Which actions are most likely to reduce the spread of ...

[awywial]

Which actions are most likely to reduce the spread of community-acquired methicillin-resistant Staphylococcus aureas (CA-MRSA) in a family in which only one member is infected? (Select all that apply.)
 
  a. Starting the noninfected family members on methicillin therapy.
  b. Not sharing towels or bed linens with the infected person.
  c. Washing the infected person's dishes separately from those of other family members.
  d. Having the infected person wear a mask when in the same room with other family members.
  e. Using good daily personal hygiene for all family members.
  f. Washing hands with soap and water after any physical contact with an infected person.

Question 2

The spouse of a patient who is prescribed promethazine (Phenergan) as part of her antiemetic therapy with chemotherapy reports that after the last dose the patient did not remember the drive home. What is the nurse's best action?
 
  a. Thank the spouse for reporting the problem, and document the adverse drug reac-tion.
  b. Hold the dose of promethazine for this round of chemotherapy until the patient is seen by the prescriber.
  c. Reassure the patient and spouse that this is a normal response to the drug and that the patient should not drive home.
  d. Perform a mini-mental status exam and assess the patient's pupillary reflexes be-fore administering the promethazine.

[lindahyatt42]

Answer to Question 1

B, E, F
MRSA is transmitted by direct contact from person-to-person and by skin contact with contami-nated linens, sports equipment, clothing, and the sharing of cosmetics or personal care items (e.g., shavers, hairbrushes). Avoiding contact with these items prevents disease spread. Starting noninfected family members on methicillin therapy is not effective because drugs are not used for prophylaxis against S. aureas. Even if they were, the organism is resistant to methicillin. Washing dishes separately and the use of a mask are not effective measures because the disease is not spread by contact with GI fluids or by the airborne route.

Answer to Question 2

C
Promethazine, a phenothiazine-based drug, induces sedation and confusion in addition to having antiemetic effects. Some patients have reduced memory about events occurring within a few hours after receiving the drug. This is an expected, temporary side effect and does not denote any permanent reduced cognition. Both the patient and the spouse should be aware of this effect so that the patient is not at risk for injury. Driving, cooking, or operating dangerous equipment should not be performed until the drug's effects have worn off.

[awywial]

Excellent

[Joy Chen]

TYSM