Explanation

is

or VAP progressive associated with increased mortality, hospital cost, and length of stay.

Because it is a nosocomial pulmonary infiltrates suggestive of pneumonia on chest x-ray.

(Option 1) Blood-tinged the second most common health care-associated infection (HAI) in the United
States and is

(MV). Characteristic clinical manifestations of VAP include purulent sputum, positive sputum infection,
signs and symptoms associated with VAP usually present within 02-3 days after initiation of mechanical
ventilation may occur but is not the best indicator of VAP.

(Option 2) Positive sputum culture, leukocytosis (12,000 mm3), elevated temperature (>100.4 F [38 C]),
and new

blood cultures may identify the microorganism causing the infection but are not the best indicator of
VAP. Positive blood pulmonary edema or just from increased mucous secretions. They are not the best
indicator of VAP.

Educational objective: VAP is cultures could be from another source of infection

(Option 4) Rhonchi and crackles are adventitious lung sounds associated with pneumonia but can be
present in

an HAI that usually VAP include purulent secretions, positive sputum culture, leukocytosis, elevated
temperature, and new or occurs within 02-3 days after the initiation of mechanical ventilation.
Characteristic manifestations of progressive pulmonary infiltrates on chest x-ray.

but mon drug used to treat trichomoniasis. Client education includes:

• Abstain from sexual intercourse until the infection is cleared (le, about 1 week after treatment)
(Option 1). • Avoid drinking alcohol w

usually seek care when a profuse, frothy, yellow-green, malodorous vaginal discharge is) is the most
com

Vaginal inflammation

OUWorld ed. Pruritus, dysuria, and dyspareunia (ie. pain during sex) may also occur. Oral metronidazole
not (Flagyl Trichomoniasis is a sexually transmitted infection caused by Tnchomonas vaginalis. Infected
clients may be asymptomatic
hile taking metronidazole and for 3 days after completion of therapy because the combination can cause
flushing, nausea/vomiting, and severe abdominal pain (Option 2). • Have partner(s) treated
simultaneously to avoid reinfection. Use condoms to prevent the infection in the future (Option 3) •
Know that potential side effects of metronidazole may include a metallic taste, gastrointestinal upset, or
dark-colored

, health care provider.

Educational objective: Trichomoniasis is a sexually transmitted infection that may cause a frothy,
malodorous, avoidance of alcohol, treatment of sexual partners, abstinence from sexual activity until the
symptoms resolve (ie, about 1 week after treatment), and awareness of possible side effects leg, dark-
colored urine).

gastric emptying.

(Option 1) Hypoglycemia can cause symptoms similar to those of dumping syndrome (eg, sweating,
dizziness) but is unlikely to pain, nausea/vomiting, dizziness, generalized sweating, and tachycardia.

To reduce the occurrence of symptoms, clients

Billroth II surgery (gastrojejunostomy) removes part of the stomach and shortens the upper gatestinal
tract. After a partial gastrectomy, many clients experience dumping syndrome, which occurs when
gastric contents empty too rapidly into the duodenum, causing a fluid shift into the small intestine. This
resstroinults in hypotension, abdominal

should avoid fluids with meals and lie down after eating to slow gastric emptying (Option 4). An upright
or sitting position increases the force of gravity, which increases the rate of

occur 30 minutes after eating.

(Option 2) Clients should avoid consuming fluids with meals, which causes stomach contents to pass
faster into the jejunum and worsens symptoms. Fluid intake should occur at least 30 minutes before/

Educational objective: Clients are at risk of dumping syndrome after a gastrectomy and may experience
abdominal cramping, nausea, vomiting, and diarrhea. To delay gastric emptying, clients should avoid
fluids with meals and lie down after eating.

yellow-green vaginal discharge. Appropriate teaching for clients undergoing treatment with oral
metronidazole includes

increasing the risk for infection (eg, bacterial vaginosis). Teach the client to cleanse the exterior vulva
using only unscented products, wear breathable undergarments. and report persisting odors/discharge
to the
wuvvono Congenital heart defects that cause blood to shunt from the higher pressure left side of the
heart to the lower pressure right side (eg, patent ductus arteriosus, atrial septal defect, ventricular
septal defect) increase pulmonary blood flow.

Left-to-right shunting results in pulmonary congestion. causing increased work of breathing and
decreased lung compliance. Compensatory mechanisms (eg, tachycardia, diaphoresis) result from
sympathetic stimulation. Clinical manifestations of acyanotic defects may include:

• Tachypnea • Tachycardia, even at rest • Diaphoresis during feeding or exertion (Option 3) • Heart
murmur or extra heart sounds (Option 4) • Signs of congestive heart failure • Increased metabolic rate
with poor weight gain (Option 5)

(Option 1) Clubbing of the fingertips is associated with chronic hypoxia caused by decreased pulmonary
circulation as occurs with right-to-left heart defects.

(Option 2) exertion.

Educational objective: Left-to-right cardiac shunts (eg, patent ductus arteriosus, atrial septal defect,
ventricular septal defect) result in excess blood flow to the lungs. Manifestations include heart murmur,
poor weight gain, diaphoresis with exertion, and signs of heart failure.

urine (Option 4).

(Option 5) Vaginal douching is not recommended as it gets rid of good bacteria and alters the pH of the
vagina after meals.

(Option 3) Reports of dizziness after standing may indicate orthostatic hypotension and warrant
assessment of blood pressure while lying and standing; dizziness after eating is indicative of dumping
syndrome.

Right-to-left congenital heart defects (eg, cyanotic defects) impede pulmonary blood flow (eg, tetralogy
of Fallot, transposition of the great vessels) and cause cyanosis, which is evident shortly after birth and
during periods of physical