A nurse is preparing for the admission of client who has suspected active tuberculosis. Which of the following precautions should the nurse plan to implement to safely care for this client?
Assign the client to a room with other clients who require droplet precautions.
Modify the protocol for donning and removing personal protective equipment before entering or leaving the client's room.
Have staff and visitors wear gowns, masks, and gloves while in the client's room.
Place the client in a private room with a special ventilation system.
The Correct Answer is D
Rationale:
A. Clients with active tuberculosis should not be placed in a room with other clients, even if they require droplet precautions, as TB requires airborne precautions.
B. While PPE protocols are important, the most critical precaution for TB is ensuring the client is in the correct environment to prevent airborne transmission.
C. Wearing gowns, masks, and gloves is important, but the most essential measure is the room's ventilation system.
D. Active tuberculosis is an airborne infectious disease, so the client should be placed in a private room with a negative pressure ventilation system to prevent the spread of the bacteria through the air.
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Correct Answer is D
Explanation
Rationale:
A. Contacting the provider for directions may be necessary in some cases, but it does not directly demonstrate grief-informed care, which involves understanding and addressing the emotional needs of the grieving client.
B. Supporting the client's privacy is important, but avoiding discussions about the loss may prevent the client from processing their grief, which is not aligned with grief-informed care.
C. Standing while speaking and keeping the door open can make the client feel uncomfortable or unsupported during a vulnerable time. Grief-informed care emphasizes creating a supportive and empathetic environment.
D. Acknowledging and recognizing that the client has experienced a loss is a key component of grief-informed care. It validates the client's feelings and opens the door for further support and therapeutic interventions.
Correct Answer is B
Explanation
Rationale:
A. Removing the PICC line should only be done if directed by a provider after further assessment.
B. The first action is to measure the circumference of both arms to assess for possible complications such as thrombosis or infiltration. This measurement will help determine the extent of the swelling and inform subsequent actions.
C. Notifying the provider is important but should be done after gathering relevant assessment data, such as the arm circumference.
D. Applying a cold pack may be appropriate for reducing swelling but is not the first step. Assessment should come first.