The nurse is reviewing collected data from a client. Which ...

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The nurse is reviewing collected data from a client. Which information should the nurse identify as a physiological barrier to defend the client's body from microorganisms?
 
  1. Heavy smoking
  2. Moisturizing the skin
  3. Breakdown of skin
  4. Voiding quantity sufficient

Question 2

The nurse is reviewing the care needs for a group of assigned clients. Which client should the nurse recognize as being most at risk for a nosocomial infection?
 
  1. A client in the emergency department with abdominal pain
  2. A 19-year-old woman in her first trimester of pregnancy
  3. A 72-year-old male client with COPD
  4. An 86-year-old female client on steroid therapy

[Li Jun]

Answer to Question 1

Correct Answer: 4
Rationale 1: Heavy smoking does not defend the body from microorganisms; it destroys the cilia in the nose that help to filter organisms.
Rationale 2: Moisturizing the skin can allow microorganisms to enter the body.
Rationale 3: Breakdown of the skin can allow microorganisms to enter the body.
Rationale 4: Voiding quantity sufficient is a barrier that helps the body defend itself against microorganisms. The act of voiding flushes those organisms that might try to enter the body through the urinary meatus.

Answer to Question 2

Correct Answer: 4
Rationale 1: A client in the emergency department with abdominal pain has just arrived in the facility, and not enough time has elapsed for this client to be considered to have a nosocomial infection. If this client has an infection, it would be community acquired.
Rationale 2: The 19-year-old female who is pregnant is at a low risk.
Rationale 3: The 72-year-old male with COPD is at a lower risk for infection than the 82-year-old because the older client has a weakened immune system because of taking steroids.
Rationale 4: The client most at risk for a nosocomial infection is the client who is 86 years old and on steroid therapy. The very old and very young are most susceptible to infections. The 86-year-old client is also on steroid therapy, which compromises the immune system.

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TYSM

[sultansheikh]

Gracias!