A nurse is caring for a 37-year-old client who smokes cigarettes and is requesting contraception. Which of the following contraceptives should the nurse recommend?

A. Airborne: Airborne precautions are used for pathogens that remain infectious over long distances when suspended in the air, such as Mycobacterium tuberculosis or measles virus. MRSA is not transmitted via airborne particles, so airborne precautions are not indicated.

B. Contact: Contact precautions are appropriate for infections transmitted by direct or indirect contact with the client or contaminated surfaces. MRSA, particularly in wound infections, can spread through touching the wound, dressings, or contaminated objects. Implementing contact precautions—including wearing gloves and gowns and practicing strict hand hygiene—reduces the risk of transmission to other clients and healthcare personnel.

C. Droplet: Droplet precautions are used for infections spread by large respiratory droplets, such as influenza or pertussis. MRSA wound infections are not transmitted via respiratory droplets, making droplet precautions unnecessary.

D. Protective environment: Protective environment precautions are designed to protect immunocompromised clients, such as those undergoing hematopoietic stem cell transplantation, from exposure to environmental pathogens. This is not relevant for a client with MRSA infection, whose care focuses on preventing transmission to others rather than shielding the client

A. The client's right radial pulse is +1: A diminished pulse can indicate compromised circulation, such as arterial compression or compartment syndrome, but it does not specifically reflect paresthesia, which is a sensory symptom. Circulatory assessment is important but assesses perfusion rather than nerve sensation.

B. The client reports the analgesics are not working: Inadequate pain control may indicate severe pain or early compartment syndrome, but it does not specifically identify paresthesia. Pain and paresthesia are related but distinct; paresthesia refers to abnormal sensations like tingling or numbness rather than general pain intensity.

C. The client describes a tingling sensation: Paresthesia is characterized by abnormal sensations such as tingling, numbness, or “pins and needles.” The client’s report of tingling below or around the cast is a direct indication of nerve irritation or compression and warrants prompt assessment to prevent permanent nerve damage.

D. The client's extremity below the cast has reduced pigmentation: Changes in skin color can indicate compromised circulation, such as cyanosis or ischemia, but reduced pigmentation is not a primary symptom of paresthesia. Sensory symptoms are the hallmark of paresthesia rather than visual changes in skin color.