The unlicensed assistive personnel (UAP) describes the appearance of the bowel movements of several clients. Which description(s) warrant additional follow-up by the nurse? (Select all that apply)

Choice A reason: Deep vein thrombosis causes pain and swelling but is not typically linked to sexual dysfunction. Sexual dysfunction often stems from vascular, neurological, or hormonal issues, like those associated with hypertension. DVT is unlikely to be noted in the record, as it lacks a direct physiological connection to the reported symptom.

Choice B reason: Hypertension is commonly associated with sexual dysfunction, as it impairs vascular function, reducing blood flow critical for sexual response. Medications like beta-blockers also contribute. The nurse should expect hypertension in the record, as it is a prevalent cause, supported by evidence linking cardiovascular health to sexual function.

Choice C reason: Fungal infections, like candidiasis, may cause localized discomfort but are not primary causes of sexual dysfunction. Dysfunction typically involves systemic or vascular issues, not superficial infections. The record is unlikely to note fungal infection as the cause, as it lacks a direct link to the client’s three-month history.

Choice D reason: Bacterial infections may cause systemic symptoms but are not strongly linked to sexual dysfunction unless involving the genitourinary tract, which is not specified. Hypertension is a more likely cause due to its vascular impact. The record is less likely to note bacterial infection as the primary contributor to this symptom.

Choice A reason: Advising the UAP to wear a gown addresses immediate infection control needs for Clostridium difficile, which requires contact precautions. Gowns and gloves prevent pathogen transmission via contaminated surfaces or feces. This action protects the UAP, other staff, and patients, aligning with CDC guidelines for managing highly contagious infections.

Choice B reason: Observing diarrhea appearance may inform infection severity but is not the priority over infection control. C. difficile spreads through contact with contaminated surfaces or feces. Ensuring the UAP wears a gown prevents transmission, protecting the healthcare environment. This action is secondary to immediate precautionary measures.

Choice C reason: Assessing skin integrity is important for long-term care but not urgent in this scenario. C. difficile requires immediate contact precautions to prevent pathogen spread. The UAP’s lack of a gown poses a transmission risk, making gown use the priority to ensure safety before addressing skin concerns.

Choice D reason: Hanging the antibiotic is part of treatment but not the first priority. The UAP’s lack of a gown violates contact precautions for C. difficile, risking pathogen spread. Ensuring proper protective equipment takes precedence to maintain a safe environment, followed by administering the antibiotic to treat the infection.