Health Promotion and Maintenance Q 96
A patient is undergoing the induction stage of treatment for leukemia. The nurse teaches family members about infectious precautions. Which of the following statements by family members indicates that the family needs more education?
A. We will bring in books and magazines for entertainment.
B. We will bring in personal care items for comfort.
C. We will bring in fresh flowers to brighten the room.
D. We will bring in family pictures and get well cards.
Correct Answer: C. We will bring in fresh flowers to brighten the room.
During induction chemotherapy, the leukemia patient is severely immunocompromised and at risk of serious infection. Fresh flowers, fruit, and plants can carry microbes and should be avoided. Teach proper hand washing using antibacterial soap before and after each care activity. Hand washing and hand hygiene lessen the risk of cross-contamination. Note: Methicillin-resistant Staphylococcus aureus (MRSA) is most commonly transmitted bacteria via direct contact with health care workers who are unable to wash hands between client contacts.
Option A: Books and magazines can be brought to the patient, but they should be disinfected. Encourage the client to cover their mouth and nose with a tissue when coughing or sneezing. Place in a private room if indicated. Wear a mask when providing direct as appropriate. Appropriate behaviors, personal protective equipment, and isolation prevent the spread of infection via airborne droplets.
Option B: Personal items can be cleaned with antimicrobials before being brought into the room to minimize the risk of contamination. Body substance isolation should be used for all infectious clients. Wound and linen isolation and hand washing may be all that is required for draining wounds. Clients with diseases transmitted through air may also need airborne and droplet precautions.
Option D: The pictures should be disinfected before given to the client. Note temperature trends and observe for shaking chills and profuse diaphoresis. Fever [101°F-105°F (38.5°C-40°C)] is the result of endotoxin effect on the hypothalamus and pyrogen-released endorphins. Hypothermia lower than 96°F (36°C) is a grave sign reflecting advancing shock state, decreased tissue perfusion, and failure of the body’s ability to mount a febrile response. Chills often precede temperature spikes in the presence of generalized infection.