A nurse manager in a community health clinic is reviewing the medical records of clients who have diagnoses of communicable diseases. Which of the following infectious diseases should the nurse report to the Centers for Disease Control and Prevention?

A. The client needs assistance with learning to eat with the opposite hand: This is an aspect of rehabilitation and occupational therapy, focusing on adaptive techniques for daily living. It is not within the social worker’s primary role, so this information should be directed to therapy services.

B. The client will require a wheelchair for use in the home: Equipment needs such as wheelchairs are usually coordinated through physical therapy or case management. While the social worker may assist with resources, the primary focus is on functional mobility, which is addressed by therapy services.

C. The client needs assistance with paying medical bills: Financial assistance, insurance navigation, and access to community resources are within the social worker’s scope of practice. Reporting this need ensures the client receives support for managing medical expenses and continuity of care at home.

D. The client will require a prescription for home therapy: Prescriptions for home health services fall under the provider’s and therapy team’s responsibilities. The social worker may support logistics, but the primary coordination of therapy prescriptions is not their role.

A. An air leak noted at the insertion site: An air leak can cause continuous bubbling in the water seal chamber, but it does not prevent tidaling. Tidaling reflects intrathoracic pressure changes with respiration, so an air leak alone does not explain the absence of tidaling.

B. The tubing may be kinked: Tidaling stops when there is an obstruction in the chest tube system, such as a kinked or clamped tube. This prevents the normal movement of fluid in the water seal chamber that corresponds with the client’s respiratory cycle, making it the most likely cause of absent tidaling.

C. Water needs to be added to the suction-control chamber: Low water in the suction-control chamber affects the amount of suction delivered, not tidaling in the water seal chamber. The water seal chamber relies on the client’s respiration to show fluctuations, so adding water to suction does not restore tidaling.

D. The suction is set too low: Suction settings influence the rate of fluid evacuation and bubbling, but they do not control tidaling. Absence of tidaling usually indicates a mechanical obstruction rather than a suction problem.