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Educational objective:When caring for a client with signs of a central line–related bloodstream infection, the nurse should obtain blood cultures andremove the device, if possible, before beginning antibiotic therapy. Other nursing interventions (eg, symptom management, documentation) should be done after initiating treatment of the infection.When making room assignments, it is important to remember that a client with an active or suspected infectionshould not be pairedwith a client who has a fresh surgical woundor is immunocompromised. A client having an asthma exacerbation does not have an infection and is not at risk for spreading infection to a client who had recent bowel resection surgery (Option 3).Educational objective:When preparing room assignments, the nurse should not place a client who has a fresh surgical wound or is immunocompromised in a room with a client who has an active or suspected infection.Advance directivesoutline the client's choices for medical care (eg, cardiopulmonary resuscitation [CPR], mechanical ventilation) ahead of time. This allows the family and care team to follow the client's wishesat the end of life, when the client may be unable to make choices known. Clients can sign a do not resuscitate (DNR)directive instructing that CPR and other life-saving measures be withheld. With an advance directive in place, the client's wishes are followed, even if they conflict with the wishes of loved ones (Option 3). This is different from a medical power of attorney (health care proxy) in which the client designates a person to make decisions on their behalf.Educational objective:Advance directives outline the client's choices for medical care at the end of life, including resuscitation status. Client's wishes for medical care are honored over the wishes of family members.Suicide risk & protective factorsRisk factorsPsychiatric disorders, prior suicide attemptsHopelessness Never married, divorced, separatedLiving aloneElderly white manUnemployed or unskilledPhysical illnessFamily history of suicide, family discordAccess to firearmsSubstance abuse, impulsivityProtective factorsSocial support/family connectednessPregnancyParenthoodReligion & participation in religious activities2
Clients receiving treatment for depression and suicidal ideationmust be carefully monitored for indications of increasing suicidal intent. During a client interview, the nurse should assess:Access to psychiatric medicationsAvailability of helpduring a crisis (eg, counselor, family)Future goals and plansHome and work environment risksOverall affect and level of energyPossible access to weaponsClients who articulate long-term personal goalsand family milestonesare less likely to commit suicide (Option 2).