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 A
Explanation
Choice A: Decrease the Infusion Rate on the IV
Decreasing the infusion rate on the IV is the appropriate action to take when a client experiences flushing of the neck and tachycardia while receiving vancomycin. These symptoms are indicative of vancomycin flushing syndrome (VFS), also known as “red man syndrome,” which is a reaction caused by the rapid infusion of vancomycin. Slowing the infusion rate allows the body more time to metabolize the drug and can help alleviate the symptoms.
Choice B: Document that the Client Experienced an Anaphylactic Reaction to the Medication
Documenting that the client experienced an anaphylactic reaction is not accurate in this scenario. Vancomycin flushing syndrome is an anaphylactoid reaction, not an anaphylactic one. Anaphylactoid reactions are not mediated by IgE antibodies and do not require prior sensitization to the drug. Therefore, it is important to distinguish between the two and document the reaction correctly.
Choice C: Change the IV Infusion Site
Changing the IV infusion site is not necessary in this case. The symptoms of flushing and tachycardia are related to the rate of vancomycin infusion, not the site of infusion. Therefore, changing the site would not address the underlying issue.
Choice D: Apply Cold Compresses to the Neck Area
Applying cold compresses to the neck area may provide some symptomatic relief, but it does not address the root cause of the reaction. The primary intervention should be to slow the infusion rate to prevent further release of histamine and alleviate the symptoms.
Correct Answer is A
Explanation
Choice A reason:
The first step in removing an NG tube is to verify the provider’s prescription to discontinue the tube. This ensures that the removal is authorized and appropriate for the client’s current condition.
Choice B reason:
Disconnecting the tube from the wall suction is an important step, but it should be done after verifying the provider’s prescription. This step prevents any suction-related complications during the removal process.
Choice C reason:
Performing hand hygiene is crucial to prevent infection, but it is not the first step. Hand hygiene should be performed after verifying the provider’s prescription and before touching the client or any equipment.
Choice D reason:
Providing mouth care to the client is important for comfort and hygiene, but it is not the first step in the process of removing an NG tube. This can be done after the tube has been safely removed.