A nurse is admitting a client who has tuberculosis and a productive cough. Which of the following types of isolation precautions should the nurse initiate for the client?

Choice A reason: "I will be able to tell how much oxygen I'm getting by looking at the flowmeter." This statement is correct because the flowmeter shows the amount of oxygen delivered in liters per minute. The client should check the flowmeter regularly and adjust it according to the prescription.

Choice B reason: "I should call my doctor if I find it harder to concentrate." This statement is correct because difficulty concentrating can be a sign of low oxygen levels or carbon dioxide retention. The client should monitor their symptoms and report any changes to their doctor.

Choice C reason: "I will wear synthetic clothing and woolen socks when using my oxygen." This statement is incorrect because synthetic clothing and woolen socks can create static electricity and increase the risk of fire when using oxygen. The client should wear cotton clothing and avoid materials that can cause sparks.

Choice D reason: "I will make sure my visitors smoke outside." This statement is correct because smoking near oxygen can cause a fire or explosion. The client should keep oxygen away from open flames, smoking materials, and heat sources.

Choice A reason: This is incorrect. Cleansing the perineum from back to front can increase the risk of urinary tract infections, as it can introduce bacteria from the anal area to the urethra. The nurse should instruct the client to cleanse the perineum from front to back, using a mild soap and water, and to change the pad or underwear frequently to prevent bacterial growth.
Choice B reason: This is incorrect. Obtaining a prescription for an indwelling urinary catheter can increase the risk of urinary tract infections, as it can create a direct route for bacteria to enter the bladder. Indwelling catheters should be avoided unless absolutely necessary, and should be removed as soon as possible. The nurse should explore other bladder management options for the client, such as intermittent catheterization, condom catheter, or suprapubic catheter.
Choice C reason: This is incorrect. Offering the client the bedpan every 2 hours can increase the risk of urinary tract infections, as it can cause urinary stasis and bladder distension. The nurse should assess the client's bladder function and determine the optimal frequency of bladder emptying, which may vary depending on the type and level of spinal cord injury. The nurse should also monitor the client's urine output, color, odor, and clarity, and report any signs of infection, such as fever, chills, or flank pain.
Choice D reason: This is correct. Encouraging fluid intake at and between meals can decrease the risk of urinary tract infections, as it can flush out bacteria from the urinary tract and prevent urinary stasis and bladder distension. The nurse should advise the client to drink at least 2 liters of water per day, unless contraindicated by other medical conditions. The nurse should also educate the client about the benefits of cranberry juice, which can inhibit bacterial adhesion to the bladder wall and prevent infection.