A nurse is caring for a client who is intubated and receiving mechanical ventilation for heroin toxicity. Which of the following assessments is the nurse's priority?

Rationale:
A. "I will have to move out of my family's home until I am no longer contagious.": It is not necessary for the client to move out of the home, but precautions such as proper ventilation, wearing a mask, and isolating in a separate room can reduce the risk of transmission to household members during the contagious period.

B. "I will place my used tissues in a plastic bag.": Disposing of used tissues in a sealed plastic bag helps contain respiratory secretions and prevent the spread of Mycobacterium tuberculosis. This is an appropriate infection control practice that demonstrates understanding of proper hygiene.

C. "I will cover my mouth with my hands when I have to cough.": Covering the mouth is essential, but using the hands increases the risk of spreading bacteria through contact with surfaces. The client should be instructed to use a tissue or the inside of the elbow to minimize contamination.

D. "I will not go in public areas until I am cured.": Total avoidance of public areas is not necessary, but the client should avoid crowded places and public transport during the initial phase of treatment, typically the first few weeks, when they are still contagious.

Rationale:
A. Verify the alarm settings on the ventilator: Ensuring alarms are properly set is a routine safety check but does not directly address the client's agitation or risk of self-extubation. It is important but not the priority action in this scenario.

B. Turn on the television: Providing distraction may help reduce mild anxiety but is insufficient for managing significant agitation in a mechanically ventilated client who may become dangerous to themselves if they pull out the endotracheal tube.

C. Obtain a prescription for a vest restraint: Physical restraints should be a last resort after attempting less restrictive methods. Using restraints without addressing the underlying cause of agitation (e.g., discomfort, anxiety, pain) can increase distress and injury risk.

D. Administer a sedative medication: Sedation is appropriate for a mechanically ventilated client who is agitated and at risk for self-extubation. Sedatives help ensure patient comfort, reduce anxiety, and promote ventilator synchrony while protecting the airway.