A patient has been put on Contact Precautions. The patient’s family is extremely apprehensive about visiting due to fear of being “contaminated” by the patient. What is the best course of action for the nurse?
Clarify that these precautions are mandated by law.
Emphasize the importance of their visit to the patient.
Assure the family that they will not contract the infection.
Demonstrate to the family how to prevent the spread of the disease.
The Correct Answer is D
Choice A: Clarify that these precautions are mandated by law.
While it's important to acknowledge the legal requirements for Contact Precautions, this approach alone may not adequately address the family's emotional concerns and fears. It could potentially increase their anxiety if they feel forced to visit without understanding the reasons behind the precautions.
Choice B: Emphasize the importance of their visit to the patient.
While family support is crucial for the patient's well-being, emphasizing the importance of their visit without addressing their fears could inadvertently pressure them to visit without feeling comfortable or confident in their ability to protect themselves.
Choice C: Assure the family that they will not contract the infection.
It's not always possible to guarantee that the family won't contract the infection. Making such assurances could create a false sense of security and potentially lead to lapses in infection control practices.
Choice D: Demonstrate to the family how to prevent the spread of the disease.
Empowering the family through education and demonstration is the most effective approach. It addresses their concerns directly, promotes understanding, and instills confidence in their ability to protect themselves while visiting.
Key elements of this demonstration include:
Proper hand hygiene techniques
Use of personal protective equipment (PPE) such as gloves and gowns Safe handling of potentially contaminated items
Maintaining a safe distance from the patient when appropriate Understanding the modes of transmission for the specific disease
By providing clear guidance and allowing for practice, the nurse can help the family feel more comfortable and confident in their ability to visit safely.
Additional considerations:
Addressing the family's emotional concerns: Acknowledge their fears and provide reassurance in a compassionate and understanding manner.
Tailoring education to the family's level of understanding: Use simple language and visual aids as needed.
Encouraging questions and open communication: Create a supportive environment where the family feels comfortable asking questions and expressing their concerns.
Collaborating with other healthcare professionals: Involve infection control specialists or other relevant team members to provide additional support and expertise.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Incorrect. Deep-breathing exercises could potentially worsen stridor. Stridor is a high-pitched, wheezing sound caused by a partial obstruction of the upper airway. Deep breathing can increase airflow through the narrowed airway, making the stridor more pronounced and potentially worsening the obstruction. In severe cases, it could lead to complete airway obstruction and respiratory distress.
Risk of aggravation: Deep-breathing exercises could aggravate the underlying cause of stridor, such as laryngeal edema or vocal cord dysfunction, by increasing inflammation or muscle tension in the airway.
Delay in definitive treatment: Focusing on deep-breathing exercises might delay more definitive interventions, such as intubation, which might be necessary to secure the airway and prevent respiratory failure.
Choice B rationale:
Incorrect. While albuterol nebulizer therapy can be helpful for bronchospasm, it is not the first-line treatment for stridor. Stridor is typically caused by an upper airway obstruction, and albuterol primarily targets the lower airways (bronchioles).
Limited effectiveness: Albuterol might not be effective in reducing stridor caused by upper airway obstruction, as it does not directly address the narrowing of the airway.
Potential for adverse effects: Albuterol can cause tachycardia, tremors, and anxiety, which could further complicate the patient's condition.
Choice C rationale:
Not the most immediate action. While calling a Rapid Response might be necessary if the patient's condition deteriorates, the first priority is to secure the airway and ensure adequate ventilation.
Time-consuming: Activating a Rapid Response team can take several minutes, and the patient's condition might not allow for that delay.
Choice D rationale:
Prioritizes airway management: Intubation is the most effective way to secure the airway and ensure adequate ventilation in a patient with stridor. It bypasses the obstruction and allows for controlled delivery of oxygen and ventilation.
Addresses potential for deterioration: Stridor can rapidly progress to complete airway obstruction, so prompt preparation for intubation is crucial to prevent respiratory failure.
Involves the primary healthcare provider: Consulting the primary health care provider ensures timely decision-making, appropriate medication administration (such as sedatives or paralytics for intubation), and coordination of care.
Correct Answer is C
Explanation
Choice A rationale:
Uncompensated Respiratory Acidosis is characterized by a low pH (less than 7.35) and a high pCO2 (greater than 45 mmHg). In this case, the pH is slightly elevated (7.46), making this option less likely.
While the pCO2 is elevated (46 mmHg), the body has begun to compensate, as evidenced by the elevated HCO3 (29 mEq/L). This partial compensation does not align with an uncompensated respiratory acidosis.
Choice B rationale:
Compensated Metabolic Acidosis would present with a normal pH (7.35-7.45) due to full compensation by the respiratory system. In this case, the pH is slightly elevated (7.46), which is not consistent with full compensation.
Additionally, the HCO3 is elevated (29 mEq/L), which is characteristic of metabolic alkalosis, not acidosis.
Choice C rationale:
Partially Compensated Metabolic Alkalosis is the most likely interpretation based on the ABG results. The pH is elevated (7.46), indicating alkalosis.
The HCO3 is also elevated (29 mEq/L), which is the primary cause of metabolic alkalosis.
The pCO2 is elevated (46 mmHg), which is a compensatory mechanism to try to normalize the pH. However, the compensation is not complete, as the pH is still slightly elevated.
This partial compensation is consistent with partially compensated metabolic alkalosis.
Choice D rationale:
Partially Compensated Respiratory Acidosis would present with a low pH (less than 7.35) and an elevated pCO2 (greater than 45 mmHg).
The HCO3 would also be elevated, but to a lesser degree than in metabolic alkalosis, as it's a secondary compensatory mechanism.
In this case, the pH is slightly elevated (7.46), making respiratory acidosis less likely.
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