The nurse is caring for four clients:

• Client A, who has emphysema and whose oxygen saturation is 94% on room air;
• Client B, with a postoperative hemoglobin of 8.2 mg/dL (82 g/L);
• Client C, newly admitted with a potassium level of 3.8 mEq/L (3.8 mmol/L);
• Client D, scheduled for an appendectomy who has a white blood cell (WBC) count of 14,000 mm3 (14 x 109/L).

Which intervention should the nurse implement?Reference Range:

• Hemoglobin [14 to 18 g/dL (140 to 180 g/L)]
• Potassium [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
• White Blood Cell [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

Rationale

A. Children with eczema often scratch their itchy skin, which can lead to skin breakdown, bleeding, and secondary infections. Short nails minimize the trauma inflicted on the skin during scratching and help prevent complications.

B. Bathing helps to hydrate the skin and remove allergens, bacteria, and other irritants that can exacerbate eczema. Bathing daily with bath oil helps to moisturize the skin and prevent dryness. Bath oils or emollients should be used instead of harsh soaps, which can strip the skin of natural oils and worsen dryness. However, it's essential to ensure the water is not too hot and to limit bath time to avoid drying out the skin.

C. Moisturizing the skin is a cornerstone of eczema management. Applying a moisturizer, such as baby lotion or emollient cream, helps to hydrate the skin, reduce dryness, and protect the skin barrier. Moisturizers should ideally be applied at least twice daily, especially after bathing or showering when the skin is damp to lock in moisture. Choosing a moisturizer that is fragrance-free and hypoallergenic is beneficial to avoid further irritation.

D. Cotton clothing is recommended for children with eczema because it is breathable and less likely to irritate sensitive skin compared to synthetic fabrics. Cotton allows better air circulation around the skin, which can help prevent overheating and sweating, both of which can exacerbate eczema symptoms. Avoiding wool and synthetic fabrics that can cause friction and irritation is important.

Rationale

A. An elevated neutrophil count suggests an active immune response to infection, supporting the clinical findings of purulent drainage. This information is crucial for the healthcare provider to assess the severity of the infection and guide treatment.

B. Hematocrit changes are more related to blood volume, fluid shifts, or bleeding rather than infection. While it may be monitored postoperatively, it does not provide specific information about infection.

C. Platelet count is important for assessing clotting function but does not directly indicate infection or purulent drainage.

D. Serum sodium levels are part of electrolyte balance and hydration status monitoring but do not directly relate to the presence of infection.