Asepsis and Infection Ch 24
NMJ toxicity
. Pyridostigmine is the antidote for nondepolarizing
neuroleptic medications
typical antipsychotics risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa), ziprasidone (Zeldox), paliperidone (Invega), aripiprazole (Abilify) and clozapine (Clozaril).
A client is admitted to the hospital with tuberculosis. Which statement by the nurse explains how to reduce the risk of transmission to others? "All visitors who enter the room must wear N95/surgical masks." "Under no circumstances should you touch the client." "Everyone who enters the room must wear a gown and gloves." "No visitors are allowed in the room to decrease the spread of disease."
"All visitors who enter the room must wear N95/surgical masks." Explanation: Tuberculosis is an airborne respiratory disease, which requires a HEPA-style respirator or N95 mask when visitors or staff enter the room of a client with known or suspected disease. Gowning and gloving do not prevent airborne transmission. Visitors are permitted and there is no firm prohibition against touching the client.
The nurse is preparing to don sterile gloves for a procedure that requires surgical asepsis. Place the following steps in the order that the nurse should take when donning sterile gloves. Use all options.
1. Carefully open the inner package taking care not to touch the inner surface of the package or the gloves. 2. With the thumb and forefinger, grasp the folded cuff of the glove, insert fingers while pulling the glove over thee hand. 3. Place the fingers of the gloved hand inside the cuff of the remaining glove and insert the fingers while stretching it over the hand. 4. Adjust gloves on both hands if necessary, touching only sterile areas with other sterile areas.
Which client would require a negative flow room? a 21-year-old man with latent tuberculosis who is postoperative following repair of a femoral fracture a 4-year-old boy with meningitis an 81-year-old man with active tuberculosis and a productive cough a 3-year-old with influenza A and a productive cough
Active tuberculosis always requires a negative flow room. Active tuberculosis is more contagious Latent TB is are not infectious and cannot spread TB infection to others.
The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?
Albuterol first, wait five minutes and then follow with flunisolide Explanation: Albuterol is a bronchodilator and should be used first, given time to open the airways, and then the inhaled corticosteroid is administered.
A client with history of alcohol abuse is brought to the emergency department after a weekend of heavy drinking, experiencing right upper quadrant pain, anorexia, nausea, jaundice and ascites. The nurse identifies these as manifestations of what disorder? Fatty liver Alcoholic hepatitis Cancer of the gallbladder Cholestasis
Alcoholic hepatitis Explanation: Alcoholic hepatitis is the next stage of liver disease after fatty liver. It is common when there is a sudden increase in alcohol intake and has a mortality rate of approximately 34 percent. The liver becomes inflamed and necrosis occurs. If the client survives and continues to use alcohol, alcoholic hepatitis develops into alcoholic cirrhosis. Fatty liver occurs when there is an accumulation of fat in the liver cells. The liver enlarges and becomes yellow. The fatty changes are reversible when alcohol intake stops. Alcoholic hepatitis is the next stage of liver disease after fatty liver. It is common when there is a sudden increase in alcohol intake and has a mortality rate of approximately 34 percent. The liver becomes inflamed and necrosis occurs. If the client survives and continues to use alcohol, alcoholic hepatitis develops into alcoholic cirrhosis. The liver develops fine, uniform nodules on the surface. As the disease progresses, the nodules become larger, and blood flow is obstructed resulting in portal hypertension, extrahepatic portosystemic shunts, and cholestasis. Gallbladder cancer occurs insidiously and has similar signs/symptoms as cholelithiasis.
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?
Autologous Autologous vaccines are made from the client's own cancer cells, which are obtained during diagnostic biopsy or surgery
A patient receiving succinylcholine experiences malignant hyperthermia. What drug is used to treat this condition?
Dantrolene Explanation: Dantrolene, a muscle relaxant, is the drug of choice to treat malignant hyperthermia. Pyridostigmine is the antidote for nondepolarizing NMJ toxicity. Phenobarbital and acetylsalicylic acid would not treat malignant hyperthermia.
The surgical nurse is administering a unit of packed red blood cells to the postoperative client. Which of the following is the most common transfusion reaction?
Febrile reaction Explanation: A febrile reaction is the most common transfusion reaction. The other options are signs and symptoms of a reaction, but are less frequent.
A client in the operating room goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The nurse knows that the area of the brain that regulates body temperature is what? Cerebellum Thalamus Hypothalamus Midbrain
Hypothalamus Explanation: The hypothalamus plays an important role in the endocrine system because it regulates the pituitary secretion of hormones that influence metabolism, reproduction, stress response, and urine production. It works with the pituitary to maintain fluid balance through hormonal release and maintains temperature regulation by promoting vasoconstriction or vasodilatation. In addition, the hypothalamus is the site of the hunger center and is involved in appetite control.
rigidity, fever, hypertension, and diaphoresis.
NMS - Neuroleptic Malignant Syndrome Neuroleptic malignant syndrome (NMS) is a rare, but life-threatening, idiosyncratic reaction to neuroleptic medications that is characterized by fever, muscular rigidity, altered mental status, and autonomic dysfunction. NMS often occurs shortly after the initiation of neuroleptic treatment, or after dose increases
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone Explanation: Progesterone is the hormone responsible for breast development and increase in body temperature during ovulation. The other options are not involved in either of these processes.
tophi
Small, whitish yellow, hard, nontender nodules in or near helix or antihelix; contain greasy, chalky material of uric acid crystals and are a sign of gout.
Rigidity is defined as
the property exhibited by the solid to change in its shape. That is when an external force is applied to the solid material, there won't be any change in the shape. This shows that the particles are closely packed and the attraction between these particles are very strong.
Sensitization
is the process by which cellular and chemical events occur after a second or subsequent exposure to an allergen.
A client who takes neuroleptic medication for treatment of chronic schizophrenia is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. Which life-threatening reaction do these findings suggest?
neuroleptic malignant syndrome
A nurse is caring for a 55-year-old postoperative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? urinary catheter PICC line Salem sump nasogastric tube endotracheal tube
urinary catheter Urinary catheters account for the highest percentage (26%) of hospital-associated infections. A peripherally inserted catheter is an invasive line. Nasogastric tubes and endotracheal tubes are not associated with HAIs.
Which is not appropriate regarding the use of gowns as PPE? use of paper or cloth gowns donning a gown when splashing use of one gown per person per shift use of a new gown each time the nurse enters the room
A new gown should be used by the nurse each time the nurse enters the client's room.
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds: "Only some of the glomeruli are affected." "Only one segment of each glomerulus is involved." "The mesangial cells are being affected." "All glomeruli and all parts of the glomeruli are involved."
"All glomeruli and all parts of the glomeruli are involved." Glomerular changes can be diffuse, involving all glomeruli and all parts of the glomeruli; focal, meaning only some of the glomeruli are affected; segmental, involving only a certain segment of each glomerulus; and mesangial, affecting only mesangial cells.
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds: "Only some of the glomeruli are affected." "Only one segment of each glomerulus is involved." "The mesangial cells are being affected." "All glomeruli and all parts of the glomeruli are involved." TAKE ANOTHER QUIZ
"All glomeruli and all parts of the glomeruli are involved." Explanation: Glomerular changes can be diffuse, involving all glomeruli and all parts of the glomeruli; focal, meaning only some of the glomeruli are affected; segmental, involving only a certain segment of each glomerulus; and mesangial, affecting only mesangial cells.
An adult client with newly diagnosed asthma presents for client education regarding situations that could precipitate an asthma attack. In this teaching, which precipitants would the nurse state may trigger an attack? Select all that apply.
Exercise Allergens Mold Cigarette smoke Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise.
hypoxia
Low oxygen saturation of the body, not enough oxygen in the blood
Negative air pressure
The situation that occurs when air flows into a room or area because the pressure in the area is less than that of surrounding areas. They are called negative pressure rooms because the air pressure inside the room is lower than the air pressure outside the room. This means that when the door is opened, potentially contaminated air or other dangerous particles from inside the room will not flow outside into non-contaminated areas.
Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply.
Wheezes Compromised gas exchange Decreased airflow Explanation: Bronchospasm, which occurs in many pulmonary diseases, reduces the caliber of the small bronchi and may cause dyspnea, static secretions, and infection. Bronchospasm can sometimes be detected on auscultation with a stethoscope when wheezing or diminished breath sounds are heard. Increased mucus production, along with decreased mucociliary action, contributes to further reduction in the caliber of the bronchi and results in decreased airflow and decreased gas exchange. This is further aggravated by the loss of lung elasticity that occurs with COPD (GOLD, 2015).
Keratitis
is the medical term for inflammation of the cornea. Keratitis has many causes, including infection, dry eyes, disorders of the eyelids, physical and chemical injury, and underlying medical diseases
Symptoms of Rhinitis
normal WBC count, and slow onset are indicative of viral pharyngitis
A client is recovering from an acute myocardial infarction (MI). During the first week of the client's recovery, the nurse should stay alert for which abnormal heart sound? :
pericardial friction rub Explanation: A pericardial friction rub, which sounds like squeaky leather, may occur during the first week following an MI. Resulting from inflammation of the pericardial sac, this abnormal heart sound arises as the roughened parietal and visceral layers of the pericardium rub against each other. Certain stenosed valves may cause a brief, high-pitched opening snap heard early in diastole. Graham Steele murmur is a high-pitched, blowing murmur with a decrescendo pattern; heard during diastole, it indicates pulmonary insufficiency, such as from pulmonary hypertension or a congenital pulmonary valve defect. An ejection click, associated with mitral valve prolapse or a rigid, calcified aortic valve, causes a high-pitched sound during systole.
The nurse is obtaining a health history from a client with laryngitis. Which causative factor, stated by the client, is least likely?
"I was chewing ice chips all day long." Explanation: Chewing ice chips, a form of pica if in excess, is not likely to cause laryngitis. Allergies, smoking, and excessive use of the voice causing straining are frequent causes.
Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis? "My eyes feel like they are on fire." "My eyelids were stuck together this morning." "It feels like there is something stuck in my eye." "My eyes hurt when I'm in the bright sunlight."
"My eyelids were stuck together this morning." Explanation: Burning, a sensation of a foreign body, and pain in bright light (photophobia) are signs and symptoms associated with any type of conjunctivitis. The drainage related to bacterial conjunctivitis is usually present in the morning, and the eyes may be difficult to open because of adhesions caused by the exudate.
A male client is taking aspirin 81 mg by mouth each day for prevention of recurrent myocardial infarction. He makes a dentist appointment for a tooth extraction. He calls the health care provider's office and asks the nurse if he is at risk for bleeding. Which response is correct?
"Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescriber's orders." Explanation: If a client has a history of taking aspirin, including the low doses prescribed for antithrombotic effects, there is a risk of bleeding from common therapeutic procedures (e.g., intramuscular injections, venipuncture, insertion of urinary catheters or GI tubes) or diagnostic procedures (e.g., drawing blood, angiography).
arteriovenous anastomoses (AVA)
-Regulates body temp Anastomosis occurs naturally in the body, where veins and arteries connect to transport blood around the body. Anastomosis in the vascular system creates a backup pathway for blood flow if a blood vessel becomes blocked.
normal axillary temperature range for neonate
97.7 to 99.5°F (36.5 to 37.5°C) A temperature of 97.3°F (36.3°C) is slightly below normal. Because the neonate is full-term, it is safe to warm the neonate using conservative measures such as placing a cap on the head and trying skin-to-skin contact
A nurse is preparing an operating room theatre for a surgical procedure. Which point regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments? When a sterile item touches something that is not sterile, it may not be contaminated. Any partially uncovered sterile package need not be considered contaminated. A commercially packaged surgical item is not considered sterile if past expiration date. Sterility may not be preserved even when one sterile item touches another sterile item.
A commercially packaged surgical item is not considered sterile if past expiration date. When preparing the operation theater for a surgical procedure, the nurse should remember that a commercially packaged surgical item is not considered sterile if it has passed its recommended expiration date. When a sterile item touches an item that is not sterile, then the sterile item is contaminated. If a sterile item touches another sterile item, it is not considered contaminated. A partially uncovered sterile package is considered contaminated.
A client newly diagnosed with otitis media reports that the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse? Assess the tympanic membrane. Educate the client on the therapeutic effects of medications. Document the effectiveness of medications. Irrigate the ear.
Assess the tympanic membrane. Explanation: A client diagnosed with otitis media who feels sudden relief of pain and/or pressure should be assessed for a tympanic membrane rupture. Educating the client on the therapeutic effects of medications is appropriate for newly diagnosed otitis media, but it does not address the sudden disappearance of pain and pressure. Because the medication usually takes 48 to 72 hours to be effective, documenting the medication as effective would be inappropriate. It is not necessary to irrigate an ear with otitis media.
The nurse is performing a medication review of a client diagnosed with myocarditis. What medication may have precipitated the client to have myocarditis?
Azathioprine is an immunosuppressive medication that can cause myocarditis.
A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?
Better mobility Explanation: The nurse should report better mobility in the patient after NSAID drug therapy for arthritis. The patient's blood sugar, respiratory rate, and body temperature are not affected and, hence, are not evaluated by the nurse after treatment.
The nurse is caring for a client with tuberculosis. The prior shift's nurse has placed the client in droplet precautions. Which is the appropriate nursing action? change to contact precautions change to airborne precautions change to standard precautions continue with droplet precautions
CORRECT ANSWER: change to airborne precautions Explanation: Tuberculosis is transmitted via the air, so airborne precautions are required. The other answers are incorrect.
A client with gastroesophageal reflux disease has metaplasia. Which explanation is the cause?
Cells are replaced in response to chronic irritation. Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type in response to chronic irritation and inflammation.
The nurse is performing a sterile change of a client's central line catheter dressing. The client receives a telephone call and stretches the phone cord across the open sterile dressing kit. What is the next best action the nurse should take? Determine what item was touched and replace it. Collect another sterile central line dressing kit. Remove the old central line dressing. Place surgical masks on the nurse and the client.
Collect another sterile central line dressing kit. The phone cord touches the sterile field in such a way that there is no way to determine what item or items are touched, and hence those items need replacement. The next best action for the nurse to take is to gather another sterile kit and start over. After opening the new kit, the nurse may place mask on self and client and remove the old central line dressing.
A 28-year-old man presents with reports of diarrhea, fecal urgency, and weight loss. His stool is light-colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and reports pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect?
Correct response: Crohn disease Explanation: Crohn disease, like ulcerative colitis, causes diarrhea, fecal urgency, weight loss, and systemic symptoms such as erythema nodosum and arthritis. Unlike ulcerative colitis, it also causes steatorrhea but is not as likely to cause blood in the stool. The granulomatous "skip" lesions confirm the diagnosis of Crohn disease. Neither diverticulitis nor colon cancer would cause this combination of symptoms and signs.
Initial first aid rendered at the scene of a fire includes preventing further injury through heat exposure. Which intervention could contribute to tissue hypoxia and necrosis and therefore should be avoided? Removal of clothing Irrigation of the wound Application of ice Removal of hair
Correct response: Application of ice Explanation: Application of ice causes vasoconstriction and diminishes needed blood flow to the zone of injury. Clothing and hair are removed from perimeter of burned area in an effort to remove course of bacterial contamination. Irrigation of the wound assists in the removal of debris.
A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client? Chalazion Stye Conjunctivitis Blepharitis marginalis
Correct response: Conjunctivitis Explanation: Conjunctivitis is inflammation of the conjunctiva and is demonstrated by watery eyes with reddened conjunctiva and sensitivity to light. Sticking of eyelids with pustular drainage is also a sign. It is very contagious and requires antibiotics for treatment. Blepharitis is a chronic scaling with discharge along the eyelid margin. A stye is a localized infection of the sebaceous gland of the eyelid. A chalazion is a chronic painless infection of the meibomian gland. The stye and blepharitis will require antibiotic treatment. A chalazion will clear on its own.
A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition? renal failure urinary tract infection prune belly syndrome acute glomerulonephritis
Correct response: acute glomerulonephritis Explanation: Recent strep infection, hematuria, and proteinuria are indicative of acute glomerulonephritis. These symptoms do not suggest any of the other options.
A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as a/an: increase in cell production. increase in circulating neutrophils. decrease in blood supply to the affected area. decrease in eosinophils at the tissue injury site.
Correct response: increase in circulating neutrophils. Explanation: Leukocytosis, or the increase in white blood cells, is a frequent sign of an inflammatory response, especially those caused by bacterial infection. Leukocytosis occurs due to an increase in circulating neutrophils and eosinophils. Leukocytosis does not occur because of increased cell production, and blood supply is typically increased as part of the inflammatory process.
A nursing student is donning sterile gloves to perform routine tracheostomy care for a client. Which behavior by the student would require immediate intervention from the instructor? washes hands for 20 seconds with soap and water picks up the glove at the folded edge with the thumb and forefinger stretches the glove over the hand without touching the unsterile area reaches down to the bed to pick up a sterile drape
Correct response: reaches down to the bed to pick up a sterile drape Explanation: The sterile gloves should always stay above waist level. Reaching down to the bed could create contamination to the sterile field and the student should be stopped and asked to don sterile gloves again. Washing the hands for 20 seconds with soap and water meets the expectation of 15 seconds. Picking up the folded edge of the glove is the appropriate step to get the glove on while maintaining sterility. The glove must be stretched over the hand carefully.
The nurse is inserting an indwelling catheter. What steps will the nurse distinguish as priority in preventing an infection? Create an area for sterile field and opening packages Place water-soluble lubricant on catheter tip prior to insertion Wash the perineal area with soap and water Ensure opening port of the catheter is closed
Create an area for sterile field and opening packages Explanation: Pathogens require a portal of entry to cause infection. Insertion of an indwelling urinary catheter is a sterile technique; any contamination could cause a portal of entry. Using water-soluble lubricant on catheter tip prior to insertion is correct but will not prevent an infection nor will closing the opening port. Likewise, washing the perineal area with soap and water will reduce microorganisms but will not prevent infection alone. Reference
A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of: Crohn disease Ulcerative colitis Peptic ulcer Zollinger-Ellison syndrome
Crohn disease Explanation: Skip lesions, demarcated granulomatous lesions that are surrounded by normal-appearing mucosal tissue, are a characteristic feature of Crohn disease.
The nurse is assisting in the care of a client during surgery. The nurse will be prepared to administer which drug if the client develops malignant hyperthermia? Acetaminophen Toradol Dantrolene sodium Diazepam
Dantrolene sodium Explanation: Clients who develop malignant hyperthermia will receive dantrolene sodium.
The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by infection control practice standards for hand hygiene? Decontaminate hands using an alcohol-based hand rub. Do not wash hands; apply clean gloves. Wash hands with soap and hot water. Wash hands with soap and water, followed by an alcohol-based hand rub.
Decontaminate hands using an alcohol-based hand rub. Alcohol-based hand rubs can be used if hands are not visibly soiled. If the hands are visibly soiled, the nurse should wash hands with soap and hot water. The nurse should wash their hands. The nurse does not need to wash their hands AND use an alcohol-based hand rub.
The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by infection control practice standards for hand hygiene? Decontaminate hands using an alcohol-based hand rub. Do not wash hands; apply clean gloves. Wash hands with soap and hot water. Wash hands with soap and water, followed by an alcohol-based hand rub.
Decontaminate hands using an alcohol-based hand rub. Explanation: Alcohol-based hand rubs can be used if hands are not visibly soiled. If the hands are visibly soiled, the nurse should wash hands with soap and hot water. The nurse should wash their hands. The nurse does not need to wash their hands AND use an alcohol-based hand rub.
A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring? Delayed hypersensitivity response Anaphylactic reaction Sensitization An immediate hypersensitivity response
Delayed hypersensitivity response Explanation: A delayed hypersensitivity response may develop over several hours or days, or it may reach maximum severity after repeated exposure. Examples of a delayed hypersensitivity response include a blood transfusion reaction that occurs days to weeks after blood administration, rejection of transplanted tissues, and reaction to a tuberculin skin test.
When preparing a sterile field, the nurse notes that the bottle of sterile saline was opened 48 hours ago and is half full. What action does the nurse take to ensure that the saline used is sterile? Since the bottle has been open, previously used, and unexpired, "lip" it by pouring a small amount into a waste container or waste cup. Discard the bottle and get a new one because the saline has expired. Pour the saline into a sterile container on the sterile field by holding it 6 in (15 cm) above the container. Use the saline for the procedure and discard the remaining amount because it has been 48 hours since opening.
Discard the bottle and get a new one because the saline has expired. Explanation: Once a bottle of sterile saline is open, the contents must be used within 24 hours of opening. Lipping the opening of the bottle and pouring the saline into a sterile container by holding it 6 in (15 cm) above the container would be appropriate, but contents in the bottle are expired. The nurse should discard the bottle and get a new one.
The nurse is preparing a sterile field for a bedside procedure. During preparation, the client reaches over the field for the water pitcher. What would be the best action by the nurse? Discard the supplies and field and prepare a new sterile field. Educate the client on sterile fields and continue preparing for the procedure. Give the client the water pitcher and continue preparation. Remove the supplies from the field and replace with new supplies.
Discard the supplies and field and prepare a new sterile field. Explanation: If sterile procedure is disrupted in any way, the nurse must discard all items (including the field) and begin preparing a new sterile field. Reaching over a sterile field would disrupt the sterility of the area. The nurse would not remove the supplies from the field and replace but rather start all over with a sterile field. Education of the client should have been performed prior to the procedure. The nurse should have asked if the client needs anything including a water pitcher prior to the procedure.
A nurse inspecting the IV site of a client notices signs of phlebitis (inflammation). What would be the appropriate nursing intervention for this situation?
Discontinue the IV and relocate it to another spot. The nurse should inspect the IV site for presence of phlebitis (inflammation), infection, or infiltration and discontinue and relocate the IV if any of these signs are noted. Cleaning with alcohol or chlorhexidine is not recommended and does not reduce the phlebitis. The nurse does not need to call the physician for anti-inflammatory medications.
The nurse has finished caring for a client on contact precautions. Which nursing action regarding the stethoscope used to auscultate this client's lungs and bowel sounds is appropriate? Discard it in the waste can. Do nothing; it can be used again immediately. Disinfect it with alcohol swabs. Sterilize it by placing it in the autoclave.
Disinfect it with alcohol swabs. Explanation: Equipment such as stethoscopes, sphygmomanometers, and other assessment tools that are used for clients on contact precautions should be cleaned and disinfected before use on other clients. The other answers are incorrect.
The nurse will assess a client who has a draining abscess. The nurse should perform what action upon entering the room?
Explanation: A draining abscess poses an infection control risk that is sufficiently addressed with contact precautions. Because there is no obvious risk of airborne or droplet transmission, masks, goggles, and face shields are not warranted.
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes: Fistula formation Rectal bleeding Constipation Dysphagia
Fistula formation Explanation: In Crohn disease all layers of the bowel are involved. Complications of Crohn disease include fistula formation, abdominal abscess formation, and intestinal obstruction. Fistulas are tubelike passages that form connections between different sites in the GI tract.
A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?
For their immunosuppressant effects Explanation: Drug therapy using anti-inflammatory and immunosuppressive agents is the mainstay for alleviating symptoms. Some antineoplastic (cancer) drugs also are used for their immunosuppressant effects. Antineoplastic drugs do not decrease the body's risk of infection; an autoimmune disease is not a neoplastic disease. Drugs are not ordered just so the client has strong drug therapy.
A client is diagnosed with rheumatic endocarditis. What bacterium is the nurse aware causes this inflammatory response? Group A, beta-hemolytic streptococcus Pseudomonas aeruginosa Serratia marcescens Staphylococcus aureus TAKE ANOTHER QUIZ
Group A, beta-hemolytic streptococcus Explanation: Acute rheumatic fever, which occurs most often in school-age children, may develop after an episode of group A beta-hemolytic streptococcal pharyngitis (Chart 28-2). Clients with rheumatic fever may develop rheumatic heart disease as evidenced by a new heart murmur, cardiomegaly, pericarditis, and heart failure.
The nurse is caring for a client diagnosed with influenza and acute otitis media. Which is the most effective action the nurse can teach the client's family to prevent the spread of infection? Hand hygiene Proper waste disposal Contact precautions Airborne precautions
Hand hygiene Explanation: Since practicing hand hygiene is the most effective way to help prevent the spread of organisms, it is the most effective action the nurse can teach any client's family to prevent the spread of infection. Proper waste disposal is important but not the most effective way to prevent the spread of infection. Contact precautions and airborne precautions are not applicable to all client situations, so they are not the most effective way to teach any client's family to prevent the spread of infection.
An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student? 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 lotions should not be used after hand hygiene.
Hand hygiene is needed after contact with objects near the client. Explanation: 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 client preparing for discharge with her first baby states that she does not know how to bathe her infant. The nurse demonstrates how to bathe the newborn. What is the best method to reinforce the teaching?
Have the client return demonstrate how to bathe the infant. Explanation: The nurse should show the woman how to bathe the infant and evaluate understanding by having her return demonstrate the skill.After the client return demonstrates the skill, the nurse can also recommend the newborn care classes, ask if there are further questions and recommend the hospital newborn care booklet.
A client is diagnosed with Crohn disease. The nurse instructs the client on which type of dietary needs?
High-calorie, vitamin, and protein diet Nutritional deficiencies are common in Crohn disease because of diarrhea, steatorrhea, and other malabsorption problems. A nutritious diet that is high in calories, vitamins, and proteins is recommended. Because fats often aggravate the diarrhea, it is recommended they be avoided. Elemental diets, which are nutritionally balanced but residue-free and bulk-free, may be given during the acute phase of the illness.
What is the most common cause of drug fever?
Hypersensitivity reaction to medication Drug fever can also be caused by the antithyroid medication propylthiouracil (PTU), atropine and anticholinergic medications, antipsychotic agents, tricyclic antidepressants, cocaine, and amphetamines. The agitation, hyperthermia, and hyperactivity of serotonin syndrome occur with overdose of serotonin reuptake inhibitors.
A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?
Hypothalamus The hypothalamus is the coordinating center of the brain for endocrine, behavioral, and autonomic nervous system function. It is at the level of the hypothalamus that emotion, pain, body temperature, and other neural input are communicated to the endocrine system. The anterior pituitary regulates several physiologic processes, including stress, growth, reproduction, and lactation. The cerebellum is involved in motor control, and the cerebral cortex is associated with sensory, motor, and association.
The nurse is assessing a client 48 hours postpartum and notes on assessment: temperature 101.2oF (38.4oC), HR 82, RR 18, BP 125/78 mm Hg. The nurse should suspect the vital signs indicate which potential situation? Dehydration Normal vital signs Infection Shock
Infection Explanation: Temperatures elevated above 100.4° F (38° C) 24 hours after birth are indicative of possible infection. All but the temperature for this client are within normal limits, so they are not indicative of shock or dehydration.
The nurse is providing an in-service educational program for the interprofessional health care team about infection control precautions. What teaching will the nurse include? Select all that apply. Wear personal protective equipment (PPE). Practice hand hygiene. Use standard precautions only for clients with infection. Use equipment repeatedly on clients with similar conditions. Keep client's environment clean.
Keep client's environment clean. Wear personal protective equipment (PPE). Practice hand hygiene Wearing PPE, practicing hand hygiene, and keeping the client's environment clean interfere with the chain of infection. Standard precautions should be used for all clients, and equipment should be cleaned, disinfected, or sterilized between uses.
A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess? Tremors Kyphosis Syndactyly Tachycardia
Kyphosis Explanation: Loss of motion in the spinal column is characteristic of the disease. Loss of lumbar lordosis occurs as the disease progresses, followed by kyphosis of the thoracic spine and extension of the neck.
A health care provider admits a client with a history of I.V. drug abuse to the medical-surgical unit for evaluation for infective endocarditis. What will an assessment by the nurse most likely reveal?
Osler's nodes and splinter hemorrhages. Explanation: Infective endocarditis occurs when an infectious agent enters the bloodstream, such as from I.V. drug abuse or during an invasive procedure or dental work. Typical assessment findings in clients with this disease include Osler's nodes (red, painful nodules on the fingers and toes), splinter hemorrhages, fever, diaphoresis, joint pain, weakness, abdominal pain, a new or altered heart murmur, and Janeway's lesions (small, hemorrhagic areas on the fingers, toes, ears, and nose). Retrosternal pain that worsens when the client is supine, pulsus paradoxus, and pericardial friction rub are common findings in clients with pericarditis, not infective endocarditis.
The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency? Heart rate of 62 Blood pressure 90/58 mm Hg Oxygen saturation of 96% Temperature of 102ºF
Temperature of 102ºF in a Thyroid Storm, your Blood pressure, HR, temperature soar high and can be fatal
A nurse is assessing a full-term neonate and discovers a heart rate of 100 beats/minute and an axillary temperature of 97.3°F (36.3°C). What action should the nurse take? Place a cap on the neonate's head, and offer the neonate to the mother for skin-to-skin contact. Place the neonate in an incubator, and notify the healthcare provider of the neonate's temperature. Perform a thorough physical assessment including checking rectal temperature. Encourage the mother to breastfeed the infant as soon as possible.
Place a cap on the neonate's head, and offer the neonate to the mother for skin-to-skin contact. Explanation: The normal axillary temperature range for a neonate is 97.7 to 99.5°F (36.5 to 37.5°C). A temperature of 97.3°F (36.3°C) is slightly below normal. Because the neonate is full-term, it is safe to warm the neonate using conservative measures such as placing a cap on the head and trying skin-to-skin contact. There is no need to encourage feeding. Performing an assessment would require exposing the neonate and is not indicated. If this were an unstable or preterm neonate, an incubator may be recommended due to the underdeveloped thermoregulation in these neonates. Neonates with hypothermia experience bradycardia, which is defined as a heart rate less than 100 beats/minute.
The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response
Plant Pollen
A central venous catheter is inserted for a client being treated for acute pancreatitis. Which of the following would the nurse need to monitor closely?
Pressure Measurements R:When the physician inserts a central venous catheter in a client who is being treated for acute pancreatitis, the nurse monitors pressure measurements. The nurse should also monitor serum electrolyte values, urine volume, and lung sounds even if a central venous catheter has not been inserted.
The nurse is caring for a client who has been placed in strict isolation. Which nursing action is appropriate? Allow many family members to visit at once. Deliver flowers and balloons to the room. Remove fresh fruit from the room. No special precautions are required.
Remove fresh fruit from the room. Explanation: Fresh fruit and flowers can carry pathogens and chemicals to which the client should not be exposed. The number of visitors should be controlled to prevent exposure to multiple infection opportunities.
The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication? LABA SABA Antiasthma Leukotriene modifier
SABA Explanation: Albuterol is a short-acting beta-2 agonist (SABA). It is used to treat and prevent bronchospasm.
A client has come to the clinic requesting a hepatitis A and B vaccination before leaving on a tropical vacation. After assessing the client, the nurse should prioritize what finding to communicate to the provider? The client takes corticosteroids to treat rheumatoid arthritis The client uses marijuana two to three times per month The client received the annual influenza vaccine seven days ago The client has type two diabetes that is controlled by diet
The client takes corticosteroids to treat rheumatoid arthritis Explanation: Corticosteroids decrease the normal immune response and could interfere with the intended stimulation of B cells. Recent influenza vaccination does not contraindicate the hepatitis vaccine, nor does type 2 diabetes. Occasional marijuana use would not contraindicate a hepatitis vaccination.
Sterile glove technique
The correct order of putting on sterile gloves is as follows. First, the nurse should open the package, taking care not to touch the inner surface of the package or gloves. Then, the nurse should pick up the glove at the folded cuff with the thumb and forefinger and insert fingers while pulling the glove over the hand. Next, the nurse should place the finger of the gloved hand inside the cuff of the remaining glove, taking care not to touch outside of the folded cuff. Once both gloves are on, the nurse adjusts the gloves touching only sterile areas. If gloves are donned not following this order, there is an increased risk for contamination of the sterile gloves.
The nurses on a busy surgical ward use hand hygiene when caring for postsurgical patients. Which action represents an appropriate use of hand hygiene? The nurse uses gloves in place of hand hygiene. The nurse keeps fingernails less than 1/4 in (0.63 cm) long. The nurse uses hand hygiene instead of gloves when in contact with blood. The nurse refrains from using hand moisturizer following hand hygiene.
The nurse keeps fingernails less than 1/4 in (0.63 cm) long. Explanation: The nurse needs to keep fingernails less than 1/4 in (0.63 cm) long. Gloves should never be used in place of hand hygiene. Gloves should always be worn when the nurse is in contact with blood. The nurse could use a hospital sanctioned hand moisturizer after hand hygiene, but this is not the best answer.
An immediate hypersensitivity response is due to
antibodies interacting with allergens and occurs rapidly.
Personal protective equipment (PPE) is used in health care facilities for primarily which reason? To protect both the staff and clients from becoming infected by one another To protect clients from becoming infected by staff members To protect staff members from becoming infected by clients To protect the hospital from legal liability
To protect both the staff and clients from becoming infected by one another
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? Apply a 1-in (2.5-cm) layer of the ointment to the site using the index finger Use a sterile cotton-tipped applicator to apply the prescription to the site Place sterile 4 × 4 gauze on the wound and secure the dressing with dressing with paper tape Put soiled dressing change supplies in the client's bathroom garbage and double bag
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 community nurse is educating a family about infection control measures. What teaching will the nurse include? Select all that apply. Hand hygiene is not needed in the home environment. 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
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.
Which instructions regarding swimming should the nurse give to a client who is recovering from otitis externa?
Wear soft plastic earplugs. The nurse should advise the client to wear soft plastic earplugs to prevent trapping water in the ear while swimming.
The nurse conducting a hand hygiene in-service determines that the participants need additional education when they state that the use of an alcohol-based hand rub is appropriate in which situation? After completing a wound dressing Before direct contact with clients After direct contact with clients When hands are visibly soiled
When hands are visibly soiled Explanation: Alcohol-based hand rubs can be effective for decontaminating a health care worker's hands before and after direct contact with clients and after completion of a wound dressing, except when the health care worker's hands are visibly soiled.
A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?
You Selected: "Monitor your body temperature." The nurse should instruct the client to monitor body temperature. Fever can signal an exacerbation and should be reported to the physician. Sunlight and other sources of ultraviolet light may precipitate severe skin reactions and exacerbate the disease. Fatigue can cause a flare-up of SLE. Clients should be encouraged to pace activities and plan rest periods. Corticosteroids must be gradually tapered because they can suppress the function of the adrenal gland. Abruptly stopping corticosteroids can cause adrenal insufficiency, a potentially life-threatening situation.
During an eye assessment the nurse notes inflammation of the client's cornea. The nurse should document this as which condition?
You Selected: Keratitis Keratitis, or inflammation of the cornea, can be caused by infections, hypersensitivity reactions, ischemia, trauma, defects in tearing, or trauma.
Which term refers to inflammation of the renal pelvis? ]
You Selected: Pyelonephritis Pyelonephritis is an upper urinary tract inflammation, which may be acute or chronic. Cystitis is inflammation of the urinary bladder. Urethritis is inflammation of the urethra. Interstitial nephritis is inflammation of the kidney.
Anaphylaxis
a severe response to an allergen in which the symptoms develop quickly, and without help, the patient can die within a few minutes.
therapeutic vaccines
are given to kill existing cancer cells and to provide long-lasting immunity against further cancer development.
Allogeneic vaccines
are made from cancer cells that are obtained from other people who have a specific type of cancer.
The nurse is performing a medication review of a client diagnosed with myocarditis. What medication may have precipitated the client to have myocarditis? azathioprine furosemide acetaminophen ciprofloxacin
azathioprine Explanation: Azathioprine is an immunosuppressive medication that can cause myocarditis. Furosemide is a diuretic and acetaminophen is an anti-inflammatory; they are not known to cause myocarditis. Ciprofloxacin is a antibiotic not known to precipitate myocarditis.
The four most common types of HAIs are related to invasive devices or surgical procedures:
catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI) surgical site infection (SSI), and ventilator-associated events (VAEs)
A woman comes to the emergency room with her 2-year-old son. She states he woke up and had a loud barking cough. The child is suffering from: atelectasis. pulmonary fibrosis. asthma. croup.
croup. Explanation: Croup and epiglottitis are common in young children. The child has an obstruction of the upper airways, with swelling of the throat tissue. Atelectasis results when the lungs collapse as a result of the alveoli being unable to expand. Symptoms include difficulty breathing and discomfort. Pulmonary fibrosis is a condition in which the lung tissue becomes stiff and unable to expand appropriately. Asthma is a condition associated with bronchoconstriction. The symptoms include nonproductive cough, dyspnea, and wheezing.
A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for: exophthalmos and conjunctival redness. flushed, warm, moist skin. systolic murmur at the left sternal border. decreased body temperature and cold intolerance.
decreased body temperature and cold intolerance. Explanation: Hypothyroidism markedly decreases the metabolic rate, causing a reduced body temperature and cold intolerance. Other signs and symptoms include dyspnea, hypoventilation, bradycardia, hypotension, anorexia, constipation, decreased intellectual function, and depression. Exophthalmos; conjunctival redness; flushed, warm, moist skin; and a systolic murmur at the left sternal border are typical findings in a client with hyperthyroidism.
Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?
elevated anti-nuclear antibodies (ANA) There is no single diagnostic test that is used to diagnose SLE, such as an "SLE assay." However, the most common laboratory test performed is the immunofluorescence test for ANA, because 95% of people eventually diagnosed with the disease have elevated ANA levels. Rheumatoid factor is relevant to the diagnosis of rheumatoid arthritis, but is not among the diagnostic criteria for SLE. SLE can cause anemia, characterized by a low RBC count, but this finding is not specific to SLE to the same degree as elevated ANA.
What is a symptom of bacterial pharyngitis? fever rhinitis symptoms have gradual onset white blood cell (WBC) count in normal range
fever Bacterial pharyngitis is most often caused by group A streptococcus. Fever is a symptom of bacterial pharyngitis. Other symptoms are an elevated WBC count, abrupt onset, headache, sore throat, abdominal discomfort, enlargement of tonsils, and firm cervical lymph nodes. It must be treated with an antibiotic. Penicillin is the drug of choice. Symptoms of rhinitis, a normal WBC count, and slow onset are indicative of viral pharyngitis.
A male client comes to the clinic with complaints of pain in his great toe. The client reports that the pain is worse at night. Assessment reveals tophi. The nurse suspects the client has osteoarthritis. gouty arthritis. rheumatoid arthritis. reactive arthritis.
gouty arthritis. Explanation: Gout results from the inability to metabolize purines. This condition is most commonly seen in men and usually affects the legs, feet, and knees. Osteoarthritis is caused by degeneration of the joints. Rheumatoid arthritis is a systemic disorder more common in women of childbearing age. Reactive arthritis is seen with infections and is most common in young adult males.
Which personal protective equipment (PPE) should the nurse don to enter the room of a client who is diagnosed with Clostridium difficile? goggles and gloves respirator mask and gown gown and gloves mask and shoe covers
gown and gloves Explanation: A client with Clostridium difficile requires contact isolation. Gown and gloves are the most appropriate options for this client; more so than goggles and gloves, respirator masks and gowns, and masks and shoe covers.
A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the priority nursing action? remove the garments that are most contaminated make contact between two contaminated surfaces make contact between two clean surfaces handwashing before leaving the client's room
handwashing before leaving the client's room Explanation: The most important nursing action is to perform a thorough handwashing before leaving the client's room and before touching any other client, personnel, environmental surface, or client care items. Regardless of which garments they wear, nurses follow an orderly sequence for removing them. The procedure involves - making contact between two contaminated surfaces or two clean surfaces. - Nurses remove the garments that are most contaminated first, preserving the clean uniform underneath.
An 85-year-old client is admitted to the ED. Heatstroke is suspected. The client's core temperature is 106.2°F (41.2°C), blood pressure (BP) 90/60 mm Hg, and pulse 102 bpm. The nurse understands that the primary treatment measure for the client will include administration of sodium supplements. IV hydration with normal saline solution. endotracheal intubation with mechanical ventilation. immersion of the client in a cold-water bath.
immersion of the client in a cold-water bath. Explanation: For the client with heat stroke, simultaneous treatment focuses on stabilizing oxygenation using the CABs (circulation, airway, and breathing; formerly called the ABCs) of basic life support. This includes establishing IV access for fluid administration. After the client's clothing is removed, the core (internal) temperature is reduced to 39°C (102°F) as rapidly as possible, preferably within 1 hour. One or more of the following methods may be used as prescribed: cool sheets and towels or continuous sponging with cool water; ice applied to the neck, groin, chest, and axillae while spraying with tepid water; and cooling blankets. Immersion of the client in a cold-water bath is the optimal method for cooling (if available). Hydration would be with lactated Ringer solution. There is no indication for intubation. Administration of sodium supplements is indicated for the treatment of heat cramps.
A nurse is taking stock of the equipment in the room of an older adult client with pneumonia who has been on parenteral nutrition for a long time. Which equipment can transmit infection to older adult clients? indwelling catheter bath blanket face shields specimen containers
indwelling catheter Explanation: Infections are often transmitted to older adult clients through equipment reservoirs (e.g., indwelling urinary catheters, humidifiers, and oxygen equipment) or through incisional sites, such as those for intravenous tubing, parenteral nutrition, or tube feedings. Use of proper aseptic techniques is essential to prevent the introduction of microorganisms. Bath blankets, face shields, and specimen containers are not part of the equipment reservoir that transmits infection easily, because they are disposed of immediately after one-time use.
The nurse is recovering from a mild upper respiratory infection with no fever. The nurse is assigned to care for four clients. What is the appropriate nursing action to prevent clients from getting the infection? perform meticulous hand hygiene only accept clients who are not immune compromised and perform meticulous hand hygiene perform meticulous hand hygiene and don a new mask with each client encounter wear a mask and don gloves with each client encounter until symptoms are completely gone.
perform meticulous hand hygiene and don a new mask with each client encounter The nurse with a mild upper respiratory infection should don a new mask and practice meticulous hand hygiene with each encounter with a client. Hand hygiene alone will not control transmission of the infection. All clients are at risk for infection, not just those who are immune compromised. The window for being contagious varies dependent on the microorganism. The absence of a fever is not always an indication that the microorganisms can't be transmitted. Gloves are not specifically needed if hand washing procedures are followed with each contact.
The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. This particular vascular structure allows a client to: regulate body temperature. prevent localized hypoxia. form "goose bumps" when cold. maximize skin perfusion.
regulate body temperature. Explanation: Anastomoses are important for temperature regulation. They can open up, letting blood flow through the skin vessels when there is a need to dissipate body heat, or close off, conserving body heat if the environmental temperature is cold. Although goose bumps are a reaction to cold, they are actually caused by the contraction of the arrector pili muscles. They are not involved specifically in oxygenation.
What organ is the primary site of heat loss in the body? skin lungs heart kidneys
skin Explanation: The skin is the primary site of heat loss in the body. The lungs, heart, and kidneys are located in the body and do not lose heat outwardly like the skin.
Prophylactic vaccines,
such as the polio vaccine, are given to prevent people from developing a disease.
The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately? earache, stiff neck, or sore throat blisters, ulcers, or a rash appear temperature of 101°F (38.3°C) or greater difficulty or pain when swallowing
temperature of 101°F (38.3°C) or greater Explanation: The parents should seek medical care immediately if the child has a temperature of 101°F (38.3° C) or greater. This is because many chemotherapeutic drugs cause bone marrow suppression; the parents must be directed to take action at the first sign of infection in order to prevent overwhelming sepsis. The appearance of earache, stiff neck, sore throat, blisters, ulcers, or rashes (or difficulty/pain when swallowing) are reasons to seek medical care, but are not as grave as the risk of infection.
Personal protective equipment (PPE) is used in health care facilities to protect the staff from potentially infected clients.
true PPE protects both the health care worker and clients from infection. It use interrupts the chain of infection.