A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?
A negative-pressure isolation room.
A private room.
A semi-private room with a client who has pediculosis capitis.
A positive-pressure isolation room.
The Correct Answer is B
Choice A: A Negative-Pressure Isolation Room
A negative-pressure isolation room is typically used for patients with airborne infections, such as tuberculosis, to prevent the spread of infectious particles through the air. Scabies, however, is spread through direct skin-to-skin contact or contact with contaminated items, not through the air. Therefore, a negative-pressure room is not necessary for a client with scabies.
Choice B: A Private Room
Placing the client in a private room is the appropriate action. This helps to prevent the spread of scabies to other patients and staff. Scabies is highly contagious, and isolating the affected individual minimizes the risk of transmission. The client should remain in the private room until the treatment regimen is complete and they are no longer contagious.
Choice C: A Semi-Private Room with a Client Who Has Pediculosis Capitis
A semi-private room with a client who has pediculosis capitis (head lice) is not appropriate. While both conditions involve parasites, they are different and require separate management and treatment protocols. Placing two clients with different contagious conditions in the same room increases the risk of cross-contamination and complicates infection control measures.
Choice D: A Positive-Pressure Isolation Room
A positive-pressure isolation room is used to protect immunocompromised patients from external contaminants by ensuring that air flows out of the room rather than in. This type of room is not suitable for a client with scabies, as it does not address the mode of transmission for this condition.
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Correct Answer is D
Explanation
Choice A reason: Administer 50,000 units of heparin by IV bolus every 12 hours:
This dosage is incorrect and potentially dangerous. Heparin dosing must be carefully calculated based on the patient’s weight and coagulation test results. Standard practice involves adjusting the dose according to the aPTT levels to maintain therapeutic anticoagulation.
Choice B reason: Have vitamin K available on the nursing unit:
Vitamin K is the antidote for warfarin, not heparin. The antidote for heparin is protamine sulfate. Having the correct antidote available is crucial for managing potential bleeding complications associated with heparin therapy.
Choice C reason: Use tubing specific for heparin sodium when administering the infusion:
While it is important to use appropriate tubing for any IV medication, there is no specific tubing required exclusively for heparin sodium. Standard IV tubing is typically sufficient.
Choice D reason: Check the activated partial thromboplastin time (aPTT) every 6 hours:
This is correct. Monitoring aPTT levels is essential when administering a continuous heparin infusion. The aPTT test measures the time it takes for blood to clot and helps ensure that the heparin dose is within the therapeutic range. Regular monitoring helps prevent both under- and over-anticoagulation, reducing the risk of clotting or bleeding complications.
Correct Answer is B
Explanation
Choice A reason:
Saying “Maybe next time you can have a vaginal delivery” is not supportive and may minimize the client’s current feelings of disappointment. It is important to acknowledge and validate the client’s emotions rather than focusing on future possibilities.
Choice B reason:
This response, “It sounds like you are feeling sad that things didn’t go as planned,” is empathetic and validates the client’s feelings. It shows that the nurse is listening and understands the client’s disappointment, which is crucial for emotional support.
Choice C reason:
While it is true that having a healthy baby is important, saying “At least you know you have a healthy baby” can come across as dismissive of the client’s feelings. It is essential to address the client’s emotions directly rather than shifting the focus.
Choice D reason:
Telling the client “You can resume sensations sooner than if you had delivered vaginally” is not relevant to the client’s expressed feelings of disappointment about not having a natural childbirth. This response does not address the emotional aspect of the client’s experience.
