A charge nurse is discussing the responsibility of nurses caring for clients who have a Clostridium difficile infection. Which of the following information should the nurse include in the teaching?

Assign the client to a room with a negative airflow system.

Use alcohol-based hand sanitizer when leaving the client's room.

Clean contaminated surfaces in the client's room with a phenol solution.

Have family members wear a gown and gloves when visiting.

Answer and Explanation

The Correct Answer is D

A. Assign the client to a room with a negative airflow system: Negative-pressure rooms are used for airborne infections, such as tuberculosis, to prevent the spread of droplet nuclei. Clostridium difficile is transmitted via the fecal-oral route, primarily through contact with contaminated surfaces or hands, so a negative airflow system is not required. Contact precautions are sufficient

B. Use alcohol-based hand sanitizer when leaving the client's room: Alcohol-based hand sanitizers are ineffective against Clostridium difficile spores. Proper hand hygiene requires washing hands thoroughly with soap and water to physically remove spores, especially after contact with the client or contaminated surfaces.

C. Clean contaminated surfaces in the client's room with a phenol solution: Clostridium difficile spores are resistant to many common disinfectants, including phenol-based solutions. The recommended disinfectant is a bleach-based solution or EPA-approved sporicidal agent to effectively eradicate spores from surfaces and reduce infection risk.

D. Have family members wear a gown and gloves when visiting: Contact precautions, including wearing gowns and gloves, are essential for anyone entering the room of a client with Clostridium difficile infection. This prevents the transfer of spores to clothing, hands, or other clients, reducing the risk of nosocomial spread. Family and visitors should adhere to the same infection control measures as healthcare personnel.

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Correct Answer is A

Explanation

A. Wrap blankets around all four sides of the bed: Protecting the client from injury is the primary goal during seizure precautions. Padding the bed rails with blankets or seizure pads helps prevent trauma to the head and extremities during tonic-clonic movements. This reduces the risk of injury without restricting the client’s movement and is a standard safety measure.

B. Apply restraints during seizure activity: Restraining a client during a seizure can cause significant injury, including musculoskeletal damage or impaired breathing. During tonic-clonic seizures, the client’s movements are involuntary, and applying restraints may increase the risk of fractures or soft tissue injury.

C. Place the client in a supine position during seizure activity: Placing a client flat on their back increases the risk of airway obstruction and aspiration of saliva or vomitus during a seizure. The recommended position is side-lying (lateral) if possible, which promotes drainage of secretions and helps maintain a clear airway. Maintaining airway safety is a key priority during seizures.

D. Have a tongue depressor at the client's bedside: Inserting objects such as a tongue depressor or any device into the client’s mouth during a seizure is contraindicated. This practice can lead to broken teeth, airway obstruction, or injury to the oral cavity. Modern seizure management emphasizes protecting the client from injury and maintaining airway safety.

A. Have the client wear a mask when receiving visitors. B. Wear a gown when caring for the client. C. Assign the client to a room with negative-pressure airflow exchange. D. Limit the client's time with visitors to no more than 30 min per day.

Correct Answer is B

Explanation

A. Have the client wear a mask when receiving visitors: Mask use is primarily indicated for airborne or droplet precautions to prevent respiratory transmission of pathogens. Shigella is transmitted via the fecal-oral route, not through respiratory droplets, so a mask is not required for visitors or staff in this case.

B. Wear a gown when caring for the client: Contact precautions are appropriate for clients with diarrhea caused by Shigella because the bacteria can be transmitted through direct or indirect contact with fecal matter. Wearing a gown protects the nurse’s clothing from contamination and helps prevent the spread of infection to other clients or surfaces.

C. Assign the client to a room with negative-pressure airflow exchange: Negative-pressure rooms are used for airborne pathogens such as tuberculosis, not for enteric infections like Shigella. Shigella does not remain suspended in the air and therefore does not require special airflow control.

D. Limit the client's time with visitors to no more than 30 min per day: Restricting visitation time is not a standard precaution for fecal-oral infections. Infection control relies on proper hand hygiene, use of personal protective equipment, and environmental cleaning rather than strictly limiting visitor duration.

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A charge nurse is discussing the responsibility of nurses caring for clients who have a Clostridium difficile infection. Which of the following information should the nurse include in the teaching?

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