A nurse is assessing a client who had a stroke 2 days ago. Which of the following findings should the nurse identify as a need for a referral to speech-language pathology?

Choice A reason: This is an incorrect action by the unit nurse. Alcohol-based hand sanitizer is not effective against Clostridium difficile spores, which can cause severe diarrhea and colitis. The nurse should wash their hands with soap and water after removing gloves to prevent the spread of the infection.

Choice B reason: This is a correct action by the unit nurse. Wearing goggles when emptying the bedpan of liquid stool is a standard precaution that protects the nurse's eyes from exposure to body fluids. The nurse should also wear gloves and a gown when handling the bedpan.

Choice C reason: This is a correct action by the unit nurse. Placing the client in contact precautions is an appropriate measure for clients who have Clostridium difficile. Contact precautions prevent direct or indirect transmission of the infection through contact with the client or the client's environment. The nurse should use a single room or cohort the client with another client who has the same infection.

Choice D reason: This is a correct action by the unit nurse. Cleaning contaminated equipment with bleach-based solution is an effective way to kill Clostridium difficile spores, which can survive on surfaces for a long time. The nurse should follow the manufacturer's instructions for the dilution and contact time of the bleach solution.

Choice A reason: I should discard personal health information documents in the trash before leaving the unit is not a correct statement, as it violates the client's privacy and the Health Insurance Portability and Accountability Act (HIPAA). I should shred or dispose of personal health information documents in a secure container or according to the facility's policy.

Choice B reason: I can post the client's vital signs in the client's room is not a correct statement, as it exposes the client's health information to unauthorized persons. I should keep the client's vital signs confidential and only share them with the client and the health care team.

Choice C reason: I can use another nurse's password as long as I log off after using the computer is not a correct statement, as it compromises the security and integrity of the electronic health record. I should use my own password and never share it with anyone else.

Choice D reason: I should encrypt personal health information when sending emails is a correct statement, as it protects the client's privacy and the HIPAA. I should use encryption or other secure methods when transmitting personal health information electronically.