What is an infectious disease that can be transmitted directly from one person to another?

Choice A reason: A 44yearold prescribed antibiotics for pneumonia is not at the greatest risk for pressure injury development, because he or she does not have any major risk factors for pressure injury. Pressure injury is a localized damage to the skin and underlying tissues caused by pressure, shear, friction, or moisture. Antibiotics for pneumonia do not directly affect the skin integrity or blood circulation, nor do they impair the mobility or sensation of the client.

Choice B reason: A 26yearold bedridden client with a fractured leg is at a high risk for pressure injury development, but not the greatest, because he or she has only one major risk factor for pressure injury. Bedridden status is a major risk factor for pressure injury, because it causes prolonged pressure on the bony prominences, such as the sacrum, heels, or hips, which can impair blood flow and oxygen delivery to the skin and tissues. However, the client's age, fracture, and mobility may mitigate some of the risk, as he or she may have better skin elasticity, wound healing, and ability to reposition.

Choice C reason: A 65yearold with hemiparesis and incontinence is at the greatest risk for pressure injury development, because he or she has multiple major risk factors for pressure injury. Age is a risk factor for pressure injury, because it causes decreased skin elasticity, thickness, and vascularity, which can affect the skin's resilience and repair. Hemiparesis is a risk factor for pressure injury, because it causes reduced mobility, sensation, and muscle mass, which can affect the client's ability to reposition, feel pain, and maintain tissue perfusion. Incontinence is a risk factor for pressure injury, because it causes moisture, irritation, and infection of the skin, which can weaken the skin barrier and delay wound healing.

Choice D reason: A 78yearold requiring assistance to ambulate with a walker is at a moderate risk for pressure injury development, but not the greatest, because he or she has only one major risk factor for pressure injury. Age is a risk factor for pressure injury, as explained above. However, the client's ambulation and assistance may reduce some of the risk, as he or she may have less pressure, shear, and friction on the skin and tissues, and more blood circulation and oxygen delivery.

Choice A reason: This is the highest risk client because surgery can cause trauma, blood loss, and infection, which can weaken the immune system and increase the susceptibility to complications. The immune system is the body's defense mechanism that protects against foreign invaders, such as bacteria, viruses, or fungi. Surgery can damage the skin and tissues, which are the first line of defense, and cause inflammation, which can impair the function of the white blood cells, which are the second line of defense. The nurse should monitor the client's vital signs, wound healing, and signs of infection and administer antibiotics, fluids, and pain medication as ordered.

Choice B reason: This is not the highest risk client, but it is a moderate risk client because extreme anxiety can cause stress, which can affect the immune system and increase the vulnerability to illness. Stress is the body's response to a perceived threat or challenge, which can activate the sympathetic nervous system and the hypothalamicpituitaryadrenal (HPA) axis. Stress can cause the release of hormones, such as cortisol and adrenaline, which can suppress the immune system and reduce the production and activity of the white blood cells. The nurse should assess the client's anxiety level and provide coping strategies, such as relaxation, breathing, or counseling.

Choice C reason: This is not the highest risk client, but it is a low risk client because awaiting surgery can cause anxiety, which can affect the immune system and increase the vulnerability to illness. However, the client's anxiety level may not be as high as the client with extreme anxiety, and the client's immune system may not be as compromised as the client who has just had surgery. The nurse should assess the client's anxiety level and provide education, reassurance, and support.

Choice D reason: This is not the highest risk client, but it is a low risk client because delivering a baby can cause blood loss, hormonal changes, and fatigue, which can affect the immune system and increase the risk of infection. However, the client's immune system may not be as compromised as the client who has just had surgery, and the client may have some protection from the antibodies that are passed from the mother to the baby through the placenta and breast milk. The nurse should monitor the client's vital signs, lochia, and signs of infection and provide hygiene, nutrition, and rest.