EAQ 1 - Infection

Which action would the nurse teach to a client with pulmonary tuberculosis who is prescribed a combination of rifampin and isoniazid?

"Continue taking the medicine even after I feel better.: Rationale: The medication should be taken for the full course of therapy; most regimens last from 6 to 9 months, depending on the state of the disease. Visual changes are not side effects of this medication. The medication should be taken 1 hour before meals or 2 hours after meals for better absorption. Urine or tears turning red-orange is a side effect of rifampin; although this should be reported, it is not an adverse side effect.

At which interval are humidified oxygen systems replaced to prevent infection?

1 day Rationale: Humidified oxygen delivery needs to be changed out daily to prevent infection. Every 3 to 5 days is too long to wait and may promote infection. Oxygen delivery without humidification will need to be changed out every 7 days.

Which statements regarding acne are correct?

Acne may be caused by stress Family history could be a reason for acne Propionibacterium acnes causes acne Acne is commonly found on the face, chest, upper back, and neck Rationale: Stress and family history may cause acne formation. The causative organism is propionibacterium acnes. Acne is commonly found on the face, chest, upper back, and neck where there are higher numbers of sebaceous glands. Acne is not a hormonal disease; rather, it is a skin disease due to hormonal imbalance

Which response would the nurse implement when the spouse of a client with pulmonary tuberculosis (TB) receives a tuberculin skin test and is found to have an induration greater than 10 mm?

Additional tests are necessary to determine infection status. Rationale: The test does not indicate whether TB is dormant or active. However, a client with an induration of 5 mm or greater is considered positive. If there is repeated close contact with a person diagnosed with pulmonary TB or if the client has a disease causing decreased resistance, the requires further diagnostic study, such as chest x-ray and sputum culture. A newly infected client will receive preventative therapy with isoniazid (INH). Isoniazid will be continued for 6 months if chest x-rays are normal, or 12 months if chest x-rays are abnormal. Repeating the sting test is not necessary; the test is considered positive.

For which client illness would airborne precautions be implemented?

Chicken Pox Rationale: Chickenpox is known or suspected to be transmitted by air. Diseases that are known or suspected to be transmitted by droplet include influenza and pneumonia. A disease that is known or suspected to be transmitted by direct contact is respiratory syncytial virus.

Which term describes the practice of placing clients with the same infection in a semi-private room?

Cohorting Rationale: Cohorting is the practice of grouping clients who are colonized or infected with the same pathogen. Isolating is limiting the exposure to individuals with an infection. Colonizing refers to the development of an infection in the body. Cross-referencing has nothing to do with an infectious process.

Which virus is responsible for causing infectious mononucleosis in clients?

Epstein-Barr virus Rationale: Epstein-Barr virus is responsible for mononucleosis and possibly Burkitt lymphoma. Parvovirus and rotavirus cause gastroenteritis. Coronavirus causes upper respiratory tract infections.

Which condition is an example of a bacterial infection?

Impetigo Rationale: Impetigo is the bacterial infection of skin caused by group A B-hemolytic streptococci or Staphylococcus aureus. Candidiasis is the fungal infection caused by Candida albicans. Plants warts and verruca vulgars are viral infections caused by the human papilloma virus.

Which finding in a urinalysis indicates a urinary tract infection?

Leukoesterase Rationale: Leukoesterases are released by white blood cells in response to an infection or inflammation. The presence of crystals in the urine indicates that the specimen had been allowed to stand. Presence of bilirubin in the urine indicates anorexia nervosa, diabetic ketoacidosis, and prolonged fasting. The presence of ketones indicates diabetic ketoacidosis.

Which clinical manifestation is associated with cellulitis?

Lymphadenopathy Rationale: Cellulitis is accompanied by lymphadenopathy. Occasional papule are present in folliculitis. Herpes simplex viral infections evolve the vesicles into pustules. Isolated erythematous pustules occur in folliculitis bacterial infections.

Which substance will the home care nurse instruct a client to use after laryngectomy to cleanse the stoma site?

Mild soap and water Rationale: Mild soap and water are used to cleanse the stoma site. Sterile saline, a humidifier, or pans of water can be used to humidify the air entering the stoma. There is no need to use steroid cream at the site unless instructed by the health care provider. Non-oil-based, rather than oil-based, lubricants can be used as needed for lubrication of the site.

Which criteria would the nurse consider when determining if an infection is a health care-associated infection?

Occurred in a conjunction with a treatment for illness Rationale: Health care-associated infections are classified as those that are contracted within a health care environment (e.g., hospital, long-term care facility) or result from a treatment (e.g., surgery, medications). Originating primarily from an exogenous source is not criterion for identifying a health care-associated infection. The source of health care-associated infections may be endogenous (originate from within the client) or exogenous (originate from the health care environment or service personnel providing care); most health care-associated infections stem from endogenous sources and are caused by Escherichia coli and Staphylococcus aureus. Association with a medication-resistant microorganism is not criterion for identifying health care-associated infection. A health care-associated infection may or may not be caused by a medication-resistant microorganism. Still having the infection despite completing the prescribed therapy is not criterion for identifying health care-associated infection.

Which condition is characterized by infection of a client's bone or bone marrow?

Osteomyelitis Rationale: Osteomyelitis is infection of bone or bone marrow. Osteomalacia is a condition characterized by softening of bones due to calcium or vitamin D deficiency. Herniated disc is caused by structural damage of the intervertebral discs in which the nucleus pulpous seeps through a torn or stretched annulus. Spinal stenosis is narrowing of the spinal canal.

Which effect has resulted in the avoidance of tetracycline use in children under 8 years old?

Permanent tooth discoloration. Rationale: Tetracycline use in children under the age of 8 years has been discontinued because it causes permanent tooth discoloration. Birth defects, allergic responses, and severe nausea and vomiting are not prevalent reasons for the discontinuation of tetracycline medication in children under 8 years old.

Which causative organism colonization signifies purulent exudates of greenish-blue pus with a fruity odor?

Pseudomonas Rationale: The purulent exudates of greenish-blue pus with a fruity odor signifies colonization with pseudomonas. Proteus colonization causes pus with a fishy odor. The colonization of Bacteroides causes brownish pus with fecal odor. Staphylococcus colonization results in purulent exudate of creamy yellow pus.

Which mechanism of action would a nurse recall when using wet-to-damp saline-moistened gauze for wound debridement?

Removing the necrotic tissue mechanically Rationale: Wet-to-damp saline-moistened gauze mechanically removes the necrotic tissue. The dilution of viscous exudates is promoted through the continuous wet-gauze technique. Topical enzyme preparations cause a breakdown of the denatured protein of the eschar. Moisture-retentive dressings promote the spontaneous separation of necrotic tissue through autolysis.

Which condition would the nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants?

Respiratory arrest Rationale: Aminoglycosides can intensify the effect of skeletal muscle relaxants, placing the client at risk for respiratory arrest. Aminoglycoside therapy with muscle relaxants does not increase risk of stroke, myocardial infarction, or abdominal discomfort.

Which type of cells are deficient in DiGeorge syndrome?

T cells Rationale: DiGeorge syndrome is a primary immune deficiency in which T cells are affected. The B cells are affected in Bruton's X-linked agammaglobulinemia; common variable hypogammaglobulinemia; and selective immunoglobulin A (IgA), IgM, and IgG deficiency. Monocytes and polymorphonuclear cells are affected in chronic granulomatous disease and Job syndrome

Which fungal infection does the client refer to as jock itch?

Tinea cruris Rationale: Tinea cruris îs a fungal infection commonly referred to as jock itch. It clinically manifests with a well-defined scaly plaque in the groin area. Tina pedis is a fungal infection commonly referred to as athlete's foot. It is clinically manifested as interdigital scaling and maceration, scaly plantar surfaces, erythema, and blistering. Tina corpora's is a fungal infection commonly referred to as ringworm. It is clinically manifested as an erythematous annular, ringlike, scaly lesion with well defined margins. Tina unguium or onychomycosis is manifested as scaliness under the distal nail plate

Which issue related to antibiotic use is an increased risk for the older adult?

Toxicity Rationale: The older adult is at increased risk for toxicity related to antibiotic use because of reduced metabolism and excretion of medications. Allergy, resistance, and superinfection are a risk for all antibiotic recipients but not an increased risk in the older adult population