Nurse Jordan, a seasoned member of the team, has been openly belittled by Nurse Taylor, a newer nurse. During handoffs, Nurse Taylor makes sarcastic remarks about Nurse Jordan's decisions, saying, "I can't believe you thought that was the right approach." This behavior creates a tense atmosphere and affects team dynamics. What type of behavior is Nurse Taylor exhibiting in this scenario?

A. Self-administer prescribed antibiotics on time and don't skip doses: This statement is not applicable for viral pharyngitis, as antibiotics are ineffective against viral infections. Teaching should clarify that antibiotics are only prescribed for bacterial infections. Therefore, this information should not be included in the teaching plan for viral pharyngitis.
B. Contact HCP promptly for drooling or inability to fully open mouth: This is an important teaching point, as these symptoms may indicate a severe throat infection or complications that require immediate medical attention. Prompt contact with the healthcare provider is essential for any signs of difficulty in swallowing or mouth opening, which may suggest a need for further evaluation and treatment.
C. Drink at least 2-3 liters of fluid/day unless contraindicated: Encouraging adequate hydration is critical for clients with viral pharyngitis, as it helps soothe the throat, thin mucus, and prevent dehydration. This recommendation is appropriate and should be included in the teaching plan, ensuring students understand the importance of hydration in managing symptoms.
D. Do not share beverage cups or food utensils with other individuals: This is a vital precaution to prevent the spread of the viral infection to others. Educating clients on the importance of hygiene and avoiding sharing personal items can help limit transmission and protect others from becoming infected.
E. Inspect body for skin rash development twice per day: While it is important to monitor for any unusual symptoms, this specific action may not be necessary for viral pharyngitis unless there are other clinical indicators that suggest a possible rash. Viral pharyngitis typically does not warrant routine skin inspections for rash development, making this point less relevant in the context of the teaching plan.

• Clostridium difficile infection is likely because the client has pneumonia and is receiving ceftriaxone, an antibiotic known to disrupt gut flora and cause opportunistic infections like C. difficile. The presence of frequent, liquid, foul-smelling stools further supports this diagnosis.
• Myocardial infarction is unlikely because while the client has chest pain, it is pleuritic and related to inspiration rather than the typical crushing, non-pleuritic chest pain seen in an MI. There is no mention of radiating pain, diaphoresis, or hemodynamic instability.
• Pulmonary edema is unlikely since it typically presents with dyspnea, crackles throughout the lung fields, pink frothy sputum, and signs of fluid overload such as peripheral edema and weight gain. The client’s symptoms do not align with this condition.
• Pulmonary embolism is also unlikely, as it presents with sudden-onset dyspnea, pleuritic chest pain, tachycardia, and often calf swelling or a history of deep vein thrombosis. The client lacks the risk factors and clinical signs of PE.
• Placing the client on contact precautions is necessary because C. difficile is highly contagious and spreads through the fecal-oral route. Gloves and gowns should be used to prevent transmission.
• Obtaining a stool culture is necessary to confirm the presence of C. difficile toxins in the stool, which is essential for accurate diagnosis and treatment.
• Requesting a prescription for an anticoagulant is not necessary because the client does not show any signs of thromboembolic disease such as deep vein thrombosis or pulmonary embolism. Anticoagulation could increase the risk of bleeding in the gastrointestinal tract, which would worsen the diarrhea.
• Requesting a prescription for a diuretic is not needed because the client is more likely to be dehydrated due to diarrhea. Diuretics would exacerbate fluid loss and electrolyte imbalances.
• Restricting fluids is not appropriate because dehydration is a major concern with C. difficile infection. Instead, fluid intake should be encouraged to prevent complications from excessive fluid loss.
• Level of consciousness should be monitored because severe dehydration and electrolyte imbalances can lead to confusion, weakness, and altered mental status. While altered mental status can occur with severe dehydration or sepsis, it is not the primary concern at this stage.
• Potassium level should be monitored because diarrhea can cause significant potassium loss, leading to hypokalemia, which can result in muscle weakness, cardiac arrhythmias, and fatigue.
• Urine output is not the most specific parameter for monitoring C. difficile infection. While dehydration is a concern, tracking electrolyte levels and neurological status is more critical.
• Calf swelling is not relevant since the client does not have signs or risk factors for deep vein thrombosis or pulmonary embolism.
• Weight: C. difficile infection can cause significant fluid loss due to persistent diarrhea, leading to dehydration and weight loss. Tracking daily weight helps assess hydration status and the effectiveness of fluid replacement therapy.