A nurse is preparing to admit a client who has a new diagnosis of methicillin-resistant Staphylococcus aureus (MRSA). The nurse should plan to place the client in which of the following types of transmission-based precautions?

Choice A Reason: Night sweats

Night sweats are not typically associated with liver disease. They are more commonly linked to conditions such as infections, hormonal imbalances, or certain cancers1. While liver disease can cause a variety of symptoms, night sweats are not a primary manifestation.

Choice B Reason: Acanthosis nigricans

Acanthosis nigricans is characterized by dark, velvety patches of skin, usually in body folds and creases. It is often associated with insulin resistance, obesity, and certain endocrine disorders. It is not a common manifestation of liver disease.

Choice C Reason: Hemosiderin staining

Hemosiderin staining refers to the deposition of iron in the skin, which can cause a brownish discoloration. This condition is more commonly associated with chronic venous insufficiency or hemochromatosis, a genetic disorder that causes iron overload. It is not a typical symptom of liver disease.

Choice D Reason: Pruritus

Pruritus, or itching, is a common symptom of liver disease. It is often caused by the accumulation of bile salts in the skin due to impaired bile flow, a condition known as cholestasis. This symptom can be particularly distressing for patients and is a significant indicator of liver dysfunction.

Choice A Reason:

Encouraging the client to bear down is not an appropriate response to abdominal cramps during an enema. Bearing down can increase discomfort and does not address the underlying cause of the cramps.

Choice B Reason:

Stopping the enema and documenting that the client did not tolerate the procedure is not the best initial action. While it is important to document the client’s response, there are other steps that can be taken to alleviate the discomfort before stopping the procedure entirely.

Choice C Reason:

This is the correct answer. Lowering the height of the solution container will reduce the flow rate of the enema solution, which can help alleviate abdominal cramps. A slower flow rate is less likely to cause cramping and discomfort.

Choice D Reason:

Allowing the client to expel some fluid before continuing can help relieve discomfort, but it is not the most immediate or effective action. Adjusting the flow rate by lowering the height of the solution container is a more direct way to address the issue.