A nurse is caring for a client who is HIV positive and is one day postoperative following an appendectomy. The nurse should wear a gown as personal protective equipment when taking which of the following actions?
Administering an intermittent IV bolus medication
Talking to the client at the bedside
Administering an IM injection
Completing a dressing change
The Correct Answer is D
A. Administering an IV bolus medication does not typically require gowning unless there is a risk of exposure to bodily fluids.
B. Talking to the client does not necessitate wearing a gown, as it does not pose a risk of exposure.
C. Administering an IM injection may require gloves but not necessarily a gown unless there is a risk of splashing.
D. Completing a dressing change involves potential exposure to bodily fluids, so wearing a gown is appropriate for infection control.
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Related Questions
Correct Answer is C
Explanation
A. While administering diphenhydramine may be appropriate for allergic reactions, the priority action is to first stop the transfusion to assess and manage the situation appropriately.
B. Checking the child's apical pulse may provide additional information, but it is not the immediate priority in response to trouble breathing.
C. Stopping the transfusion is the critical first step in managing a suspected transfusion reaction, particularly since the child is exhibiting respiratory distress and a fever, which could indicate an acute hemolytic or allergic reaction.
D. Collecting a urine sample may be indicated later, particularly if a hemolytic reaction is suspected, but it is not an immediate priority over stopping the transfusion and ensuring patient safety.
Correct Answer is D
Explanation
A. Administering Children's Tylenol (acetaminophen) is appropriate for pain relief in toddlers and does not indicate a need for further teaching.
B. Children's Ibuprofen is also acceptable for pain management in this age group, demonstrating the caregiver's understanding of pain management options.
C. Completing the entire course of antibiotics is essential to ensure the infection is fully treated and helps prevent antibiotic resistance.
D. Baby aspirin is contraindicated in children due to the risk of Reye’s syndrome, indicating that the caregiver needs further teaching regarding safe medication administration for pain.
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