A nurse is caring for a client who has the communicable disease influenza. Which of the following isolation precautions should the nurse take?

Double-bag the client's trash before removing it from the room.

Place the client in a negative air pressure room with 6 to 12 air exchanges per hour.

Ensure all air in the client's room is filtered through a HEPA filter.

Wear a surgical mask when within 1 m (3 ft) of the client.

Answer and Explanation

The Correct Answer is D

A) Double-bag the client's trash before removing it from the room: While double-bagging is a precaution used in certain infections to prevent contamination, it is not necessary for influenza. Influenza spreads via respiratory droplets rather than contact with contaminated objects. Standard waste disposal methods are typically sufficient to manage the risk of contamination from trash.

B) Place the client in a negative air pressure room with 6 to 12 air exchanges per hour: Negative air pressure rooms are designed to contain airborne pathogens by preventing contaminated air from escaping the room. Diseases such as tuberculosis or measles require this level of isolation. However, influenza spreads through droplets that settle quickly rather than remaining airborne, making negative air pressure rooms unnecessary for influenza isolation.

C) Ensure all air in the client's room is filtered through a HEPA filter: HEPA (High-Efficiency Particulate Air) filters are used to trap airborne particles. For influenza, which is spread by larger respiratory droplets, such filtration is not needed. The droplets are too large to remain suspended in the air and are typically spread through close contact, rather than requiring air filtration.

D) Wear a surgical mask when within 1 m (3 ft) of the client: This is the most appropriate precaution. Influenza is primarily spread through respiratory droplets that can travel about 1 meter (3 feet) when a person coughs, sneezes, or talks. Wearing a surgical mask within this distance helps prevent inhaling these droplets, thus reducing the risk of transmission. This aligns with droplet precautions which are standard for managing influenza.

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Correct Answer is B

Explanation

A) "Switch from breastfeeding to formula feeding when your baby is 2 months old": Breastfeeding is associated with a reduced risk of otitis media, as breast milk contains antibodies and other factors that help protect against infections. Switching to formula feeding may not reduce the incidence of otitis media and can potentially increase the risk.

B) "Avoid exposing your baby to secondhand smoke": Exposure to secondhand smoke is a significant risk factor for otitis media. Smoke irritates the respiratory tract and can lead to inflammation and fluid accumulation in the middle ear, increasing the likelihood of ear infections. Avoiding secondhand smoke can help reduce the incidence of otitis media.

C) "Ensure your baby receives the Hepatitis B vaccine": While the Hepatitis B vaccine is important for preventing Hepatitis B infection, it does not have a direct impact on the incidence of otitis media. The vaccine’s primary role is in preventing liver disease rather than ear infections.

D) "Place your baby in a supine position during feeding": Placing a baby in a supine position (lying on their back) during feeding does not reduce the risk of otitis media. In fact, feeding a baby while lying flat can increase the risk of ear infections as it may cause milk to flow into the middle ear. It is generally recommended to hold the baby in an upright or semi-upright position during feeding.

A. Wash hands for 10 seconds after caring for the client. B. Monitor the client for manifestations of dehydration. C. Use toilet paper to remove stool from the client's skin. D. Administer diphenoxylate/atropine to the client.

Correct Answer is B

Explanation

A) "Wash hands for 10 seconds after caring for the client.": Proper hand hygiene is critical in preventing the spread of infections, but the recommended duration for handwashing is at least 20 seconds. This option does not specify the necessary steps to ensure effective hand hygiene.

B) "Monitor the client for manifestations of dehydration.": Older adults are at a higher risk of dehydration due to gastroenteritis, which can cause significant fluid loss through vomiting and diarrhea. Monitoring for signs of dehydration, such as dry mucous membranes, decreased skin turgor, and reduced urine output, is a priority in managing their condition and preventing complications.

C) "Use toilet paper to remove stool from the client's skin.": While keeping the client clean is important, using toilet paper might not be sufficient or gentle enough to effectively clean and protect the skin. Using appropriate cleansing methods and skin care products is better for maintaining skin integrity.

D) "Administer diphenoxylate/atropine to the client.": While this medication can help reduce diarrhea, it may not be the first action to take. In some cases, stopping diarrhea too quickly can prevent the elimination of harmful pathogens. Monitoring and addressing hydration status is more critical initially in the management of gastroenteritis.

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