The client has protective precautions (reverse isolation) in place due to a severely depressed neutrophil count. Which statement by the client demonstrates a good understanding of the precautions?

“The precautions will protect me and help my blood count recover faster."

"Persons entering the room with colds should stay at least 3 feet from me."

"My family plans to bring flowers from my garden to help me feel better."

"Persons entering my room should perform hand hygiene before entering."

Answer and Explanation

The Correct Answer is D

A. “The precautions will protect me and help my blood count recover faster.”: While protective precautions are meant to safeguard the client from infections, this statement does not specifically address the necessary actions or behaviors that need to be followed to maintain reverse isolation. Recovery of blood counts is a complex process that depends on multiple factors, including the underlying condition and treatment.

B. "Persons entering the room with colds should stay at least 3 feet from me.": This statement is not sufficient for reverse isolation. Individuals entering the room should be free of any respiratory illnesses, and maintaining a distance may not be adequate protection. Ideally, anyone entering the room should be healthy and ideally wearing appropriate protective gear, such as masks, to reduce the risk of transmitting infections.

C. "My family plans to bring flowers from my garden to help me feel better.": Bringing flowers from outside can introduce pathogens and compromise the sterile environment necessary for a client in reverse isolation. This statement demonstrates a lack of understanding of the precautions required to maintain a safe environment.

D. "Persons entering my room should perform hand hygiene before entering.": This statement accurately reflects an understanding of the precautions needed in reverse isolation. Hand hygiene is critical in preventing the introduction of pathogens into the sterile environment of a client with a severely depressed neutrophil count. It helps to minimize the risk of infections, which is the primary goal of reverse isolation.

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Correct Answer is A

Explanation

A. Provide the client with an electric toothbrush: An electric toothbrush is an appropriate option for a client with impaired upper extremity strength. It requires less physical effort to use compared to a manual toothbrush, making it easier for the client to maintain oral hygiene effectively. The powered brushing action can help ensure more thorough cleaning of the teeth and gums.

B. Give the client an alcohol-based mouth wash: Alcohol-based mouthwashes can be irritating to the oral mucosa, especially in clients who may have dry mouth or other oral health issues. Instead, a non-alcoholic mouthwash or rinse should be considered to promote comfort and effective oral care.

C. Give the client lemon-glycerin mouth swabs: Lemon-glycerin swabs are not recommended for oral care, as they can be irritating and may cause dryness in the mouth. Additionally, lemon can be acidic and potentially harm the enamel of the teeth. It is better to use products designed for sensitive oral care.

D. Provide the client with a spool of dental floss: While dental floss is important for maintaining oral hygiene, using it requires manual dexterity and strength that may be difficult for a client with impaired upper extremity strength. Instead, alternatives such as floss holders or interdental brushes could be suggested, but the initial focus should be on ensuring the client can effectively brush their teeth.

A. Potassium B. WBC count C. BUN D. RBC count

Correct Answer is B

Explanation

A. Potassium: While potassium levels can be affected by various medical conditions, including kidney function and medications, an elevation in potassium is not specifically indicative of an infection. Instead, potassium levels are more relevant in the context of electrolyte balance and cardiac function.

B. WBC count: An elevated white blood cell (WBC) count is a classic indicator of infection. The body responds to infection by increasing the production of white blood cells to fight off pathogens. A significantly elevated WBC count, especially if accompanied by a shift to the left (an increase in immature neutrophils), suggests an acute inflammatory response and the presence of an infection, making this the correct answer.

C. BUN: Blood urea nitrogen (BUN) levels can increase due to dehydration, renal impairment, or increased protein metabolism but are not a direct indicator of infection. While BUN can provide information about kidney function, it does not specifically indicate the presence of an infection.

D. RBC count: A decrease in red blood cell (RBC) count may indicate anemia or other underlying conditions, but an elevation in RBC count is not associated with infection. RBC count is more relevant to oxygen-carrying capacity and overall blood health rather than the inflammatory response to infection.

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The client has protective precautions (reverse isolation) in place due to a severely depressed neutrophil count. Which statement by the client demonstrates a good understanding of the precautions?

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