A nurse is reinforcing discharge teaching with a client on how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching?

Choice A reason: The Mantoux skin test, also known as the tuberculin skin test, measures the immune response to the tuberculin purified protein derivative (PPD) injected under the skin. An induration of less than 1 mm is not necessarily an indication of non-infectiousness; it may indicate a lack of infection or an inadequate immune response. This test does not reflect the current infectious status as it measures a delayed hypersensitivity reaction and can remain positive for life once someone has been exposed to TB or has received the BCG vaccine.

Choice B reason: Negative sputum cultures for acid-fast bacillus are a strong indication that the client is no longer infectious. Pulmonary tuberculosis is diagnosed and monitored through sputum cultures to detect the presence of Mycobacterium tuberculosis. A series of negative cultures typically indicates that the client is not excreting the bacteria and is, therefore, not contagious.

Choice C reason: While the cessation of coughing up blood-tinged sputum is a positive sign of clinical improvement, it does not conclusively indicate that the client is no longer infectious. The absence of blood in the sputum may simply mean that the damage to lung tissues is healing, but the client could still be harboring and potentially spreading TB bacteria.

Choice D reason: The Quantiferon-TB Gold test is a blood test that measures the immune system's response to TB bacteria. A positive result indicates TB infection, but it does not distinguish between latent infection and active disease, nor does it provide information on infectiousness. The parenthetical "negative" is confusing and should be clarified in the context of the test results.

Step 1: Total volume = 1000 mL (which is 1 liter)

Step 2: Total time = 2 hours. But since the infusion pump rate is typically set in mL per minute, we need to convert this to minutes. There are 60 minutes in an hour, so 2 hours is 2 × 60 = 120 minutes.

Step 3: Now we can calculate the rate. The rate is the total volume divided by the total time. So, the rate = 1000 mL ÷ 120 minutes.

Calculating the above gives us the rate at which the nurse will set the infusion pump. Let's calculate it:

Step 4: Rate = 1000 mL ÷ 120 minutes = 8.33 mL/minute.

So, the nurse will set the infusion pump at a rate of approximately 8.33 mL per minute. If rounding is required, this can be rounded to 8.3 mL per minute.