infection control saunders

A client with tuberculosis, whose status is being monitored in an ambulatory care clinic, asks the nurse when it is permissible to return to work. What should the nurse tell the client?

"Three sputum cultures must be negative before returning to work." The client must have sputum cultures tested every 2 to 4 weeks after the initiation of antituberculosis medication therapy. The client may return to work when the results of three sputum cultures are negative because the client is considered noninfectious at that point. The chest x-ray may or may not be negative. The Mantoux test will not revert to negative once it is positive.

The nurse should plan to reinforce instructions to which clients about the risk for transmission of disease through blood and sexual contact? Select all that apply.

A client diagnosed with hepatitis B virus A client diagnosed with hepatitis C virus A client diagnosed with human immunodeficiency virus (HIV)

A 70-year-old client who has been treated for cellulitis of the leg asks the nurse how to improve resistance to infection. Which measures should the nurse reinforce in the teaching plan? Select all that apply.

Balance activity, rest, and avoid stress. Keep skin on arms and legs well lubricated. Wash any breaks in the skin with soap and water. Receive recommended vaccines against influenza and pneumonia.

A client is admitted to the hospital with a diagnosis of neutropenia. Which interventions should the nurse include in planning care for this client? Select all that apply.

Check temperature at least every 4 hours. Monitor white blood cell count daily as prescribed. Remove fresh flowers or plants from the client's room.

The nurse is changing a dressing on the wound of a postsurgical client who is receiving contact precautions because of a history of methicillin-resistant Staphylococcus aureus (MRSA) from a previous surgery. Which interventions should the nurse follow? Select all that apply.

Observe the incision line for redness and drainage. Change gloves between removal of the old dressing and applying the new.

The nurse is preparing to set up a sterile field using the principles of aseptic technique to perform a dressing change. Which should the nurse include in the preparations? Select all that apply

Open the distal flap of a sterile package first. Prepare the sterile field just before the planned procedure. Avoid placing items within 1 inch of any area surrounding the outer edge of the sterile field.

The nurse reinforces instructions to a client diagnosed with impetigo. Which statements by the client indicate a need for further teaching? Select all that apply.

"I can wash my laundry with other household members' items." "I should not wash the lesions of the infection once the skin lesions have scabbed over". Impetigo is a highly contagious skin infection caused by staphylococci or streptococci

A client is seen in the health care clinic, and a diagnosis of conjunctivitis is made. The nurse reinforces discharge instructions to the client regarding care of the disorder while at home. Which statement by the client indicates a need for further teaching?

"I do not need to be concerned about spreading this infection to others in my family." Conjunctivitis is highly contagious and clients must follow strict hand washing and avoid touching their eyes and others.

A hospitalized child with leukemia has received chemotherapy by the intravenous (IV) route, and a discharge to home is being planned. Laboratory values indicate that the child is neutropenic. The child is being treated daily by cleansing and the application of a topical antibiotic on an open area from an old IV site. The nurse reinforces instructions to the mother regarding the signs of infection at this affected site. Which statement by the mother indicates that the mother understands the instructions?

"I will clean the site and apply the topical ointment every day." Rationale: Some neutropenic children will not produce purulent drainage. Because pus is made of white blood cells, drainage cannot be used as a sign of infection. Redness may be the only sign. An elevated temperature is a sign of infection.

The nurse, employed in a long-term care facility, is planning the clinical assignments for the day. The nurse knows not to assign which staff member to the client with a diagnosis of herpes zoster?

An unlicensed assistive personnel who has never had chickenpox Herpes zoster is caused by a reactivation of the varicella zoster virus, which is the causative virus of chickenpox. Individuals who have not been exposed to the varicella zoster virus are susceptible to chickenpox. Options 1, 2, and 4 are not associated with the herpes zoster virus.

A client is diagnosed with Haemophilus influenzae pneumonia. In addition to standard precautions, which other precautions should be instituted immediately by the nurse?

Droplet precautions Droplet precautions are instituted when the disease is transmitted via large particle droplets, such as in the case of H. influenzae pneumonia.

The nurse prepares to give a bath and change the bed linens for a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Which should the nurse use during the bathing of this client?

Gown and gloves Gowns and gloves are required if the nurse anticipates contact with soiled items, such as wound drainage on bed linens. Masks are not required unless droplet or airborne precautions are necessary.

A health care worker who signed a waiver and never received the hepatitis B vaccine receives a needle stick from a client who has hepatitis B. Which treatments are indicated for the health care worker under this situation? Select all that apply.

Hepatitis B immune globulin Initiate hepatitis B vaccine series Cleanse needlestick site with soap and water

Which instructions should be included in the teaching plan for a mother whose newborn is human immunodeficiency virus (HIV) positive?

Instruct the mother and family to provide meticulous skin care to the newborn and to change the newborn's diaper after each voiding or stool.

In preparing to care for a hospitalized child with a diagnosis of measles (rubeola), which supplies should the nurse bring to the child's room to prevent the transmission of the virus?

Mask and gloves Rubeola is transmitted via airborne particles or direct contact with infectious droplets.

Following a cleft lip repair, the nurse reinforces instructions to the parents of the infant. Which of the instructions should be given to the parents of the infant? Select all that apply.

Monitor frequency of diaper changes. Cleanse the surgical site with normal saline Apply prescribed antibiotic ointment to the surgical site.

The nurse is preparing to set up a sterile field using the principles of aseptic technique to perform a dressing change. Which should the nurse include in the preparations? Select all that apply.

Open the distal flap of a sterile package first. Prepare the sterile field just before the planned procedure. Place the sterile field 1 foot behind the working area and out of view of the client. Avoid placing items within 1 inch of any area surrounding the outer edge of the sterile field.

The nurse is preparing to give a bed bath to an immobilized client with tuberculosis (TB). The nurse should plan to wear which items when performing this care

Particulate respirator, gown, and gloves

The nurse will perform a sterile dressing change after removing the old dressing with clean gloves. The nurse removes the gloves, uses alcohol-based hand sanitizer to perform hand hygiene, and prepares to perform open sterile gloving. The nurse removes the gloves from the outer package. The nurse is right-handed. The nurse opens the inner wrapper and flattens the wrapper to expose the gloves. Which is the next action the nurse takes when donning sterile gloves?

Pick up right glove at cuff with left thumb and forefinger.

When checking a client's skin, the nurse notes the presence of multiple straight and wavy threadlike lines beneath the skin and suspects the presence of scabies. Which precaution should the nurse institute before making contact with the client?

Put on a gown and gloves The Centers for Disease Control and Prevention recommend the wearing of gowns and gloves for close contact with a person infested with scabies. Masks are not necessary. Transmission via clothing and other inanimate objects is uncommon, but hospital workers have become infected with soiled linen. Scabies is usually transmitted from person to person by direct skin contact.

The nurse is preparing to care for a client with acquired immunodeficiency syndrome (AIDS) who has Pneumocystis jiroveci pneumonia. In planning infection control for this client, which should be the appropriate form of isolation to use to prevent the spread of infection to others?

Standard precautions The acquired immunodeficiency syndrome (AIDS) virus is transmitted through anal, vaginal, or oral sexual contact with infected semen or vaginal secretions; contact with infected blood or blood products; from mother to fetus during childbirth; or during breastfeeding P. jiroveci pneumonia is an opportunistic infection seen in clients with compromised immune function.

Which are the most important interventions that can help reduce the incidence of hospital-acquired urinary catheter infections? Select all that apply.

Use indwelling urinary catheters judiciously. Remove indwelling catheters when no longer needed. Use strict aseptic technique when inserting all urinary catheters.

A client with methicillin-resistant Staphylococcus aureus (MRSA) needs to be placed on contact precautions, and the licensed practical nurse (LPN) in charge asks a newly licensed LPN to initiate contact precautions. Which action by the new LPN would indicate the need to review the procedure for contact precautions?

Wears a gown when caring for the client and removes the gown immediately after leaving the client's room The nurse wears gown and gloves while caring for the client. The gown worn by the nurse must be removed before he or she leaves the client's room. MUST be removed before leaving the clients room not AFTER

The nurse receives a telephone call from the admissions office and is told that a child with acute bacterial meningitis will be admitted to the pediatric unit. The nurse prepares for the child's arrival and plans to implement which type of precautions?

droplet precautions A major priority in nursing care for a child suspected of having meningitis is to administer the prescribed antibiotic as soon as it is prescribed. The child also is placed in a private room, with droplet precautions, for at least 24 hours after antibiotics are given