A nurse is assisting with the admission of a client who has tuberculosis with a productive cough.
Which type of isolation precautions should the nurse initiate for the client?

The correct answer is choice B and C.

Choice A rationale:

Cervical insufficiency is a condition where the cervix begins to shorten and open too early during pregnancy, leading to premature birth or loss of an otherwise healthy pregnancy. However, the client’s symptoms do not indicate cervical insufficiency. There are no reports of lower abdominal pressure, mild pelvic cramps, or a change in vaginal discharge, which are common symptoms of cervical insufficiency.

Choice B rationale:

The client’s severe headache unrelieved by acetaminophen, +3 pitting edema in bilateral lower extremities, and hyperactive reflexes (patellar reflex 4+) are indicative of severe preeclampsia. One of the complications of severe preeclampsia is seizures, also known as eclampsia. Therefore, the client is at risk for developing seizures.

Choice C rationale:

Placental abruption is a serious pregnancy complication in which the placenta detaches from the uterus prematurely. The client’s report of decreased fetal movement could be a sign of placental abruption. In addition, severe preeclampsia can increase the risk of placental abruption. Therefore, the client is at risk for developing placental abruption.

Choice D rationale:

Heart failure occurs when the heart can’t pump enough blood to meet the body’s needs. While preeclampsia can eventually affect many organ systems including the cardiovascular system, there are no immediate signs of heart failure in the client’s symptoms.

Choice E rationale:

Hypoglycemia refers to low blood sugar levels. The client’s symptoms do not suggest hypoglycemia. Symptoms of hypoglycemia typically include confusion, dizziness, feeling shaky, hunger, headaches, irritability, pounding heart or irregular heartbeat, sweating, trembling or tremors, and weakness. In conclusion, based on the client’s symptoms and clinical presentation, she is at greatest risk for developing seizures (Choice B) and placental abruption (Choice C) due to severe preeclampsia.

Choice A rationale:

"This medication can increase your risk for sunburn." Ciprofloxacin, a fluoroquinolone antibiotic, can increase the risk of sunburn and photosensitivity reactions. Patients taking this medication should be advised to use sunscreen, wear protective clothing, and avoid excessive sun exposure to prevent sunburn.

Choice B rationale:

"Take an antacid if the medication causes gastrointestinal upset." Ciprofloxacin should not be taken with antacids or other products containing calcium, magnesium, aluminum, or iron, as these can interfere with its absorption. Therefore, advising the patient to take an antacid with ciprofloxacin is incorrect.

Choice C rationale:

"Restrict your daily fluid intake while taking this medication." There is no need to restrict fluid intake while taking ciprofloxacin. In fact, it is important for patients to stay well-hydrated to prevent potential side effects like crystalluria. Adequate fluid intake helps dilute the urine and reduce the risk of crystal formation.

Choice D rationale:

"Expect to experience diarrhea while taking this medication." Diarrhea can be a side effect of ciprofloxacin, but it is not something patients should necessarily expect. While gastrointestinal upset is a known side effect, not everyone who takes the medication will experience diarrhea. Patients should be advised to report any severe or persistent diarrhea to their healthcare provider.