A nurse working in the emergency department is admitting a client who has pertussis. Which of the following actions should the nurse take?

Choice A reason: Thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland. While there are risks associated with any surgery, thyroidectomy is not typically associated with fat embolism syndrome (FES). FES is more commonly linked to orthopedic procedures and trauma, particularly those involving long bones.

Choice B reason: Internal fixation of a fractured hip is a procedure that carries a risk for developing FES. FES is a serious and potentially life-threatening condition that occurs when fat globules enter the bloodstream and lodge within the blood vessels of the lungs or other organs. Hip fractures, especially those involving the long bones, can result in the release of fat globules into the bloodstream during the surgical repair process. Early surgical fixation is thought to reduce the risk of FES.

Choice C reason: Repair of a torn rotator cuff involves the shoulder joint and, while it is a significant surgical procedure, it is not typically associated with a high risk of FES. The rotator cuff is composed of muscles and tendons, and its repair does not usually involve manipulation of the long bones where fat embolism is more likely to occur.

Choice D reason: Tympanoplasty is a surgical procedure to repair a hole in the eardrum. It is an otologic procedure that does not involve the long bones or orthopedic manipulation. Therefore, it is not associated with a risk of developing FES.

Choice A reason: The Mantoux skin test, also known as the tuberculin skin test, measures the immune response to the tuberculin purified protein derivative injected into the skin. An induration of less than 1 mm is not considered a positive result. However, the size of the induration in the Mantoux test does not indicate whether the person is infectious or not.

Choice B reason: Negative sputum cultures for acid-fast bacillus (AFB) are a strong indication that the client is no longer infectious. Pulmonary tuberculosis is diagnosed and monitored by the presence of AFB in the sputum. When the sputum cultures are negative, it suggests that the client is not excreting the bacteria and is less likely to spread the infection to others.

Choice C reason: While no longer coughing up blood-tinged sputum is a sign of clinical improvement, it does not necessarily mean that the client is no longer infectious. The absence of blood in the sputum may indicate reduced inflammation or healing of lung tissue, but the client could still be capable of transmitting tuberculosis if AFB is present in the sputum.

Choice D reason: The Quantiferon-TB Gold test is a blood test that measures the immune response to Mycobacterium tuberculosis antigens. A positive result indicates that the person's immune system has been exposed to the bacteria, but it does not determine if the person is infectious. The term "positive (negative)" is contradictory and does not provide clear information about the client's infectious status.