A nurse is teaching a group of newly licensed nurses about caring for a client who has a Clostridium difficile infection. Which of the following Instructions should the nurse include in the teaching?

Wear a gown while providing personal hygiene.

Place the client in a room with negative airflow,

Apply a mask when providing care.

Wipe the stethoscope with alcohol after leaving the client's room.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Wear a gown while providing personal hygiene: Contact precautions are required for clients with Clostridium difficile to prevent transmission via contaminated surfaces or direct contact. Wearing a gown during personal care protects the nurse’s clothing and skin from spores.

B. Place the client in a room with negative airflow: Negative airflow rooms are required for airborne infections such as tuberculosis or measles. C. difficile is spread via the fecal–oral route and does not require airborne isolation measures.

C. Apply a mask when providing care: Masks are necessary for droplet or airborne pathogens, but C. difficile spores are transmitted through direct or indirect contact, not respiratory droplets, so masks are not routinely required unless there is another indication.

D. Wipe the stethoscope with alcohol after leaving the client's room: C. difficile spores are resistant to alcohol-based disinfectants. Cleaning equipment requires soap and water or a sporicidal disinfectant to effectively remove spores and prevent spread.

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Correct Answer is D

Explanation

A. Administer fluid bolus immediately when the client arrives to the facility: Rapid fluid boluses are reserved for clients in hypovolemic shock. For burn resuscitation, fluids are calculated and administered according to formulas rather than as a one-time bolus.

B. Administer one-third of the total fluid volume for resuscitation within the first 12 hr: Burn fluid resuscitation formulas, such as the Parkland formula, typically require half of the total calculated fluids to be given within the first 8 hours post-burn, not 12 hours.

C. Calculate fluid volume for resuscitation beginning with client arrival time at the facility: Fluid calculation is based on the time of the burn occurrence, not the arrival time, to ensure accurate resuscitation over the initial 24 hours.

D. Use the total body surface area of the client's burns when calculating fluid volume for resuscitation: The extent of burns, expressed as a percentage of total body surface area (TBSA), is a key factor in calculating fluid needs. Accurate TBSA assessment ensures appropriate fluid resuscitation to maintain perfusion and prevent complications.

A. "You will need to change the IV dressing site once per week." B. "You will need to warm the solution in the microwave before administration." C. "You will need to weigh the client twice per week." D. "You will need to monitor the client's electrolytes daily."

Correct Answer is D

Explanation

Rationale:

A. "You will need to change the IV dressing site once per week.": Central line dressings for TPN are typically changed every 48–72 hours for gauze or every 5–7 days for transparent dressings, or sooner if the dressing becomes damp, loose, or soiled, to reduce infection risk.

B. "You will need to warm the solution in the microwave before administration.": TPN solutions should never be microwaved due to the risk of uneven heating and nutrient degradation. They should be administered at room temperature.

C. "You will need to weigh the client twice per week.": Clients receiving TPN require daily weights to monitor fluid balance, nutritional status, and detect fluid retention or dehydration promptly. Twice-weekly measurements are insufficient for close monitoring.

D. "You will need to monitor the client's electrolytes daily.": TPN can cause rapid changes in fluid and electrolyte balance, so daily electrolyte monitoring allows timely adjustments to prevent complications such as hypo- or hypernatremia, hypokalemia, and metabolic imbalances.

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A nurse is teaching a group of newly licensed nurses about caring for a client who has a Clostridium difficile infection. Which of the following Instructions should the nurse include in the teaching?

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