Which patient(s) would be able to take an alpha-adrenergic decongestant safely? (SELECT ALL THAT APPLY)

A. Place tissue soiled with respiratory secretions in a paper bag for later disposal:

This instruction is not accurate or recommended for managing tissue soiled with respiratory secretions, particularly in the context of tuberculosis (TB) infection. TB is transmitted through the air via respiratory droplets, so proper disposal of contaminated materials is crucial to prevent the spread of the infection. Instead of placing tissue in a paper bag, it should be disposed of in a sealed plastic bag to minimize the risk of transmission. Additionally, individuals with TB should be instructed on proper respiratory hygiene practices, such as covering their mouth and nose with a tissue or their elbow when coughing or sneezing, to prevent the spread of infectious droplets.

B. Provide samples for sputum cultures every 6 weeks:

Sputum cultures are an essential component of monitoring and managing tuberculosis (TB) treatment. However, obtaining samples every 6 weeks is not frequent enough, especially during the initial phase of treatment. In the early stages of TB treatment, sputum cultures are typically obtained more frequently, often weekly or biweekly, to monitor the response to treatment, assess for drug resistance, and ensure treatment effectiveness. As treatment progresses and the patient's condition stabilizes, the frequency of sputum cultures may be adjusted based on clinical judgment and guidelines.

C. Consume alcohol in moderation while taking antituberculosis medications:

Alcohol consumption is generally discouraged while taking antituberculosis medications. Some antituberculosis drugs, such as isoniazid and rifampin, can interact with alcohol and cause adverse effects, such as liver toxicity or drug metabolism issues. Therefore, individuals undergoing treatment for tuberculosis should be advised to abstain from alcohol consumption or limit it to a minimum to avoid potential complications. Providing instructions on alcohol consumption is an important aspect of tuberculosis management and medication adherence.

D. Wear a mask while out or around crowds of people:

This instruction is crucial for individuals with pulmonary tuberculosis to prevent the spread of the infection to others. Tuberculosis is transmitted through the air via respiratory droplets, particularly when an infected person coughs, sneezes, or talks. Wearing a mask while out or in crowded settings helps reduce the risk of transmitting infectious droplets to others and is an important infection control measure. It is especially important during the early stages of treatment when the individual is still infectious and shedding bacteria. Proper mask use, along with other respiratory hygiene practices, can help protect both the individual with tuberculosis and those around them from the spread of infection.

A. Auscultate breath sounds at least every 2 hours.

Regularly auscultating breath sounds is important for assessing respiratory status and detecting any signs of respiratory complications such as pneumonia or atelectasis. However, it is not the priority action in this scenario compared to applying antiembolic stockings, which directly addresses the increased risk of DVT and PE associated with immobility.

B. Perform range-of-motion exercises at least two to three times daily.

Range-of-motion exercises help prevent contractures and maintain joint mobility in immobile clients. While they are important for preventing musculoskeletal complications, they are not the priority action compared to applying antiembolic stockings, which directly addresses the increased risk of DVT and PE associated with immobility.

C. Make sure the client has an intake of 2,000 to 3,000 mL of fluid per day.

Maintaining adequate hydration is important for overall health and prevention of complications such as urinary tract infections and constipation. However, it is not the priority action in this scenario compared to applying antiembolic stockings, which directly addresses the increased risk of DVT and PE associated with immobility.

D. Apply antiembolic stockings.

The priority action for the nurse to contribute to the plan of care for an immobile client is to apply antiembolic stockings. Immobility increases the risk of deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE). Antiembolic stockings (also known as compression stockings or TED stockings) help prevent venous stasis and decrease the risk of blood clots forming in the lower extremities. Therefore, applying antiembolic stockings is essential in mitigating the risk of potentially life-threatening complications associated with immobility.