A nurse is changing the bed linen of a client admitted to the health care facility. Which of the following isolation precautions should the nurse follow?
A) Standard precautions
B) Droplet precautions
C) Contact precautions
D) Airborne precautions
Ans: A
Health care personnel follow standard precautions whenever there is the potential for contact with the following: blood; body fluids except sweat, regardless of whether they contain visible blood; non-intact skin; and mucous membranes. Standard precautions are measures for reducing the risk of microorganism transmission from both recognized and unrecognized sources of infection. The other three precautions are transmission-based precautions, which are measures for controlling the spread of infectious agents from clients known to be, or suspected of being, infected with highly transmissible or epidemiologically important pathogens.
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The nurse is providing discharge instructions to the mother of a child admitted for fever of unknown origin. Which of the following statements, if made by the mother, would indicate the need for further instruction?
1. "I should use Tylenol or aspirin to bring down the temperature." 2. "I should contact the doctor if I cannot wake up my child." 3. "I should observe how much my child urinates." 4. "I should monitor my child's intake of fluids throughout the day."
When reviewing an older client's medical record, which findings lead the nurse to perform a nutrition assessment? (Select all that apply.)
a. Widow/widower status b. Chronic constipation c. History of depression d. Random blood sugar level of 198 mg/dL e. Cholecystectomy 4 years ago f. Inability to afford a new pair of glasses
The nurse is teaching a patient about proper administration of eardrops. Which statements are correct?
(Select all that apply.) a. Remove cerumen with a cotton-tipped swab before instilling the drops. b. Instill the drops while still cool from refrigeration. c. Warm the eardrops to room temperature before instillation. d. The adult patient should pull the pinna of the ear up and back. e. Insert a dry cotton ball firmly into the ear canal after instillation. f. Massage the earlobe after instillation.
The nurse is conducting a home care assessment for a patient who was recently discharged from the hospital. Which question will assess safety needs regarding elimination?
1) "Is your bathroom accessible?" 2) "Do you have grab bars installed by the toilet?" 3) "Do you get up often in the middle of the night to use the toilet?" 4) "Do you require help with hygiene after using the toilet?"