A patient who is receiving an immune suppressant has been admitted to the unit. What would be a priority action by the nurse?
A) Monitor nutritional status.
B) Provide patient teaching regarding the drug.
C) Protect the patient from exposure to infection.
D) Provide support and comfort measures in relation to adverse effects of the drug.
C
Feedback:
Patients taking immune suppressant drugs are more susceptible to infection because the patient's normal body defenses will be diminished. As a result, the priority action by the nurse would to protect the patient from exposure to infection through room selection, good hand hygiene, and taking care to avoid exposure to sick staff members. Teaching will need to include avoiding crowded places and people with known infection and those working in soil. Nutritional status is important as are comfort and support measures and other instructions concerning the drug. However, protecting the patient from infection should be the priority action.
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