A nurse is assisting with planning interventions for an influenza outbreak in a long-term care facility. Which of the following interventions should the nurse include in the plan?
Provide prophylactic antibiotics for clients who have been exposed to influenza.
Assign health care personnel to non-direct care activities for 24 hours after developing influenza symptoms.
Place restrictions on visitation.
Implement airborne precautions for clients who have influenza.
The Correct Answer is C
A. Provide prophylactic antibiotics for clients who have been exposed to influenza: Antibiotics are not effective against viral infections like influenza. Antiviral medications may be used for prophylaxis in exposed individuals.
B. Assign health care personnel to non-direct care activities for 24 hr after developing influenza symptoms: Healthcare personnel should not provide care while symptomatic. The recommended restriction period is typically longer than 24 hours.
C. Place restrictions on visitation. During an influenza outbreak, limiting visitation can reduce the spread of infection, especially in vulnerable populations like those in long-term care facilities.
D. Implement airborne precautions for clients who have influenza: Influenza is spread through droplets, not airborne particles. Droplet precautions are appropriate.
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Correct Answer is A
Explanation
A. Continuous bubbling in the water-seal chamber: Continuous bubbling in the water-seal chamber indicates a possible air leak in the system, which needs to be assessed and potentially reported to the charge nurse for further evaluation.
B. Patient respiratory status is stable and denies pain to chest tube site: This is a normal finding and does not require reporting.
C. Tidalling, fluctuations in the fluid level in the water-seal chamber: This is a normal finding, indicating that the chest tube is functioning properly and that the lungs are expanding.
D. Occasional bubbling in the water-seal chamber: This may be acceptable, especially with respiratory movements, as it could indicate that the patient is exhaling, but continuous bubbling is concerning.
Correct Answer is C
Explanation
A. "It delivers the highest concentration of oxygen possible." This is inaccurate; other methods (like non-rebreather masks) deliver higher concentrations.
B. "It delivers a specific concentration of oxygen constantly." While it does provide a specific concentration, it is not as constant as other devices because it can vary based on the client's breathing patterns.
C. "It delivers the low concentration of oxygen you need." A nasal cannula typically delivers a low concentration of oxygen (approximately 24-44% oxygen depending on the flow rate), which is appropriate for clients who need supplemental oxygen but do not require a high concentration.
D. "It allows you to remove it for a while when it gets uncomfortable." This is misleading; while the client can remove it temporarily, it is essential to maintain oxygen therapy as prescribed for adequate oxygenation.