The nurse is providing care to a client having surgery to repair a retinal detachment to the left eye. Which intervention should the nurse implement during the postoperative period?

The clinical scenario involves postoperative management of a surgical site in a patient colonized with methicillin-resistant Staphylococcus aureus. Successful intervention requires applying principles of wound hygiene, bacterial proliferation kinetics, and aseptic technique to mitigate localized moisture which fosters rapid staphylococcal replication and subsequent infection.

Choice A rationale: Elevated white blood cell counts, typically exceeding 11,000 mm3, indicate a systemic inflammatory response or active infection. While monitoring hematologic data is essential for detection, it is a reactive measure rather than a proactive intervention to prevent localized MRSA recurrence.

Choice B rationale: Contact precautions prevent the horizontal transmission of resistant pathogens between the patient and others. While vital for institutional infection control and public health safety, these measures do not directly address the localized physiological environment of the patient's own surgical incision.

Choice C rationale: Saturated dressings create a warm, moist environment that facilitates capillary action, pulling contaminants into the wound. Maintaining a dry, sterile environment inhibits the colonization of methicillin-resistant Staphylococcus aureus, as moisture promotes the rapid exponential growth of these resistant gram-positive cocci.

Choice D rationale: Face masks primarily provide protection against respiratory droplet transmission. While beneficial for preventing the introduction of oropharyngeal flora into a sterile field, they are less critical than moisture control for preventing MRSA recurrence, which is primarily spread through direct or indirect contact.

The correct answer is: C. Experiences facial swelling after eating crab.

Choice A Reason: Drinking a glass of water in the past 2 hours is not typically a concern unless the patient has been instructed to fast. For most cardiac catheterization procedures, patients are asked to fast for a certain period before the procedure to reduce the risk of aspiration. However, small sips of water may be allowed with medications.

Choice B Reason: While reports of left chest wall pain are clinically significant and warrant investigation, they are not as immediately concerning for the angioplasty procedure itself. Chest pain is a symptom that may have led to the decision to perform angioplasty but does not pose an immediate risk of complication during the procedure as an allergy might.

Choice C Reason: As previously mentioned, experiencing facial swelling after eating crab is indicative of a shellfish allergy. This is important because the contrast dye used in angioplasty may contain iodine, and patients with shellfish allergies could have an increased risk of an allergic reaction to the iodine in the dye. It is essential to explore this further to take necessary precautions, such as premedication with antihistamines or using a different contrast agent.

Choice D Reason: Verbalizing a fear of being in a confined space, or claustrophobia, is a psychological concern that should be addressed to ensure the patient’s comfort during the procedure. However, it does not pose a direct risk to the safety of the angioplasty procedure like an allergic reaction does. Managing patient anxiety is important, but it is not the most critical factor to explore prior to the procedure.