A nurse is assisting in the care of a client who has the hepatitis A virus.
Which of the following modes of transmission should the nurse identify as how the client acquired the virus?

Choice A rationale

Dextrose 5% in 0.45% sodium chloride is hypotonic and inappropriate for transfusing packed RBCs, as it can cause hemolysis due to the lower osmolarity of the solution compared to the intracellular environment of the RBCs.

Choice B rationale

Lactated Ringer’s contains calcium, which can chelate with the citrate in stored blood, leading to clots in the transfusion line. This makes it unsuitable for use as an intravenous solution for packed RBCs.

Choice C rationale

0.9% sodium chloride is isotonic and compatible with packed RBCs. It preserves the integrity of RBCs during transfusion, ensuring that no hemolysis or clotting occurs due to interaction with the solution.

Choice D rationale

Dextrose 5% in water is hypotonic and unsuitable for transfusion of packed RBCs, as it can cause hemolysis. The low osmolarity of this solution compromises the cell membrane of the erythrocytes, leading to their destruction. .

Choice A rationale

Alzheimer's disease affects cognitive function, making it difficult for clients to process and remember complex instructions. Limiting instructions to two steps at a time reduces cognitive overload and enhances the client's ability to follow directions. This approach is supported by evidence-based guidelines for managing Alzheimer's, which emphasize simplifying tasks to match the individual's functional capabilities.

Choice B rationale

Encouraging independence in activities of daily living (ADLs) may lead to frustration and increased agitation in clients with Alzheimer's. As cognitive decline progresses, the client often lacks the ability to independently complete ADLs, requiring structured assistance to prevent anxiety and promote safety.

Choice C rationale

Using socialization as a distractor during agitation is not effective because it may overstimulate the client, worsening the agitation. Alzheimer's clients are often sensitive to changes in environment and increased activity, necessitating calm and consistent approaches during episodes of distress.

Choice D rationale

Varying staff providing care disrupts consistency and routine, which are crucial for clients with Alzheimer's. Familiar caregivers help foster trust and reduce confusion, aligning with care practices that prioritize stability and minimize anxiety caused by frequent changes in personnel.