A nurse is caring for a toddler who has varicella zoster. Which of the following actions should the nurse take?

A. Educating the client how to cover nose and mouth with tissues when coughing: Covering the nose and mouth helps prevent airborne transmission of Mycobacterium tuberculosis. Proper disposal of tissues and hand hygiene further reduce the risk of spreading the infection to others.

B. Recommending the client may return to work after two negative sputum cultures: Returning to work should only be considered after the client is no longer contagious and cleared by the healthcare provider. This often requires multiple negative sputum cultures and clinical evaluation, not just a time-based recommendation.

C. Instructing the client that he is no longer contagious after 1 week of medication therapy: Clients with active TB are not automatically non-contagious after one week of therapy. Contagiousness decreases gradually, and adherence to medication and follow-up sputum tests determine when the client is safe to interact with others.

D. Teaching the client’s family to wear protective masks while with the client: Family members do not routinely need masks if proper airborne precautions are in place and the client is receiving treatment at home. Emphasis should be on client respiratory hygiene, ventilation, and adherence to treatment.

A. Dermatitis: Dermatitis affects the skin and is not associated with an increased risk of pneumonia. While skin integrity issues can lead to infections, they do not directly predispose a client to respiratory infections like pneumonia.

B. Type II diabetes mellitus: Diabetes mellitus impairs immune function and increases susceptibility to infections, including pneumonia. Hyperglycemia can impair neutrophil function, reducing the body’s ability to fight bacterial respiratory infections.

C. Smoking history: Smoking damages the respiratory epithelium and impairs mucociliary clearance, increasing the risk of bacterial colonization and infection in the lungs. A long-term smoking history is a well-established risk factor for pneumonia.

D. Hypothyroidism: Hypothyroidism can slow metabolism and affect multiple organ systems but is not a direct risk factor for pneumonia. While severe hypothyroidism may influence respiratory function, it is not considered a primary predisposing condition.

E. COPD: Chronic obstructive pulmonary disease leads to compromised lung function, impaired clearance of secretions, and increased susceptibility to respiratory infections. COPD is a significant risk factor for developing pneumonia, particularly in the lower lobes.

F. Hypertension: Hypertension affects cardiovascular health but does not directly impair immune function or pulmonary defenses. It is not considered a risk factor for pneumonia.