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. Emphasize vowel sounds when speaking. Consonants are typically more difficult to hear than vowels, and overemphasizing vowels can distort speech and make it harder to understand. Clear, natural enunciation is more effective.
B. Sit next to the client when speaking to them. Sitting in front of the client is more effective, as it allows the client to read lips and observe facial expressions, both of which are important in supporting communication for individuals with hearing loss.
C. Lower the tone of voice at the end of each sentence. Lowering pitch or volume at the end of sentences can make speech harder to follow. A steady, moderate tone throughout conversation is more helpful and easier to understand.
D. Decrease background noise when talking with the client. Reducing environmental noise helps the client focus on the speaker’s voice, improving their ability to hear and comprehend the message. It’s one of the most effective strategies in communication with hearing-impaired individuals.

A. The client engages in quiet activities in their room. While this may seem positive, it is not a reliable indicator of improvement in this context. It could suggest withdrawal or sedation rather than clinical stabilization. Further assessment would be needed to determine its significance.
B. The client slept 5 hr the previous night. This is a clear sign of improvement. The client had not slept for 2 days previously, and sleep is one of the first indicators of recovery in clients experiencing mania. Restorative sleep helps stabilize mood and reduce disorganized thinking.
C. The client takes 2 short naps during the day. Napping indicates the client is able to rest voluntarily, which contrasts with their earlier constant movement and hyperactivity. This suggests reduced mania-related agitation and increased capacity for rest.
D. The client appears to listen to unseen others. This behavior reflects ongoing hallucinations, which indicate that the client is still experiencing active psychosis. This is not an improvement and suggests further monitoring and treatment adjustment may be needed.
E. The client consumes 8 oz of high-calorie fluids each hour. Adequate nutrition and hydration are key components of recovery, especially since the client had been unable to recall their last meal and showed signs of dehydration. This is a positive sign of improved self-care and physical stability.