Chapter 24 PrepU

A pediatric client's caregiver states, "I will never give my child vaccinations." What is the priority nursing response? "Vaccinations prevent disease." "Has your child received any previous vaccinations?" "Transmission of certain diseases is halted with vaccination." "Help me understand your thoughts about vaccinations."

"Help me understand your thoughts about vaccinations." Seeking to understand the caregiver's perspective helps the nurse to collect assessment data and create a therapeutic relationship of trust. The nurse could then collect assessment data regarding past vaccines and provide appropriate teaching.

A client admitted for fever, crackles in the lungs, and cough asks the nurse, "If they do not know what type of bacteria caused my pneumonia, why are they giving me these antibiotics?" What is the appropriate response by the nurse? "We give antibiotics to treat the virus that are causing your the pneumonia." "The antibiotics we are giving you will boost your immune system and help fight off whatever pathogen is present." "We are giving you broad spectrum antibiotics because they are active for many types of bacteria." "You cannot be admitted to the hospital with pneumonia without receiving some sort of antibiotics."

"We are giving you broad spectrum antibiotics because they are active for many types of bacteria." Many bacteria are susceptible to broad-spectrum antibiotics and prior to the diagnosis of a specific bacteria, a broad-spectrum antibiotic will be prescribed to help eradicate the present bacteria until a culture result is returned. A client may be admitted to the hospital with pneumonia without receiving antibiotics, although it is likely that an antibiotic will be given at some point during hospitalization. Antibiotics do not boost the immune system and may destroy normal healthy flora. Antibiotics are used to treat bacterial infections, not viral infections; antibiotics do not kill viruses.

A client is being screened for a parasitic infection and the health care provider orders stool specimens. When explaining to the client about collecting the specimens, the nurse would inform the client that the specimens will be collected daily for: 5 days. 2 days. 4 days. 3 days.

3 days. Usually when a client is being screened for a parasitic infection, stool specimens are collected daily for 3 days. Parasites lay eggs in the GI tract that can be detected on examination. Moving organisms can easily be detected in fresh specimens.

An older adult client is admitted into the hospital due to tuberculosis. In addition to standard precautions, which transmission-based precautions should the nurse initiate? Fomite Airborne Contact Droplet

Airborne The nurse should implement airborne precautions for clients who have infections that spread through the air such as tuberculosis, varicella (chicken pox), and rubeola (measles). Droplet precautions should be used for clients with an infection that is spread by large-particle droplets such as rubella, mumps, diphtheria, and the adenovirus infection in infants and young children. Contact precautions should be used for clients who are infected or colonized by a multidrug-resistant organism (MDRO).

The nurse is preparing to help mobilize a client with an abdominal wound that is colonized by methicillin-resistant Staphylococcus aureus (MRSA). Which of the shown actions should the nurse perform before assisting the client?

Drug-resistant wounds normally require contact precautions. This necessitates the use of gloves and a gown but not a mask, goggles, or face shield.

Upon review of a client's microbiology culture results, the nurse recognizes which organism as indicative of normal flora? Escherichia coli in the intestinal tract Shigella in the intestinal tract Escherichia coli in the urinary tract Shigella in the urinary tract

Escherichia coli in the intestinal tract Escherichia coli resides in the intestinal tract, is normal flora, and does not cause harm or infection in the client. Shigellosis is an infectious disease caused by a group of bacteria called Shigella, closely related to E. coli. Most people who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria.

The client is concerned about "catching the flu." What primary information can the nurse teach the client to best prevent the spread of infection? Avoid crowded areas and people who have the flu Hand hygiene How to properly wear a mask during flu season Good nutrition and getting enough rest

Hand hygiene Hand hygiene is the most effective way to control the spread of microorganisms. While it is true that the client may be less susceptible to illness when well rested, exposure to a pathogen can still result in influenza. Avoiding those with the flu is also appropriate; however, hand washing remains the best answer for prevention. Wearing a mask all season may or may not prevent the flu and is not the most reasonable choice.

An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student? Hand lotions should not be used after hand hygiene. Hand hygiene is needed after contact with objects near the client. The use of gloves eliminates the need for hand hygiene. The use of hand hygiene eliminates the need for gloves.

Hand hygiene is needed after contact with objects near the client. Hand hygiene must be performed when moving from a contaminated body site to a clean body site during client care and after contact with inanimate objects near the client. Using gloves does not eliminate the need for hand hygiene and, in some cases, gloves must still be used after hand hygiene. Lotions may be used to prevent irritation.

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. What is an accurate guideline for using this technique? Consider the outside of the sterile package to be sterile. Consider the outer 3-in. (8-cm) edge of a sterile field to be contaminated. Hold sterile objects above waist level to prevent inadvertent contamination. Open sterile packages so that the first edge of the wrapper is directed toward the nurse.

Hold sterile objects above waist level to prevent inadvertent contamination. Holding a sterile object above waist level ensures the object is kept in sight and prevents accidental contamination. The outside of the sterile package and the outer 1 in. (2.5 cm) of a sterile field are contaminated. Sterile packages should be opened so that the first edge of the wrapper is directed away from the nurse.

A nurse has been exposed to feces while changing the linens of a client's bed. Which guideline is followed for performing handwashing after this client encounter? Use an alcohol-based hand rub to decontaminate the hands. Remove all jewelry, including wedding bands, before hand washing. Pat dry with a paper towel, beginning with the forearms and moving down to fingertips. Keep hands lower than elbows to allow water to flow toward fingertips.

Keep hands lower than elbows to allow water to flow toward fingertips. Handwashing, as opposed to hand hygiene with an alcohol-based rub, is required when hands are exposed to body fluids. Jewelry should be removed, if possible, and secured in a safe place, but a plain wedding band may remain in place. Wet the hands and wrist area, and keep hands lower than elbows to allow water to flow toward fingertips and pat hands dry with a paper towel, beginning with the fingers and moving upward toward forearms.

A client has a diagnosis of HIV and has been admitted to the hospital with an opportunistic infection that originated with the client's normal flora. Why did this client most likely become ill from his resident microorganisms? The client's immune system became further weakened The client's normal flora began producing spores The client's normal flora proliferated because of a nutritional deficit The resident microorganisms mutated and became virulent

The client's immune system became further weakened Unless the supporting host becomes weakened, normal flora remains controlled. If the host's defenses are weakened, as in cases of HIV/AIDS, even benign microorganisms can cause opportunistic infections. This phenomenon is not due to mutations, spore production or the direct effects of a nutritional deficit.

The nurse is removing gloves after performing care for a client on droplet precautions. What action best adheres to principles of infection control?

The nurse should complete the removal of gloves by peeling off the second glove while minimizing incidental contact. This includes contact with the contaminated glove by the thumb or fingers of the ungloved hand. The first glove should be removed by slipping two fingers under the cuff, not pulling by the ends of the fingers.

The nurse is preparing to perform handwashing. Place the following steps in the correct order. Use all options.

Turn on the faucet and adjust force and temperature of the water. Wet the hand and wrists. Apply soap. Wash the palms and backs of the hands for at least 20 seconds. Pat the hands dry with a paper towel. Turn the faucet off with a paper towel. The correct steps to hand washing are as follows. Turn on the faucet and adjust force and temperature of the water. Wet the hand and wrist areas. Apply soap product. Wash the palms and back of the hands for at least 15 seconds. Pat hands dry with a paper towel. Finally, turn the faucet off with a paper towel.

The nurse is preparing to apply a prescription ointment to the client's wound. After reviewing the image, what is the most important step for the nurse to take? Use a sterile cotton-tipped applicator to apply the prescription to the site Put soiled dressing change supplies in the client's bathroom garbage and double bag Apply a 1-in (2.5-cm) layer of the ointment to the site using the index finger Place sterile 4 × 4 gauze on the wound and secure the dressing with dressing with paper tape

Use a sterile cotton-tipped applicator to apply the prescription to the site Applying the ointment with the gloved finger contaminates the prescription ointment. Sterile cotton-tipped applicators are used to apply ointments or solutions to the wound bed to avoid contaminating the wound. A 4 × 4 gauze pad should not be applied until the wound is cleansed properly with sterile supplies. Soiled dressing supplies should be placed in a biohazardous trash bag or container.

The nurse is preparing to insert an intravenous catheter into a client. Which infection control procedure will the nurse use to ensure safe client care? Dip the IV catheter into an antiseptic before use. Use a sterile intravenous catheter. Wear a mask and gown for the procedure. Clean the site with a disinfectant.

Use a sterile intravenous catheter. Any item entering sterile tissues or the vasculature must be sterile. Therefore, an IV catheter must be sterile. It should not be dipped in an antiseptic before use. A chemical used on lifeless objects is called a disinfectant, whereas one used on living objects is an antiseptic. The nurse would clean the IV site with an antiseptic, not a disinfectant, before insertion. An IV insertion does not require the nurse to wear a mask and gown.

The community nurse is educating a family about infection control measures. What teaching will the nurse include? Select all that apply. Do not share drinking glasses with family members who are ill. Wear personal protective equipment (PPE) when appropriate. Hand hygiene is not needed in the home environment. Keep the entire living environment as clean as possible. Standard precautions should be used when family members have active infections.

Wear personal protective equipment (PPE) when appropriate. Standard precautions should be used when family members have active infections. Do not share drinking glasses with family members who are ill. Keep the entire living environment as clean as possible. Wearing PPE when appropriate, practicing good hand hygiene, and keeping the living environment clean interfere with the chain of infection. Drinking glasses should be cleaned or sterilized (depending on type of infection present) between uses. Standard precautions should be used if a family member has an active infection.

The client is an employee on the medical unit at the local children's hospital. The nurse is an occupational health nurse educating the client on various routes of exposure. The nurse knows that as a hospital employee, the client is most susceptible to infection by what mode of transmission? droplet airborne contact vehicle

contact Contact may be either direct or indirect.

To eliminate needlesticks as potential hazards to nurses, the nurse should: slide the needle into the cap and deposit it in a puncture-proof plastic container. place the uncapped needle on a tray and carry it to the medicine room for disposal. stick the uncapped needle into a Styrofoam block and deposit it in a plastic container. immediately deposit uncapped needles into a puncture-proof plastic container.

immediately deposit uncapped needles into a puncture-proof plastic container. All uncapped needles should be placed in a puncture-proof plastic unit immediately after use.

Any microorganism capable of disrupting normal physiologic body processes is a: pathogen. fomite. virus. bacterium.

pathogen. Microorganisms that are capable of harming people are called pathogens or pathogenic.

Every 2 hours, the nurse turns and repositions the client who is experiencing frequent diarrhea. This action supports, among other things, infection prevention. Which assessment indicates that there is a positive outcome from this nursing care? skin is dry and intact blanching over elbow area noted slight bleeding noted while old dressing is removed redness size over sacral area is with minimal increase

skin is dry and intact The first line of defense against infection is intact skin and mucous membranes covering body cavities. They are the most important barriers to infection, and when they are intact, infection is rare.