the unit’s supply stock:

Incorrect. Returning unused supplies to the general supply stock can pose a risk of cross-contamination and infection. Once supplies have been brought to a patient's bedside, they are considered contaminated and should not be returned to the supply area.