A charge nurse has four new clients arriving on the unit for admission. Which of the following clients should the nurse place in airborne precautions?
A client who has tuberculosis.
A client who has pneumonia.
A client who has shigella.
A client who has strep throat.
The Correct Answer is A
Choice A Reason:
Tuberculosis (TB) is a highly contagious bacterial infection that primarily affects the lungs and is spread through airborne particles. When a person with active TB coughs, sneezes, or talks, they release tiny droplets containing the bacteria into the air, which can be inhaled by others1. Therefore, placing a client with TB in airborne precautions is essential to prevent the spread of the infection. This involves using a negative pressure room and requiring healthcare workers to wear N95 respirators or higher-level protection.
Choice B Reason:
Pneumonia is an infection that inflames the air sacs in one or both lungs, which can fill with fluid or pus. While pneumonia can be caused by bacteria, viruses, or fungi, it is typically spread through respiratory droplets rather than airborne particles. Therefore, droplet precautions, rather than airborne precautions, are usually sufficient for managing clients with pneumonia. This includes wearing masks and maintaining a safe distance from the infected person.
Choice C Reason:
Shigella is a bacterial infection that primarily affects the intestines and is spread through the fecal-oral route. It is not transmitted through the air, so airborne precautions are not necessary. Instead, contact precautions are recommended to prevent the spread of Shigella, which involves wearing gloves and gowns when handling the patient or their environment and practicing good hand hygiene.
Choice D Reason:
Strep throat is a bacterial infection caused by group A Streptococcus. It is spread through respiratory droplets when an infected person coughs or sneezes. Similar to pneumonia, droplet precautions are sufficient for managing clients with strep throat. This includes wearing masks and maintaining a safe distance from the infected person to prevent the spread of the bacteria.
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Correct Answer is A
Explanation
Choice A reason:
“Why do you feel upset about this?” is a response that opens up a dialogue and allows the nurse to express their feelings and concerns. It shows that the nurse manager is interested in understanding the nurse’s perspective and is willing to listen. This approach can help identify any underlying issues and work towards a resolution. It is important for managers to create an environment where employees feel heard and supported.
Choice B reason:
“You should be working harder.” is a dismissive response that does not address the nurse’s concerns. It can make the nurse feel undervalued and unappreciated, leading to decreased morale and job satisfaction. This response does not foster a supportive work environment and can exacerbate feelings of frustration and resentment. Effective management involves acknowledging employees’ efforts and addressing their concerns constructively.
Choice C reason:
“I will reprimand your team members.” is a response that may seem supportive at first glance, but it can create a negative work environment. Reprimanding team members without understanding the full context can lead to resentment and conflict within the team. It is important for managers to address performance issues in a fair and constructive manner, focusing on solutions rather than punishment.
Choice D reason:
“You must feel frustrated.” is an empathetic response that acknowledges the nurse’s feelings. It shows that the nurse manager understands the nurse’s frustration and is willing to listen. This response can help build trust and rapport between the nurse and the manager, creating a more positive and supportive work environment. Empathy is a key component of effective leadership and can help address and resolve workplace issues.
Correct Answer is D
Explanation
Choice A reason:
“Use a size 20 French catheter for catheterization.” This statement is incorrect. Using a larger catheter size, such as 20 French, can increase the risk of trauma and infection. It is generally recommended to use the smallest catheter size possible to minimize the risk of catheter-associated urinary tract infections (CAUTIs) and other complications.
Choice B reason:
“Allow the drainage bag to fill completely before emptying.” This statement is incorrect. Allowing the drainage bag to fill completely can increase the risk of infection and cause backflow of urine into the bladder. It is recommended to empty the drainage bag when it is two-thirds full to prevent these issues.
Choice C reason:
“Disconnect the drainage tube if the catheter requires irrigation.” This statement is incorrect. Disconnecting the drainage tube can break the closed system and increase the risk of infection. If irrigation is necessary, it should be done using a closed system to maintain sterility and reduce the risk of CAUTIs.
Choice D reason:
“Keep the collection bag below bladder level.” This statement is correct. Keeping the collection bag below bladder level helps prevent backflow of urine into the bladder, which can reduce the risk of infection. This practice is a key component of preventing CAUTIs and is recommended in clinical guidelines.