NU372 Week 1 PrepU: Chapter 71: Management of Patients With Infectious Diseases

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A nurse is assessing a client with vaginal discharge. The nurse suspects bacterial vaginosis when the client states which of the following? "I noticed a strange fishy odor during my period." "I've been experiencing some really intense itching." "The discharge looks almost like cottage cheese." "The discharge is yellowish but thin."

"I noticed a strange fishy odor during my period." Bacterial vaginosis is characterized by a fishlike odor that is particularly noticeable after sexual intercourse or during menstruation. Most clients do not experience local discomfort or pain; more than one half of clients do not notice any symptoms. Intense itching is often associated with candidiasis or trichomoniasis. A cottage-cheese like discharge is associated with candidiasis. A thin, yellow discharge is most commonly noted with trichomoniasis.

The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client? "It is very important to maintain good handwashing, even while you are being treated." "Abstain from any sexual activity for 1 week after the antibiotic is complete." "Coinfection with the herpes simplex virus is common with chlamydia." "If you become reinfected, symptoms will immediately be present."

"Abstain from any sexual activity for 1 week after the antibiotic is complete." Client counseling includes abstinence for 1 week after treatment, in addition to the completion of the partner's treatment. Although handwashing is an important aspect of preventing the spread of infection, the nurse must emphasize prevention of chlamydia through the normal route of transmission of this infection, which is sexually. Coinfection with chlamydia often occurs in clients infected with gonorrhea. Chlamydia and gonorrhea are caused by bacteria that are transmitted during sexual relations. Both chlamydia and gonorrhea infections frequently do not cause symptoms in women and thus are often referred to as "silent" related to clinical presentation. It is important to retest women 3 months' posttreatment, due to the possibility of reinfection.

You are a school nurse teaching a health class about the chain of infection in the transmission of sexually transmitted diseases (STDs). A student asks you which part of the chain of infection can be missing when transmission occurs. What would be your best answer? "Not everyone is susceptible to STDs, but they still get them." "STDs can be gotten from bed linens and toilet seats, so you don't really need a reservoir." "You can be missing any part of the chain of infection except the infectious agent." "All parts of the chain of infection have to be present for the disease to be passed to another human."

"All parts of the chain of infection have to be present for the disease to be passed to another human." All components in the chain of infection must be present for an infectious disease to be transmitted from one human or animal to a susceptible host. This makes options A, B, and C incorrect.

The nurse educator, who is teaching a class on sexually transmitted infections, recognizes that teaching has been effective when students indicate which statement is true about the difference between colonization and infection? "Colonization and infection are interchangeable terms used to describe a bacterial invasion." "Colonization becomes infection when the host and organism interact." "Colonization results in symptoms such as redness and swelling, infection results in fever." "Both colonization and infection require treatment with different antibiotics."

"Colonization becomes infection when the host and organism interact." The term colonization is used to describe microorganisms present without host interference or interaction. Infection indicates a host interaction with an organism. Organisms reported in microbiology test results often reflect colonization rather than infection. Clinical evidence of redness, heat, and pain and laboratory evidence of white blood cells on the wound specimen smear suggest infection. In this situation, the host identifies the staphylococci as foreign. Infection is recognized by the host reaction (manifested by signs and symptoms) and by laboratory-based evidence of white blood cell reaction and microbiologic organism identification. Colonization does not require treatment with antibiotics because the host has not experienced physiological consequences from the presence of colonization. Infection may require treatment with antibiotics due to the severity of the host reaction.

The nurse is instructing the family on home care of a client with shingles. The family member asks whether their teenage children should stay in a different room. What is the best response by the nurse? "Yes, shingles is highly contagious." "Have they had chickenpox or the varicella vaccine?" "No, shingles is not contagious." "Because the client is in quite a bit of pain, it would probably be best."

"Have they had chickenpox or the varicella vaccine?" To answer the question correctly, the nurse needs to know whether the children have had chickenpox or received the varicella vaccine. If the children have been vaccinated or had the disease, then they are immune and no precautions are needed. If the children have not been vaccinated for chickenpox nor had the disease, it would be best to maintain distance. Shingles is contagious. Even though the client may be in pain, this should not guide the nurse's response.

The nurse is seeing a client who came into the sexual health clinic after discovering condylomata along her labia. The client states, "This makes no sense, I don't even know who I got this from and I have been so careful!" What is the nurse's best response? "If you make a list of your sexual partners over the past month you should be able to narrow down the person who is the source of your infection." "If a condom was used during all sexual contacts, it is unlikely the warts that you have were caused by the human papillomavirus (HPV)." "It sounds like you are feeling angry. Let's talk more about human papillomavirus (HPV) and strategies to stay healthy while you are being treated." "You are high risk simply because you are sexually active with more than one partner. Do you know how many partners all your partners have had?"

"It sounds like you are feeling angry. Let's talk more about human papillomavirus (HPV) and strategies to stay healthy while you are being treated." In many cases, clients are angry about having warts from HPV and do not know who infected them because the incubation period can be long and partners may have no symptoms. Acknowledging emotional distress that occurs when a sexually transmitted infection is diagnosed and providing support and facts are important nursing actions. The client in this case is clearly feeling angry and overwhelmed. The nurse should first provide empathy and help the client focus on information regarding treatment in a solution focused way. Discussing the number of sexual partners and risk factors is important in prevention; however, given the client's emotional state the alternative responses would not be helpful and supportive. In addition, to inform the client that if a condom was used the virus cannot be transmitted is incorrect. Transmission can also occur through skin-on-skin contact in areas not covered by condoms.

The nurse is giving an educational talk to a local parent-teacher association. A parent asks how he can help his family avoid community-acquired infections. What would be the nurse's best response to help prevent and control community-acquired infections? "Encourage your family to adopt a healthy diet and exercise regimen." "Encourage your family to stop smoking." "Make sure your family has all their childhood immunizations." "Make sure your family has regular checkups."

"Make sure your family has all their childhood immunizations." To help prevent and control community-acquired infections, nurses should encourage childhood immunizations. Vaccines stimulate the body to produce antibodies against a specific disease organism. The immunization of children protects children as well as adults who may not have developed sufficient immunity. Following a proper diet and exercise regimen and going for regular checkups are important, but these measures do not help prevent or control community-acquired infections. Smoking cessation does not reduce the risk of such infections either.

A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response? "People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital." "People in hospitals sometimes exhibit signs of infections they had before being admitted." "Sometimes people in hospitals get exposed to microorganisms that their visitors bring in." "People in hospitals are surrounded by infectious agents, so they can get infections they didn't have before being admitted."

"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital." Hospitalized clients are more susceptible to infections than well people because they are exposed to pathogens in the health care environment, may have incisions or invasive equipment (e.g., intravenous lines) that compromise skin integrity, or may be immunosuppressed from poor nutrition, their disease process, or its treatment. Although all answers are correct, the most complete answer is A.

A 36-year-old client is in the clinic for an annual physical. The client asks the nurse, "Should I get a flu shot?" Which is the best response by the nurse? "No, you are not in the age range for the flu shot." "Do you have any chronic illnesses?" "The flu shot is recommended for all people over 6 months of age." "Only if you work around children or the elderly."

"The flu shot is recommended for all people over 6 months of age." The influenza vaccine is recommended for all people over 6 months of age; therefore the client is in the recommended age range. Ascertaining whether the client has any chronic illnesses is important, but it does not change the recommendation by the Centers for Disease Control and Prevention. No recommendation suggests that the immunization be given only if the client works around children or the elderly.

The nurse is meeting with the mother of an 11-year-old girl to provide decision making support and education regarding human papillomavirus (HPV) vaccination. The mother states, "I am confused about why my 11 year old needs to be protected from a sexually transmitted infection. She is so young and not sexually active. Why does she need the vaccination now?" What is the nurse's best response? "The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination" "HPV vaccination is very common and most parents are choosing to protect their children. Although your child is not sexually active now, she will be soon and this will protect her from sexually transmitted infections." "You're daughter is at risk for ectopic pregnancy and even infertility without this vaccination. If you chose not to vaccinate, you are choosing to put your daughter at risk." "Although HPV infections are not very common, it is important to take precaution with vaccination. If you prefer, you can wait until your daughter is older than 15 years, because she would require fewer doses of the vaccine."

"The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination" When counseling clients regarding the HPV vaccination, it is important to use supportive communication to help reduce the client's anxiety and help them make the best decision for his or her health. The nurse should provide facts about the benefits of vaccination along with the potential long term consequences of abstaining from vaccination. The nurse should be careful when stating the child will be "protected from sexually transmitted infections." The HPV vaccination only protect against infections caused by HPV and the primary purpose of the vaccination is to prevent the development of certain cancers related to the infection. Telling the mother her daughter is at risk for ectopic pregnancy and infertility is ineffective because the nurse has not yet discussed the possible consequences of a HPV infections. The nurse is not communicating in a manner that would reduced the mother's anxiety. The response may be perceived as accusatory and judgmental. By telling the mother if she waits to vaccinate her daughter until she is 15 years old, the nurse is providing incorrect information. Children between the ages of 9 and 14 require fewer doses of the vaccination that children 15 and older up to 26 years of age.

What are the main sexually transmitted diseases (STIs) in Australia?. Gonorrhea Syphilis Chlamydia All of the above

All of the above Chlamydia, gonorrhea and syphilis are the main sexually transmitted diseases in Australia.

A client comes to the clinic and informs the nurse that he has a "painful area under his armpit." The nurse observes a 2-cm raised area that is erythremic and has a white substance inside of it. What does the nurse suspect the client may be experiencing? A lesion An abscess A fluid-filled vesicle A cancerous tumor

An abscess To prevent the spread of pathogens to adjacent tissues, a fibrin barrier forms around the injured area. Inside the barrier, a thick, white exudate (pus) accumulates. This collection of pus is called an abscess, which may break through the skin and drain or continue to enlarge internally. A lesion would not be filled with pus, nor would a cancerous tumor. A fluid-filled vesicle is associated with a viral type illness.

A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result? An induration of 12mm An uneven erythemic area An induration of less than 1 mm An induration of 4 mm

An induration of 12mm The size of the induration, not including the surrounding area of erythema, is measured in millimeters. The measurement determines whether the reaction is significant. For example, a tuberculin skin test is test is considered positive if the induration is 10 mm or greater in persons with no known risk factors for TB; smaller measurements are significant in certain risk groups, such as immunocompromised clients. The other answers are not indicative of positive results.

You are caring for a client with an impaired immune system. You are concerned about the client acquiring a nosocomial infection. What intervention would help nurses control nosocomial infections? Apply principles of medical and surgical asepsis. Maintain a proper diet and exercise regimen. Use proper antibiotics. Ensure childhood immunizations.

Apply principles of medical and surgical asepsis. Nosocomial infections are acquired when receiving care in a healthcare facility. To help prevent and control nosocomial infections, nurses should apply principles of medical and surgical asepsis whenever they care for clients. Childhood immunizations control community-acquired infections. Maintaining a proper diet and exercise regimen and use of antibiotics do not help control nosocomial infections.

The nurse observes a physician leave the room of a client in isolation for infection with Clostridium difficile. The physician uses the alcohol-based hand sanitizer hanging on the wall to wash her hands and leaves the door open. Which action should the nurse take? No action is needed. The physician was following isolation protocol. Ask the physician to wash her hands with soap and water. Close the door to the room. Report the observation to the infection control department.

Ask the physician to wash her hands with soap and water. C. difficile is resistant to alcohol-based and other hand sanitizers; therefore physicians should be instructed to wash their hands with soap and water. The nurse could report the observation to the infection control department, but that does not address the immediate concern of the physician contaminating other clients. There is no need for the room door to be closed. The nurse must take action to ensure the safety of other clients.

A client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client's history and physical findings, the physician suspects legionnaires' disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What's the drug of choice for treating legionnaires' disease? Azithromycin (Zithromax) Rifampin (Rifadin) Amantadine (Symmetrel) Amphotericin B (Fungizone)

Azithromycin (Zithromax) Azithromycin is the drug of choice for treating legionnaires' disease. Rifampin is used to treat tuberculosis. Amantadine, an antiviral agent, and amphotericin B, an antifungal agent, are ineffective against legionnaires' disease, which is caused by bacterial infection.

A nurse on your unit sustains a needlestick injury while caring for a client whose infectious status is unknown. What would be the best course of action for the nurse to follow? Avoid notifying the supervisor of the injury until the client's infectious status is confirmed. Avoid revealing the identity of the client or source of blood. Be tested for disease antibodies at appropriate intervals. Document the injury in writing after the client's infectious status is confirmed.

Be tested for disease antibodies at appropriate intervals. If a needlestick injury has occurred, the nurse should be tested for disease antibodies immediately and at appropriate intervals thereafter. The nurse should document the injury in writing immediately and should not wait until the client's infectious status is confirmed. The nurse should also notify the supervisor of the injury immediately and identify the person or source of blood, if possible.

A nurse practitioner advised the mother of a 16-year-old girl, who was diagnosed with human papillomavirus (HPV), that the infection can cause cancer of the _______ in the future. Vagina Urethra Cervix Uterus

Cervix Certain types of HPV can cause cells of the cervix to become abnormal, contributing to 70% of cervical cancers.

The nurse is caring for a group of clients at a public health clinic. Which sexually transmitted disease would the nurse focus the client education on curative goals? Chlamydia HIV HPV Genital herpes

Chlamydia Chlamydia is the most common and fast spreading bacteria. Because it is a bacteria, with proper treatment, chlamydia is able to be cured. Sexually transmitted diseases that are viruses, such as HIV, HPV, and herpes, can lay dormant in the body thus being difficult to treat.

A nurse would anticipate instituting contact precautions for a client with which of the following? Clostridium difficile infection Measles Varicella Mumps

Clostridium difficile infection Contact precautions would be appropriate for a client with an infection due to Clostridium difficile. Airborne precautions are appropriate for clients with measles or varicella. Droplet precautions are appropriate for clients with mumps.

Which of the following describes microorganisms present without host interference or interaction? Colonization Infection Infectious disease Reservoir

Colonization The term colonization is used to describe microorganisms present without host interference or interaction. Infection indicates a host interaction with an organism. Infectious disease is the state in which the infected host displays a decline in wellness due to the infection. Reservoir is the term used for any person, plant, animal, substance, or location that provides nourishment for microorganisms and enables further dispersal of the organisms.

SARS is caused by which virus? Escherichia coli Salmonella Shigella Coronavirus

Coronavirus SARS is an acute severe respiratory illness caused by the coronavirus. The signs and symptoms may include cough, fever, shortness of breath, and pneumonia.

Patients who have had pelvic inflammatory disease (PID) are prone to which of the following complications? Ectopic pregnancy Bacteremia Thrombophlebitis Inguinal lymphadenopathy

Ectopic pregnancy All patients who have had PID need to be informed of the signs and symptoms of ectopic pregnancy because they are prone to this complication. Other complications include bacteremia with septic shock and thrombophlebitis with possible embolization. Patients who have PID are not prone to inguinal lymphadenopathy

A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? Rashes on the palms of the hands and soles of the feet Cauliflower-like warts on the penis Painful red papules on the shaft of the penis Foul-smelling discharge from the penis

Foul-smelling discharge from the penis Symptoms of gonorrhea in men include purulent, foul-smelling drainage from the penis and painful urination. Rashes on the palms of the hands and soles of the feet are symptoms of the secondary stage of syphilis. Cauliflower-like warts on the penis are a sign of human papillomavirus. Painful red papules on the shaft of the penis may be a sign of the first stage of genital herpes.

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? Genital herpes Syphilis Gonorrhea Chlamydia

Genital herpes Besides AIDS, the five most common STIs are chlamydia, gonorrhea, syphilis, genital herpes, and genital warts. Of these, chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes recurs.

The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection? Gonorrhea Primary syphilis Herpes genitalis Trichomoniasis

Gonorrhea When symptoms of gonorrhea are present in male clients, the symptoms may include burning during urination and penile discharge. Clients with Neisseria gonorrhoeae infection also may report painful swollen testicles. The latter symptoms distinguishes this infection from the infections in the alternate options. Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. A painless lesion at the site of infection is called a chancre. Untreated, these lesions usually resolve spontaneously within about 2 months. With herpes genitalis primary infection may begin with macules (small flat spots on skin) and papules (small circumscribed elevations) and progress to vesicles (small, serous-filled elevated spots) and ulcers. The vesicular state often appears as a blister, which later coalesces, ulcerates, and encrusts. Influenza-like symptoms may occur 3 or 4 days after the lesions appear, often with inguinal lymphadenopathy (enlarged lymph nodes in the groin). Men with trichomoniasis may notice itching or irritation inside the penis, burning after urination or ejaculation, discharge from the penis.

A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condyloma? Herpes virus Human papilloma virus Treponema pallidum Hemophilus ducreyi bacillus

Human papilloma virus Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Hemophilus ducreyi bacillus is the cause of chancroid.

A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata? Herpes virus Human papilloma virus Treponema pallidum Hemophilus ducreyi bacillus

Human papilloma virus Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Hemophilus ducreyi bacillus is the cause of chancroid.

The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority? Knowledge Deficit Powerlessness Anxiety Impaired Skin Integrity

Impaired Skin Integrity The priority nursing diagnosis focuses on the Impaired Skin Integrity. Interventions would include nursing instruction on the care of the skin to prevent further infection to self and others. The nurse would also focus on the management of the disease. Because this is a reoccurrence, Knowledge Deficit is not a priority. Psychosocial nursing diagnoses are not a priority at this time unless other data suggests.

The nurse is completing the admission assessment on a client with renal failure. The client states, "I was diagnosed with impetigo yesterday." Which is the appropriate nursing intervention? Obtain the name of the antiviral medication used to treat the impetigo. Initiate contact isolation protocol. Transfer the client to a negative-pressure room. Educate the client about wearing a mask outside of the assigned room.

Initiate contact isolation protocol. Impetigo is a bacterial infection transmitted via contact. Therefore, the nurse should initiate contact isolation protocol. The client would not be taking an antiviral medication for impetigo, would not need a negative-pressure room, and would not wear a mask when outside the room.

A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning? Instruct the patient not to drink alcohol with this treatment. Counsel the patient to refrain from sex for 1 week. Advise the patient to take medication with a glass of milk. Reassure the patient further sexually transmitted infection (STI) testing is not indicated.

Instruct the patient not to drink alcohol with this treatment. While counseling to abstain from sex for 1 week is appropriate, the most important intervention is counseling to avoid alcohol during Flagyl treatment. Alcohol consumption while taking Flagyl creates a severe gastrointestinal reaction of nausea, vomiting, and flushing. Flagyl does not have to be taken with milk, and further STI testing is indeed recommended with the diagnosis of an STI.

Which of the following is the medication of choice for early syphilis? Penicillin G benzathine Doxycycline Tetracycline Rocephin

Penicillin G benzathine A single dose of penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Patients who are allergic to penicillin are usually treated with doxycycline or tetracycline. Rocephin is not the medication of choice for syphilis.

A client with influenza is admitted to an acute care facility. The nurse monitors the client closely for complications. What is the most common complication of influenza? Septicemia Pneumonia Meningitis Pulmonary edema

Pneumonia Pneumonia is the most common complication of influenza. It may be either primary influenza viral pneumonia or pneumonia secondary to a bacterial infection. Other complications of influenza include myositis, exacerbation of chronic obstructive pulmonary disease, and Reye's syndrome. Myocarditis, pericarditis, transverse myelitis, and encephalitis are rare complications of influenza. Although septicemia may arise when any infection becomes overwhelming, it rarely results from influenza. Meningitis and pulmonary edema aren't associated with influenza.

Which organism is responsible for impetigo? Histoplasma capsulatum Bacillus anthracis Clostridium difficile Staphylococcus aureus

Staphylococcus aureus S. aureus and Streptococcus pyogenes are the organisms responsible for impetigo. H. capsulatum is responsible for histoplasmosis. B. anthracis is responsible for anthrax. C. difficile is responsible for some diarrheal diseases.

Painless chancres or ulcerated lesions are associated with which systemic disease? Kaposi sarcoma Syphilis Psoriasis Urticaria

Syphilis Syphilis is manifested by a painless chancres or ulcerated lesions. Psoriasis is exhibited by plaques with scales. Kaposi sarcoma are cutaneous lesions that are blue-red or dark brown in color. Urticaria is wheals or hives due to infection or allergic reactions.

A client is suspected of sepsis from a postsurgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply. Temperature of 102F Heart rate of 120 beats/minute Respiratory rate of 24 breaths/minute PaCO2 of 42 mm Hg Blood pressure of 120/80 mm Hg

Temperature of 102F Heart rate of 120 beats/minute Respiratory rate of 24 breaths/minute Two or more of the following characterize sepsis: temperature greater than 100.4F (38C), heart rate greater than 90 beats/minute, respiratory rate greater than 20 breaths/minute or PaCO2 less than 32 mm Hg, WBC count greater than 12,000 cells/mm3, or 10% immature (band) forms. Blood pressure is not an indicator of sepsis, and a PaCO2 of 42 mm Hg is not an indicator.

The nurse is assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual partners in the past 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented? The client will require treatment for the secondary stage of syphilis. Treatment planning for a chlamydial infection is needed. Pelvic inflammatory disease is the likely cause of the hair loss. The client will require a colposcopy to confirm any diagnosis.

The client will require treatment for the secondary stage of syphilis. In the secondary stage of syphilis, generalized signs of infection may include lymphadenopathy (abnormal enlargement of lymph nodes), arthritis, meningitis (inflammation of the pia mater, arachnoid, and the subarachnoid space), hair loss, fever, malaise, and weight loss. Hair loss and arthritis are not common symptoms associated with a chlamydial infection or pelvic inflammatory disease. The information collected in the health history confirms that the client has moved past the primary stage of the infection. A colposcopy is a diagnostic procedure carried out to determine if there have been any changes in cervical cells (dysplasia). Given the client's reported health history, secondary syphilis should be further investigated first.

Which statement reflects what is known about the Ebola virus? The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa. Treatment during the acute phase includes administration of penicillin and ventilator and dialysis support. The viruses are usually transmitted by airborne exposure. Symptoms include severe lower abdominal pain, nausea, vomiting, and dehydration.

The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa. The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa, or who has handled animals or animal carcasses from those parts of the world. Antibiotic therapy, such as penicillin, would not be effective for the treatment of viruses. Treatment must be largely supportive maintenance of the circulatory and respiratory systems. The infected client likely would need ventilator and dialysis support through the acute phases of illness. The viruses are usually spread by exposure to blood or other body fluid, insect bite, and mucous membrane exposure. Symptoms include fever, rash, and encephalitis, which progress rapidly to profound hemorrhage, organ destruction, and shock.

The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session? The effect of the vaccination is optimized if it is administered before the child becomes sexually active. The vaccination is available only to girls but, in the long term, protects both genders from sexually transmitted infections. The HPV vaccination prevents the future need for cervical cancer screening in women. A Pap smear test is required prior to administration of the HPV vaccination.

The effect of the vaccination is optimized if it is administered before the child becomes sexually active. The nurse should advise the parents that the vaccination should ideally be administered before the onset of sexual activity, to prevent genital warts. The vaccination is available and effective when administered to both men and women. The HPV vaccination does not preclude women from having regular cervical cancer screening in the future. A Pap smear prior to the administration of the vaccination is not required, particularly for those woman who are not yet sexually active.

You work on a long-term care unit. In the last two weeks more than half the clients on your unit have been diagnosed with gastroenteritis. What is the most likely reason? The clients are in too small an area, so they pass around diseases. The clients don't wash their hands after going to the bathroom. The visitors brought the disease into the unit. The infection is being transmitted by healthcare personnel.

The infection is being transmitted by healthcare personnel. Healthcare personnel are in frequent and direct contact with many clients who harbor various microorganisms; the risk for transmitting pathogenic microorganisms between clients is high.

Nursing students are reviewing information about infectious diseases and events associated with infection. Students demonstrate understanding of the information when they identify the incubation period as which of the following? Time between exposure and onset of symptoms Presence of microorganisms without the host interacting with them State in which the host displays a decrease in wellness Process of the host shedding the microorganisms to another

Time between exposure and onset of symptoms The incubation period is time between contact or exposure and the development of the first signs and symptoms. The presence of microorganisms without the host interacting with them is called colonization. The state in which the host displays a decrease in wellness characterizes an infectious disease. The process of the host shedding the microorganisms to another reflects the mode of exit.

The nurse is presenting a community lecture about STIs, and emphasizes that some STIs are easily cured with early and adequate treatment. Which is not among these easily treated diseases? genital herpes chlamydia gonorrhea syphilis

genital herpes Chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes is not.

During flu season, a nurse is teaching clients about the chain of infection. What components are considered "links" in this chain? Select all that apply. virulence infectious agent portal of entry susceptible host fomites

infectious agent portal of entry susceptible host The six components involved in the transmission of microorganisms are described as the chain of infection. All components in the chain of infection must be present to transmit an infectious disease from one human or animal to a susceptible host: an infectious agent, an appropriate reservoir, exit route, means of transmission, portal of entry, and susceptible host.

A college student comes to the campus health care center complaining of headache, malaise, and a sore throat that has worsened over the past 10 days. The nurse measures a temperature of 102.6° F (39.2° C) and finds an enlarged spleen and liver and exudative tonsillitis. Laboratory tests reveal a leukocyte count of 20,000/mm3, antibodies to Epstein-Barr virus, and abnormal liver function tests. These findings suggest: mumps. poliomyelitis. herpangina. infectious mononucleosis.

infectious mononucleosis. The client's clinical manifestations and laboratory test results suggest infectious mononucleosis. Mumps, a viral disease, usually causes an earache and fever from parotid gland involvement. Poliomyelitis is an acute communicable disease that has been largely eradicated by the polio vaccine. Although its symptoms resemble those of mononucleosis, it typically has a central nervous system component, causing back, neck, and arm pain or paralysis. Herpangina is an acute viral infection that causes seizures, vomiting, stomach pain, and grayish papulovesicles on the soft palate.

The nurse teaches the parent of a child with chickenpox that the child is no longer contagious to others when: the vesicles and pustules have crusted. the first rash appears. the fever disappears. the rash is changing into vesicles, and pustules appear.

the vesicles and pustules have crusted. When the lesions have crusted, the client is no longer contagious to others. The child remains contagious when the rash is present, if fever occurs as the rash is progressing, and when the rash is changing into vesicles and pustules.

A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include: coma or seizures. sunken eyeballs and poor skin turgor. increased heart rate with hypotension. thirst or irritability.

thirst or irritability. Early signs and symptoms of dehydration include thirst, irritability, dry mucous membranes, and dizziness. Coma, seizures, sunken eyeballs, poor skin turgor, and increased heart rate with hypotension are all later signs.


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