A nurse preceptor has asked the new graduate nurse to provide a client with influenza instructions about isolation precautions. Which instruction by the new graduate nurse requires the nurse preceptor to intervene?

Disaster management in healthcare follows structured principles of surge capacity, resource reallocation, client prioritization, and rapid bed availability creation, focusing first on increasing treatment space and capacity for incoming mass casualty victims while maintaining safe ongoing inpatient care.

Rationale:

A. This action is premature because activating off-duty staff occurs after assessing internal capacity. Disaster response prioritizes immediate resource optimization within existing staffing before expanding workforce availability.

B. This action is correct because identifying clients who can be safely discharged immediately increases bed availability, supports surge capacity, and ensures rapid accommodation of incoming mass casualty victims from the bus accident.

C. This action is secondary because staffing adjustments to the ED are important but follow initial capacity creation steps. Bed availability must be addressed first to ensure proper patient placement before reallocating personnel.

D. This action is incorrect as visitor restriction may be part of disaster protocols but does not directly address immediate surge capacity needs. The priority is freeing inpatient beds to receive incoming critically injured clients.

Osteoarthritis (OA) is a chronic degenerative joint disorder characterized by cartilage breakdown, synovial inflammation, osteophyte formation, and progressive joint space narrowing, leading to pain, stiffness (especially after inactivity), decreased mobility, and functional impairment primarily in weight-bearing joints such as hips and knees.

Rationale:

A. This is correct because heat therapy promotes vasodilation, reduces joint stiffness, improves synovial fluid viscosity, and decreases pain perception in chronic degenerative joint disease, improving functional mobility in osteoarthritis.

B. This is correct because a firm mattress supports spinal alignment and reduces joint stress during sleep. It helps prevent abnormal joint positioning and minimizes morning stiffness commonly seen in osteoarthritic joints.

C. This is incorrect because placing a pillow under the knees promotes knee flexion contractures, reduces joint extension, and worsens long-term deformity in osteoarthritis, especially in weight-bearing joints already prone to stiffness and limited range of motion.

D. This is correct because avoiding pain-induced joint stress during exercise prevents further cartilage degeneration and inflammation. Exercise should remain within a tolerable range to maintain mobility without exacerbating joint destruction and synovial irritation.

E. This is incorrect because tub baths increase risk of falls, especially in clients with reduced mobility and joint instability. Safer alternatives include showers with assistive devices, as osteoarthritis impairs balance and lower extremity strength.