Which of the following does the nurse implement as the most important measure in preventing transmission of harmful pathogens to patients with depressed bone marrow function?
Creation of a "sterile" environment for the patient with the use of laminar airflow rooms
Placement of patients in private rooms with high-efficiency particulate air (HEPA) filtration
Strict and frequent handwashing by all people having contact with the patient
Administration of combinations of prophylactic antibiotics
The Correct Answer is C
A. Creation of a "sterile" environment with laminar airflow rooms is not practical or necessary for preventing transmission of pathogens to patients with depressed bone marrow function. It may also not be feasible in many healthcare settings.
B. Placement of patients in private rooms with HEPA filtration may help reduce airborne pathogens but is not the most important measure for preventing transmission of harmful pathogens to patients with depressed bone marrow function.
C. Strict and frequent handwashing by all people having contact with the patient is the most important measure for preventing transmission of harmful pathogens, including bacteria and viruses, to immunocompromised patients. Hand hygiene is a fundamental infection control measure that significantly reduces the risk of healthcare-associated infections.
D. Administration of prophylactic antibiotics may be part of the treatment plan for some patients with depressed bone marrow function to prevent bacterial infections, but it is not the most important measure for preventing transmission of harmful pathogens. Hand hygiene is more effective in reducing the transmission of a wide range of pathogens, including bacteria, viruses, and fungi.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Severe pain in the abdomen and joints. Severe pain is the hallmark symptom of a sickle cell crisis, often occurring in the abdomen, joints, and bones due to vaso-occlusive events.
B. Fever and chills. While fever can be a sign of infection in individuals with sickle cell disease, it is not the most common symptom during a sickle cell crisis.
C. Cough and shortness of breath. These symptoms are more indicative of respiratory infections or complications like acute chest syndrome but are not the primary symptoms of a sickle cell crisis.
D. Numbness and tingling in the extremities. These symptoms are not typically associated with a sickle cell crisis.
Correct Answer is D
Explanation
A. Risk for Injury related to compromised blood volume is not the most appropriate nursing diagnosis for a patient with sickle cell disease in crisis. While patients may experience anemia and blood volume loss during a crisis, the primary concern is tissue perfusion due to vascular occlusion by sickled cells.
B. Risk for Deficient Fluid Volume related to infection is not directly related to the pathophysiology of sickle cell disease or sickle cell crisis.
C. Ineffective Airway Clearance related to sickled cells may be a concern for patients with sickle cell disease, especially during acute chest syndrome, but it is not the primary nursing diagnosis for a patient admitted for sickle cell crisis.
D. Ineffective Tissue Perfusion related to vascular occlusion is the most appropriate nursing diagnosis for a patient with sickle cell disease in crisis. Sickle cell crisis involves the occlusion of blood vessels by sickled cells, leading to impaired tissue perfusion and potential organ damage.
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