A nurse is caring for a client with chickenpox. Which nursing intervention should the nurse prioritize to prevent transmission of the virus?
Monitor vital signs, fluid intake, and output.
Provide comfort measures such as cool compresses and loose clothing.
Encourage oral hygiene and a soft diet.
Isolate the patient until all lesions are crusted over.
The Correct Answer is D
Choice A rationale:
Monitoring vital signs, fluid intake, and output is important for assessing the client's overall health and hydration status, but it does not specifically address preventing the transmission of the virus.
Choice B rationale:
Providing comfort measures like cool compresses and loose clothing can help alleviate symptoms and discomfort, but it does not directly address preventing the transmission of the virus.
Choice C rationale:
Encouraging oral hygiene and a soft diet is essential for managing the client's symptoms and promoting healing, but it does not focus on preventing the spread of the virus to others.
Choice D rationale:
Isolating the patient until all lesions are crusted over is a crucial nursing intervention to prevent transmission of the chickenpox virus. Chickenpox is highly contagious, primarily spread through respiratory droplets and contact with the fluid from the skin lesions. By isolating the patient until all lesions have crusted over, the risk of spreading the virus to others is significantly reduced.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale:
Postherpetic neuralgia is a potential complication of shingles. It occurs when nerve pain persists even after the rash has healed and can be a long-term and debilitating condition.
Choice B rationale:
Cranial nerve palsies can be a complication of shingles when the herpes zoster virus affects the cranial nerves, leading to neurological symptoms and complications.
Choice C rationale:
Bacterial superinfection is not a common complication of shingles. Shingles is caused by a viral infection, and while bacterial superinfection can occur if there is a secondary bacterial infection of the skin lesions, it is not a primary concern.
Choice D rationale:
Reye syndrome is not associated with shingles or its treatment. Reye syndrome is a rare but serious condition that primarily affects children recovering from viral infections, particularly those who have taken aspirin.
Choice E rationale:
Eye involvement is a potential complication of shingles, particularly if the herpes zoster virus affects the ophthalmic nerve, leading to eye pain, redness, and sometimes vision problems. Immediate medical attention is required in such cases to prevent complications that could lead to vision loss.
Correct Answer is B
Explanation
Choice A rationale:
Administering the Td vaccine only if the wound is severe is not the correct response. Tetanus prophylaxis is recommended based on wound type and vaccination history, not just the severity of the wound.
Choice B rationale:
This is the correct response. Tetanus prophylaxis involves giving Tetanus Immunoglobulin (TIG) for immediate protection against tetanus toxin, along with the Tetanus and Diphtheria (Td) vaccine to promote long-term immunity. The decision to administer TIG and Td vaccine depends on the patient's wound type and their vaccination history.
Choice C rationale:
Tetanus prophylaxis is necessary even if the client received the DTP vaccine in childhood. The immunity from childhood vaccines may wane over time, and tetanus prophylaxis is recommended after potential exposure to the tetanus-causing bacteria.
Choice D rationale:
Giving the Td vaccine every 5 years is not the correct approach. The recommended schedule for Td booster doses is every 10 years, not every 5 years.
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