Immediately after log-rolling a client to a lateral position, which intervention should the practical nurse (PN) implement?

Choice A rationale:

Increasing the supplemental oxygen to 15 L/min via nasal cannula may seem like a logical step given the client’s low oxygen saturation. However, it’s important to note that oxygen therapy should be titrated carefully. Too much oxygen can lead to oxygen toxicity, which can cause cellular damage and worsen the client’s condition. Therefore, this is not the priority action.

Choice B rationale:

Notifying the health care provider of the client’s condition is the priority action. The client’s oxygen saturation is 88% on room air, which is below the normal range of 95% to 100%. This indicates that the client is not getting enough oxygen, which can lead to hypoxia and other serious complications. The health care provider needs to be informed immediately so that appropriate interventions can be initiated.

Choice C rationale:

Administering ibuprofen as ordered for fever is important, but it’s not the priority in this situation. While fever can indicate an infection, which could be contributing to the client’s low oxygen saturation, addressing the immediate issue of hypoxia is more critical.

Choice D rationale:

Obtaining a sputum culture from the client could provide valuable information about the type of bacteria causing the pneumonia and guide antibiotic therapy. However, this is not an immediate priority compared to addressing the client’s low oxygen saturation. In summary, while all these actions are important in caring for a client with pneumonia, the nurse must prioritize interventions based on their urgency and potential impact on the client’s health status. In this case, notifying the health care provider of the client’s condition is the most critical action.

Choice A rationale:

Nosocomial transmission in the medical area. Rationale: Nosocomial transmission refers to infections that are acquired in healthcare settings. While it's essential for healthcare professionals to be aware of this risk, the client's presentation of diarrhea in a hurricane disaster area is more likely due to environmental factors rather than hospital-acquired infection.

Choice B rationale:

Food contamination from floodwaters. Rationale: In the aftermath of a hurricane, floodwaters can carry contaminants and pathogens, leading to food contamination. This is a significant concern, and the nurse should educate the client about the potential risks associated with consuming food exposed to floodwaters. However, the primary source of contamination for diarrhea is typically waterborne pathogens, which is addressed in choice C.

Choice C rationale:

Drinking water contaminated by sewage. Rationale: During natural disasters like hurricanes, sewage systems can become compromised, leading to the contamination of drinking water sources. This contamination poses a significant risk for diarrheal illnesses, as sewage often contains harmful pathogens. Therefore, the nurse should consider this as the most probable source of the client's exposure.

Choice D rationale:

Close living quarters at evacuation centers. Rationale: Close living quarters in evacuation centers can contribute to the spread of infectious diseases, including diarrheal illnesses. However, in this scenario, the client's chief complaint is diarrhea, and the nurse should prioritize investigating potential sources of waterborne contamination, as this aligns more closely with the client's symptoms.