The nurse has entered a client's room to find the client diaphoretic (sweat-covered) and shivering, inferring that the client has a fever. How should the nurse best follow up this cue and inference?
A) Measure the client's oral temperature.
B) Ask a colleague for assistance.
C) Give the client a clean gown and warm blankets.
D) Obtain an order for blood cultures.
Ans: A
An inference must be followed by a validation process. In this case, the inference of fever is best validated or rejected by measuring the client's temperature. This should precede interventions such as blood work or even providing a warm blanket.
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