A nurse is caring for a client who is on isolation precautions. Which of the following pieces of personal protective equipment should the nurse remove first?

Rationale:

• Antibiotic: Administering an antibiotic addresses the underlying infection, which is likely causing the fever, low blood pressure, and altered mental status. Prompt antibiotic treatment reduces the risk of progression to septic shock. Early intervention improves patient outcomes in suspected sepsis.

• Antipyretic: An antipyretic helps reduce fever but does not treat the underlying infection. Lowering the temperature alone would not address the systemic inflammatory response seen in sepsis. This option does not prevent clinical deterioration.

• Anti-anxiety medication: An anti-anxiety medication may temporarily calm the patient but can worsen confusion and mask signs of deterioration. It does not treat the infection or improve hemodynamic status. This is inappropriate in suspected sepsis.

• Suspected surgical site infection and sepsis: The inflamed, draining surgical wound, fever, hypotension, and high WBC strongly indicate a developing infection. Mental status changes are also typical in sepsis. This makes infection the most urgent concern requiring antibiotic therapy.

• Elevated temperature and heart rate: While these signs are concerning, they are common with many conditions and not specific to sepsis. They are part of the clinical picture but not the driving reason for immediate antibiotic treatment.

• History of Parkinson’s disease and confusion: The confusion may partly relate to Parkinson’s or sensory impairment, but acute mental status changes with fever and hypotension suggest sepsis. Parkinson’s is chronic and not the immediate priority.

Rationale:

A. 300 mg PO od: The dose is written clearly with no trailing zeros, and “od” (once daily) is acceptable though “daily” is preferred for clarity. This entry minimizes risk of misinterpretation and decimal errors.

B. 3.0 mg PO gd: Using a trailing zero (3.0 mg) increases the risk of a tenfold dosing error if the decimal point is missed. Also, “gd” is an incorrect abbreviation; “daily” or “once daily” should be used.

C. 10.000 units IV dally: Writing “10.000” with multiple trailing zeros is dangerous because the decimal point might be overlooked, causing a ten-thousand-fold error. Also, “dally” is a misspelling of “daily.”

D. 05 mL IM daily: Leading zeros before whole numbers (05 mL) are unnecessary and can cause confusion. The correct notation is “5 mL.” Leading zeros should only be used before decimals less than one (e.g., 0.5 mL).