A student nurse is helping with the care of a client receiving an IV heparin infusion.
Which medication should be readily available in case of a heparin overdose?

Choice A rationale

Applying cold packs, or cryotherapy, is primarily indicated for acute soft tissue injuries to induce vasoconstriction, thereby decreasing local blood flow, metabolism, and inflammation, which reduces pain and swelling. For chronic or recurring lower back pain prevention, heat is often more effective, as it promotes vasodilation, increasing blood flow to relax muscles and reduce stiffness, making cold less suitable as a frequent preventative strategy.

Choice B rationale

Prolonged static postures, like sitting, increase intradiscal pressure and muscle tension in the lumbar region, leading to muscle fatigue and reduced blood flow to the supporting structures, which exacerbates back pain. Regular movement and changing positions is crucial to maintain flexibility, promote circulation, and distribute mechanical stress across different structures, minimizing sustained strain on the spinal ligaments and discs.

Choice C rationale

Sleeping on a mattress that is too soft fails to provide adequate support for the spine's natural curvature (lumbar lordosis), allowing the trunk to sink, which can lead to spinal misalignment and increased strain on the back muscles and ligaments. A medium-firm mattress is generally recommended to maintain proper spinal alignment during sleep, which reduces mechanical stress and prevents morning stiffness and pain.

Choice D rationale

Asking for help when moving clients ensures the nurse can use proper body mechanics, which involves keeping the load close to the body, maintaining a wide base of support, and lifting with the legs, not the back. This principle minimizes the mechanical stress and sheer forces applied to the intervertebral discs and paraspinal muscles, significantly lowering the risk of acute muscle strains or chronic cumulative trauma to the lumbar spine.

Choice E rationale

Partial sit-ups with the knees bent strengthen the abdominal and oblique muscles, which are key components of the body's core musculature. A strong core acts as a stabilizer for the lumbar spine, increasing intra-abdominal pressure to support the vertebral column and reducing the load and mechanical strain on the lower back structures during movement and daily activities, thereby preventing injury recurrence.

Choice A rationale

While Chlamydia trachomatis infection, if untreated or recurrent, can ascend to the upper reproductive tract, causing pelvic inflammatory disease (PID), which can lead to scarring of the fallopian tubes, infertility is not an absolute certainty. Prompt and effective antibiotic treatment significantly reduces this risk. This statement is overly pessimistic and may cause unnecessary anxiety, as future pregnancy remains possible for many.

Choice B rationale

Chlamydia treatment usually involves a single dose or a 7-day course of antibiotics (e.g., azithromycin or doxycycline). Resuming sexual activity prematurely, even if symptoms improve, risks re-infection and transmission to partners. The client should abstain from sexual activity for 7 days after a single dose of azithromycin or until completion of a 7-day course, and until all partners are treated, to ensure eradication of the bacterium.

Choice C rationale

Chlamydia trachomatis is a bacterium that is effectively cured and eliminated from the body with appropriate antibiotic therapy. It does not become truly dormant like a virus (e.g., Herpes Simplex Virus) or a parasite. Any recurrence or future presence of the bacteria indicates a new infection or re-infection from an untreated partner, not reactivation of a dormant state.

Choice D rationale

Chlamydia is a reportable sexually transmitted infection (STI). The client's sexual partner(s) in the preceding 60 days must be evaluated, tested, and empirically treated to prevent re-infection of the client (the "ping-pong" effect) and to limit the spread of the infection within the community, thereby interrupting the transmission cycle. This is a critical public health measure.