A nurse is teaching a client who has burns to the upper body about positioning to prevent contractures. Which of the following information should the nurse include?

A. Dry hands by starting from the wrist and moving toward the fingers: Proper hand drying should begin at the fingertips and move toward the wrist to prevent recontamination of the cleaned areas. Starting at the wrist could transfer microorganisms back toward the fingers.

B. Lather hands with soap and apply friction under running water for 5 seconds: Effective handwashing requires at least 20 seconds of friction with soap and water to remove microorganisms. Five seconds is insufficient to achieve proper decontamination, especially when caring for immunocompromised clients.

C. Decontaminate hands with an alcohol-based hand rub after taking the client's pulse: Using an alcohol-based hand rub after brief, low-risk contact, such as taking a pulse, is appropriate for routine hand hygiene. It is an effective, quick method to reduce microbial load without the need for soap and water.

D. Wash hands with an alcohol-based hand rub if you have artificial nails: Artificial nails can harbor microorganisms and are not a contraindication for alcohol-based hand rubs alone. Proper handwashing with soap and water is preferred when hands are visibly soiled or when caring for high-risk clients.

A. Administer an enema to promote bowel evacuation: Enemas increase intraluminal pressure and can worsen inflammation or risk perforation in acute diverticulitis. The bowel should be rested during the acute phase to reduce irritation and allow healing. Using an enema can aggravate symptoms and is contraindicated.

B. Prepare to insert a nasogastric tube: The client has nausea, vomiting, abdominal distention, and worsening pain, which can indicate possible ileus or obstruction associated with acute diverticulitis. An NG tube may be needed to decompress the stomach and prevent further vomiting. Preparing for NG tube insertion supports symptom management and prevents complications.

C. Ensure the client is on bed rest: Bed rest decreases bowel activity and reduces discomfort during acute diverticulitis episodes. It helps limit movement that can exacerbate abdominal pain and reduces metabolic demands while the inflammation is being treated.

D. Administer a laxative to prevent constipation: Laxatives stimulate bowel motility, which increases pressure within the colon and can worsen inflammation or risk perforation in acute diverticulitis. These medications are avoided during the acute phase to prevent exacerbation of symptoms or complications.

E. Provide the client with foods that are high in fiber: High-fiber foods help prevent future diverticulitis episodes but are not appropriate during an acute flare. Fiber increases bowel workload and irritation, worsening pain and inflammation. Dietary fiber is introduced only after acute symptoms have resolved.

F. Ensure client is NPO: Keeping the client NPO rests the bowel and reduces stimulation during acute inflammation. NPO status also prepares the client for potential procedures and reduces the risk of worsening symptoms from food intake. This is standard treatment during acute diverticulitis until symptoms improve.

G. Position client in high-Fowler's position: High-Fowler’s position is more useful for clients with respiratory compromise rather than abdominal inflammation. Although sitting upright may provide minor comfort, it does not specifically support management of acute diverticulitis. Supine or semi-Fowler's positions are better tolerated to reduce abdominal strain.