The nurse counsels a female patient who has been diagnosed with a sexually transmitted infection (STI). Which interventions should the nurse promote? Select all that apply.

End-stage heart failure is progressive myocardial pump failure causing systemic hypoperfusion, pulmonary congestion, hypoxia, dyspnea, palliative care, DNR directives prioritizing symptom relief, comfort-focused management, and avoidance of life-prolonging interventions therapies.

Rationale:

A. In a patient with comfort measures only and active DNR status, priority is symptom relief rather than resuscitation. The nurse should assess dyspnea severity and provide prescribed oxygen and morphine. This aligns with palliative goals and MRSA precautions protocol adherence.

B. Calling a Code Blue violates DNR orders and advance directive specifying comfort-only care. CPR initiation is inappropriate in end-stage disease. This action disregards end-of-life wishes and exposes patient to unwanted aggressive resuscitation contrary to ethical palliative care principles standards violated.

C. Documenting condition alone is incomplete during acute respiratory distress. Hypoxia requires immediate symptom management in comfort care settings. Failure to intervene with oxygen or opioids neglects palliative intervention priorities and does not address respiratory distress urgency per comfort protocol guidelines.

D. Contacting healthcare provider for ICU transfer conflicts with advance directive specifying comfort-only care. Escalation to intensive care contradicts palliative goals and DNR status. Focus should remain on symptom relief rather than invasive life-prolonging interventions in terminal heart failure clinical priority.

Paramyxovirus infection causes parotitis with painful glandular swelling, fever, and malaise. Viral replication in salivary epithelium leads to inflammation, edema, and ductal obstruction. Complications include orchitis, meningitis, and pancreatitis. Transmission occurs via respiratory droplets.

Rationale:

A. Bell’s palsy is an acute peripheral facial nerve paralysis affecting cranial nerve VII, leading to unilateral facial weakness. It does not involve salivary gland enlargement. Absence of parotid swelling and presence of facial paralysis distinguish it from infectious parotitis.

B. Goiter refers to enlargement of the thyroid gland, typically presenting as anterior neck swelling. It is associated with iodine imbalance or thyroid dysfunction. The thyroid location differs anatomically from the parotid glands, and neck mass presentation excludes salivary gland involvement.

C. Graves disease is an autoimmune hyperthyroid condition characterized by diffuse thyroid enlargement, ophthalmopathy, and hypermetabolic symptoms. It does not cause parotid gland swelling. The presence of thyrotoxicosis and exophthalmos differentiates it from viral parotitis.

D. Mumps is a viral infection causing bilateral painful swelling of the parotid glands due to inflammation and edema. It commonly presents with fever and malaise. The hallmark bilateral swelling and parotitis directly indicate this condition.

E. Pancreatitis involves inflammation of the pancreas, presenting with epigastric pain and elevated pancreatic enzymes. Although mumps can cause pancreatitis as a complication, it does not cause parotid enlargement independently. Abdominal pain and enzyme elevation are primary findings.