During a skin inspection at the outpatient clinic, the nurse notices patches of thick, red skin with silvery scales on the client's elbows and knees. What skin abnormality does the nurse suspect?

Choice A reason: Fowler's position is a semisitting position with the head of the bed elevated at 45 to 60 degrees. This position allows for maximum expansion of the chest and improves ventilation and oxygenation. It also reduces the work of breathing and prevents the abdominal organs from compressing the diaphragm.

Choice B reason: Sim's position is a sidelying position with the lower arm behind the back and the upper knee flexed. This position is used for patients who are unconscious, have difficulty swallowing, or are receiving an enema. It does not facilitate breathing or oxygenation for patients with COPD.

Choice C reason: Prone position is a lying position with the face down and the arms at the sides or bent at the elbows. This position is used for patients with acute respiratory distress syndrome (ARDS) or severe lung injury to improve oxygenation and reduce lung inflammation. It is not recommended for patients with COPD as it may increase the risk of aspiration, pressure ulcers, and nerve damage.

Choice D reason: Lateral position is a sidelying position with the upper leg slightly flexed and supported by a pillow. This position is used for patients who are resting or sleeping to prevent pressure ulcers and promote comfort. It does not improve breathing or oxygenation for patients with COPD.

Choice A reason: Properly disposing of contaminated equipment is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Contaminated equipment, such as gloves, gowns, masks, or needles, should be disposed of in designated containers or bags to prevent exposure or injury to others. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.

Choice B reason: Discarding used syringes into appropriate containers is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Used syringes, especially those that contain blood or body fluids, should be discarded into punctureresistant, leakproof, and labeled containers to prevent needlestick injuries or exposure to others. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.

Choice C reason: Changing soiled linens is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Soiled linens, especially those that contain blood or body fluids, should be changed and handled with gloves and minimal agitation to prevent contamination or aerosolization of pathogens. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.

Choice D reason: Performing hand hygiene is the most effective way to prevent the spread of pathogens during client care, because it reduces the number of microorganisms on the hands of the health care worker, which are the most common source and mode of transmission of infection. Hand hygiene should be performed before and after contact with the client, after contact with potentially infectious materials, after removing gloves, and before and after performing invasive procedures. Hand hygiene can be performed by washing with soap and water or using alcoholbased hand rubs.