Which situation should be reported to the nursing supervisor as an exposure for the nurse caring for a patient diagnosed with acquired immunodeficiency syndrome (AIDS)? The nurse
was touching the client on the shoulder without gloves.
was recapping a needle before medication administration.
was not wearing a mask while in the client's room.
had fluids splashing in their eyes while emptying a bedpan.
The Correct Answer is D
A. Touching a patient’s shoulder does not pose a risk of HIV transmission, as it is not spread through casual skin contact.
B. While recapping needles is discouraged due to the risk of needlestick injury, it is not an exposure unless an actual needlestick occurs.
C. Not wearing a mask is typically not necessary in all interactions with HIV/AIDS patients unless there is an active infection requiring airborne precautions.
D. Exposure of bodily fluids to mucous membranes (such as the eyes) is a significant occupational exposure risk and should be reported. This requires immediate response and evaluation for potential infection.
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Correct Answer is B
Explanation
A. While taking some medications with food or milk can help with absorption, this is not a specific requirement for lisinopril.
B. Lisinopril, an ACE inhibitor, can lead to elevated potassium levels. Periodic monitoring of potassium levels is essential to prevent hyperkalemia, a potentially dangerous side effect.
C. Increasing intake of green vegetables is generally healthy but does not directly impact lisinopril's effects.
D. Many salt substitutes contain potassium, which could elevate potassium levels further when taken with ACE inhibitors like lisinopril, posing a risk for hyperkalemia.
Correct Answer is D
Explanation
A. Establishing IV access may be necessary if hypotension persists but is not the initial priority.
B. Bladder distension assessment is essential for managing autonomic dysreflexia in SCI patients; however, symptoms here suggest orthostatic hypotension rather than autonomic dysreflexia.
C. Rescheduling therapy may be considered if dizziness persists, but it does not address the immediate concern.
D. Lowering the head of the bed and obtaining vital signs can help stabilize blood pressure and monitor for orthostatic hypotension, which is common in patients with SCI due to autonomic dysfunction. This intervention helps to prevent syncope.