A parish nurse is counseling a family following a client's recent diagnosis of heart disease. Which of the following actions should the nurse take first?

Choice A reason: Koplik spots are small, white, bluish-gray spots that appear on the inner cheeks, gums, or roof of the mouth before the rash develops. They are a characteristic sign of measles and can help to distinguish it from other viral infections.

Choice B reason: Persistent low-grade temperature is not a finding that the nurse should expect in a client who has measles. Measles typically causes a high fever that can reach up to 40°C (104°F) and lasts for four to seven days. The fever may spike when the rash appears and subside when the rash fades.

Choice C reason: Muscle aches and tenderness are not findings that the nurse should expect in a client who has measles. Measles mainly affects the respiratory system and the skin, and does not cause significant muscle involvement. The client may experience fatigue, weakness, or malaise, but not muscle pain or soreness.

Choice D reason: Rash confined to the trunk of the body is not a finding that the nurse should expect in a client who has measles. Measles causes a red, blotchy rash that usually starts on the face and spreads to the rest of the body, including the arms, legs, and feet. The rash may last for up to a week and may cause itching or peeling of the skin.

Choice A reason: You should avoid sexual contact until therapy is complete. This is to prevent the transmission of the infection to others, and to avoid reinfection or complications. The usual treatment for chlamydia is a single dose of an antibiotic, such as azithromycin or doxycycline. You should abstain from sexual activity for at least 7 days after taking the medication.

Choice B reason: Notify anyone with whom you have had sexual contact over the past 2 months. This is to inform them of their possible exposure to the infection, and to encourage them to get tested and treated if necessary. Chlamydia is a sexually transmitted infection that can cause pelvic inflammatory disease, infertility, ectopic pregnancy, and neonatal complications. It can also increase the risk of acquiring or transmitting other STIs, such as HIV.

Choice C reason: You will need to take an antiviral medication for 30 days. This is not a correct information that the nurse should include in the teaching. Chlamydia is a bacterial infection, not a viral infection. Antiviral medications are not effective against chlamydia, and are not indicated for its treatment.

Choice D reason: Once you complete treatment, you will have an acquired immunity against chlamydia. This is not a correct information that the nurse should include in the teaching. Chlamydia does not confer immunity, and you can get infected again if you are exposed to the bacteria. You should get tested for chlamydia at least once a year, or more often if you have multiple or new sexual partners.

Choice E reason: You might experience painful urination until the infection has resolved. This is a correct information that the nurse should include in the teaching. Chlamydia can cause inflammation and irritation of the urethra, which can result in dysuria, or painful or difficult urination. Other symptoms of chlamydia may include abnormal vaginal or penile discharge, lower abdominal pain, bleeding between periods, or pain during sex. However, some people may not have any symptoms, and may not know they are infected. Therefore, it is important to get tested regularly and to use condoms to prevent the spread of the infection.