VAP is the second associated with increased mortality, hospital cost, and length of stay.

Because it is a nosocomial infection, signs and symptoms associated with VAP usually present within 02-
3 days t sputum, most common health care-associated infection (HAI) in the United States and is

positive sputum culture, leukocytosis (12,000 mm3), elevated temperature (>100.4 F [38 C]), and new or
infiltrates suggestive of pneumonia on chest x-ray.

(progressive pulmonary

itive blood cuafter initiation of mechanicaicrol ventilation (MV). Characteristic clinical

manifestationsOption 1) Blood-tinged sputum may occur but is not the best indicator of VAP.

(Option 2) Pos of VAP include purulenltures may identify the morganism causing the infection but are
not the

Educational objective: VAP is an HAI that usually occurs within 02-3 days after the initiation of
mechanical ventilation. of VAP. Positi ased mucous secretions. They are not the best indicator of VAP.,
and Characteristic manifestations of VAP include ve blood cultures could be from another source of
infection

(Option 4) Rhonchi and adventitious luncretiong sounds associated with pneumonia but can be present
in pulmonary edema or just from incre purulent ses, positive sputum culture, best indicator crackles are

new or progressive pulmonary infiltrates on chest x-ray.

the force of

leukocytosis, elevated temperaturee

a infection caused by Tnchomonas vaginalis. Infected clients maxdriny be from seking sxually
transmitted

can cause flushing, nausea/vomiting, and severe abdominal pain (Option 2). • common drug used side
effectsgreen, m

Vaginal discharge is noted. Pruritus, dysuria, and dys ed asymptomatic but usually seek care when a
profuse, frothy, yellow- alodorous vaginal taking pareunia (ie. pain ex) during s may also occur. Oral
metronidazole (Flagyl) is the most inflammation

OUWorld Trichomoniasis is alcohol while Have partner(s) treat metronidazole and for 3 days after
completion of therapy because the combinual intercourse e a metallic until the infection is cleared (le,
about 1 week after treatment) (Option 1). • Avoid ation of metronidazole may includ taste,
gastrointestinal upset, or dark-colored urine (Option 4). to treat trichomoniasis. Client education
includes:
• Abstain

not Know that potential

(Option 5) Vaginal recommended simultaneously to avoid reinfection. Use condoms to prevent the
infection in the future (, abstinence • as it gets rid of good bacteria and alters the pH of the vagina,
unscented Option 3) nts. ansexual pd report persisting odors/discharge to includes avoidance of alcohol,
treatment of artners products to cleanse the exterior vulva using only symptoms resolve (ie, Appropriate
leg, dark-colored urine). about the douchin undergarme from sexual th oral metronidazole 1 week after
treatment), and egsexually g is, wear breathable awareness of effects t, bacterial vaginosis). Teach the
client health care provider. activity until the increasing the risk for infection (possible side teaching for
clients undergoing treatment wi

Educational objective: Trichomoniasis is a ransmitted infection that may cause a frothy, malodorous,
yellow-green vaginal discharge.

removes part of the stomach and shortens the upper contents empty too rapidly into the duodenum,
causin eals and lie down after eating to slow gastric emptying the rate gastrointestinal tract. After a
partial

Billroth II surgery (gastrojejunostomy) g a fluid shift into the small intestine. This results in f symptoms,
clients should avoid fluids with m gastrectomy, many clients experience dumping syndrome, which
occurs when gastric hypotension, abdominal pain, nausea/vomiting, dizziness, generalized sweating, and
tachycardia.

To reduycemce the occurrunlikely (Oence o of gastric emptying.

(Option 1) Hypoglia can cause symptoms similar to those of dumping syndrome (eg, sweating, dizziness)
but is ption 4). An upright or sitting position increases gravity, which increases

to occur 30 minutes after eating.

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

(Option 3) Reports of dizziness after standing worsens sy g, and diarrhea. To delay gastric emptying,
clients should avoid fluids with meals and lie down after eating. mptoms. Fluid intake shoul

Educational objective: Clients are at risk of dumping syndrome after a gastrectomy and may experience
abdominal ping, nausea, vomitin

and may indicate ocramrthostatic hypotension and warrant assessment of blood pressure while lying
and standing; dizziness after eating is indicative of dumping syndrome.