A nurse is teaching a class about infection control to a group of nurses. The nurse should identify which of the following diseases as requiring the implementation of droplet precautions?

A. Choose a vein that is palpable and straight. A palpable, straight vein provides the best access for successful IV catheter insertion. It allows for easier threading of the catheter and reduces the risk of complications like infiltration.
B. Select a site on the client's dominant arm. The non-dominant arm is usually preferred to minimize interference with daily activities and reduce the risk of dislodgement due to frequent use.
C. Elevate the client's arm prior to insertion. Elevating the arm can decrease venous filling, making veins less prominent and harder to access. Instead, the arm should be placed in a dependent position to promote vein distention.
D. Apply a tourniquet below the venipuncture site. The tourniquet should always be placed above the insertion site to restrict venous return and make the veins more prominent and easier to access.

• Postoperative ileus: Ileus is a common complication after abdominal surgery due to anesthesia, opioid use, and limited mobility. It presents as delayed return of bowel function, marked by absent bowel sounds and abdominal discomfort. In this case, the child has absent bowel sounds and increasing tenderness, supporting this risk.
• Atelectasis: Atelectasis generally presents with diminished breath sounds and hypoxia, not clear breath sounds. Although the child has shallow respirations and is refusing the incentive spirometer, there are no respiratory findings such as decreased oxygen saturation or adventitious breath sounds that support this condition currently.
• Peritonitis: Peritonitis would present with systemic symptoms like fever, severe abdominal pain, rebound tenderness, or signs of sepsis. The child has mild abdominal tenderness and stable vital signs, which do not indicate peritoneal inflammation at this time.
• Urinary retention: This would be characterized by lack of urination, bladder distension, or discomfort—none of which are noted in the scenario. The child’s urinary output and bladder status are not identified as concerns, making this diagnosis unlikely.
• Absent bowel sounds: This is a key clinical sign of ileus. After surgery, bowel activity should return gradually. Continued absence of sounds, especially along with abdominal tenderness, strongly indicates impaired gastrointestinal motility.
• Shallow respirations: While shallow breathing is often a contributing factor to respiratory complications, in the context of abdominal surgery, it also limits diaphragmatic movement, which can further suppress bowel activity and contribute to postoperative ileus.
• Clear breath sounds: This is a normal respiratory finding and does not support the presence of atelectasis or other pulmonary complications. It suggests that lung fields are adequately ventilated despite shallow breathing.
• Intact abdominal dressing: This is an expected postoperative finding and does not support a diagnosis of infection, wound complication, or ileus. It indicates proper surgical wound healing.