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What is the best goal for pain control in a client with rheumatoid arthritis?

Choice A reason: Flushing the exposed skin with water is the first action that the nurse should take if they are stuck by a needle. This is to reduce the amount of blood or body fluid that may have entered the wound and to prevent infection. The nurse should flush the skin for at least 15 minutes and avoid using soap, antiseptic, or bleach as they may damage the skin or increase the risk of infection.

Choice B reason: Reporting the exposure is the second action that the nurse should take after flushing the exposed skin with water. This is to inform the supervisor, the occupational health department, or the infection control team about the incident and to initiate the postexposure protocol. The nurse should provide the details of the exposure, such as the type and source of the needle, the depth and location of the wound, and the status of the source patient.

Choice C reason: Seeking medical attention is the third action that the nurse should take after reporting the exposure. This is to receive a medical evaluation and treatment, such as testing, prophylaxis, counseling, and followup. The nurse should consult a health care provider as soon as possible and follow the recommendations for preventing or treating any potential infections, such as hepatitis B, hepatitis C, or HIV.

Choice D reason: Completing an incident report is the last action that the nurse should take after seeking medical attention. This is to document the exposure and the actions taken and to identify the causes and the preventive measures for the future. The nurse should fill out the incident report form accurately and objectively and submit it to the appropriate authority. The incident report is not a part of the client's record and should not be mentioned in the client's chart.

Choice A reason: Cleansing the skin around the pins is the action that the nurse takes first, because it is the most urgent and relevant action. Cleansing the skin around the pins is a procedure that involves removing any dirt, debris, or secretions from the pin sites, which can help prevent or treat infection, inflammation, or pain. Cleansing the skin around the pins is a priority intervention, as it can reduce the risk of complications, such as osteomyelitis, sepsis, or pin loosening.

Choice B reason: Collecting a culture of the purulent fluid is not the action that the nurse takes first, because it is not the most urgent and relevant action. Collecting a culture of the purulent fluid is a procedure that involves obtaining a sample of the pus from the pin sites and sending it to the laboratory for analysis, which can help identify the type and source of infection. Collecting a culture of the purulent fluid is an important intervention, but it should be done after cleansing the skin around the pins, and with a medical order and a sterile technique.

Choice C reason: Administering an antibiotic is not the action that the nurse takes first, because it is not the most urgent and relevant action. Administering an antibiotic is a procedure that involves giving the client an antimicrobial agent, which can help fight or prevent infection. Administering an antibiotic is an important intervention, but it should be done after cleansing the skin around the pins, and with a medical order and a proper route.

Choice D reason: Instructing the client to complete exercises of the affected extremity is not the action that the nurse takes first, because it is not the most urgent and relevant action. Instructing the client to complete exercises of the affected extremity is a procedure that involves teaching the client how to move and strengthen the muscles and joints of the limb in traction, which can help prevent or treat atrophy, contracture, or thrombosis. Instructing the client to complete exercises of the affected extremity is an important intervention, but it should be done after cleansing the skin around the pins, and with a medical order and a safe technique.