Clients must be told to wait a minimum of a year until trying for another pregnancy if they have a fibroids mole. A fibroids mole is a sign of imminent malignancy, thus the patient has to be monitored closely for 12 months.
What does the phrase "hydatidiform mole" mean?(HY-duh-TIH-dih-form...) trophoblastic cells, who assist an embryo in attaching to the uterine and assisting in the formation of the pregnancy, grow into a slow-growing cancer once an egg is fertilized by a sperm. A hydatidiform mole has numerous lesions (sacs of fluid)
What brings about hydatidiform?The embryo produced when a typical single sperm reproduces a single of these oocyte has just one pair of chromosomes. A congenital mole results from an abnormal pregnancy so because embryo lacks chromosomes from the mother.
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a patient with a fever and cough has a positive purified protein skin test which action is most appropriate for the nurse
The right action to take for a patient who has a positive protein skin test is to provide a special room and wear a mask.
What is a protein skin test?The protein skin test is also known as the Mantoux test. This test is a kind of test done to diagnose tuberculosis. The doctor will inject a small amount of a fluid called tuberculin just under the skin on the forearm.
This fluid contains some inactive TB proteins to check if there is a reaction after the injection is made. If the protein is active then the patient is likely to have tuberculosis.
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the nurse is providing teaching about pancreatic enzyme replacement to a patient diagnosed with chronic pancreatitis. which statement by the patient indicates the need for further teaching?
Pancreatic enzymes should be taken with meals and snacks, not a half hour before meals.
What chronic pancreatitis symptom also coexists with acute pancreatitis?The most typical sign of chronic pancreatitis is a persistent abdominal ache in the midsection. There may also be times when your discomfort suddenly gets worse and the pancreas flares up (called acute pancreatitis). (Read "Patient Education: Acute Pancreatitis (Beyond the Basics)" for more information.) Instead of taking them 30 minutes prior to meals, pancreatic enzymes should be taken with meals and snacks. Chewing is not necessary before swallowing the tablet. Protein-rich meals shouldn't be combined with the enzyme. After taking an antacid, the pancreatic enzyme should be administered.Due to damaged pancreatic cells and an inability to control glucose, patients with chronic pancreatitis are at a greater risk of developing hyperglycemia. The patient's glucose levels should be monitored by the nurse.To learn more about Pancreatic enzymes refer to:
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the nurse is reviewing the clinical record of a client with a diagnosis of benign prostatic hyperplasia (bph). which test result would confirm the diagnosis?
The test results would support the diagnosis of prostatic tissue biopsy. A biopsy is a process to take a sample of cells or tissue from your body so that it may be examined in a lab.
What is a biopsy?An interventional radiologist, a surgeon, or a cardiologist frequently performs a biopsy as a medical test. In order to detect the existence or severity of a disease, the method entails the extraction of sample cells or tissues. If you show particular symptoms or if your doctor finds a problem area, you might be required to have a biopsy. However, just because your doctor orders a biopsy doesn't necessarily mean you have cancer. Biopsies are frequently related to cancer. When determining if anomalies in your body are the result of cancer or another ailment, doctors perform biopsies.Infection and bleeding at the place where the needle was inserted are minimal risks associated with needle biopsy.To learn more about biopsy refer to:
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what is the name of the form that patients must sign to give permission to the medical facility to disclose health information?
The form that patients must sign to give permission to the medical facility to disclose health information is commonly referred to as a "Authorization for Release of Medical Information" or "Consent to Release Medical Information."
This form typically includes information such as the patient's name, date of birth, and the specific information that the patient is giving permission to disclose, as well as the names of the individuals or organizations that are authorized to receive the information. It also includes the expiration date of the authorization and the patient's signature.
It's important to note that the specific name and content of the form may vary depending on the medical facility or organization and the laws and regulations of the state where the facility is located. Patients should carefully read and understand the form before signing it and should keep a copy for their own records.
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a client who has been told she needs a hysterectomy for cervical cancer reports being upset | about being unable to have a third child. which action would the nurse take?
A client who has been told she needs a hysterectomy for cervical cancer is upset about being unable to have a third child. The next nursing action is for Ensure that other treatment options for her will be explored.
What is cervical cancer?A cancerous tumor of the cervix, which is the lowest portion of the uterus.An HPV vaccine and PAP smear screening can prevent this malignant tumour of the lowermost portion of the uterus (womb).Symptoms might not exist. There may occasionally be pain or erratic bleeding.Chemotherapy, radiation, and surgery are all forms of treatment.All cervical cancer patients had a 66% 5-year survival rate. However, factors including race, ethnicity, and age might affect survival rates differently. The 5-year survival rate is 71% for White women. Black women had a 58% 5-year survival rate. cervical cancer that is in stage IA1 or IA2. In the tissues of the cervix, there is a very little quantity of cancer that can only be seen under a microscope. Cancer that is in stage IA1 has a depth of no more than 3 millimetres. The malignancy is deeper than 3 millimetres but not deeper than 5 millimetres at stage IA2.To learn more about cervical cancer refer to:
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emergency surgery is scheduled for a client with a bowel obstruction. the licensed practical nurse (lpn) tells the registered nurse (rn) that she is unable to obtain informed consent from the client because the client has received opioid analgesics and is sedated. the lpn understands that which action would be implemented
Obtaining a telephone consent from the family member and ensuring that the oral consent is witnessed by two persons
What is an opioid analgesic?Natural opioid analgesics, including morphine and codeine; Semi-synthetic opioid analgesics, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone; Methadone, a synthetic opioid that can be prescribed for pain reduction or for use in MAT for opioid use disorder (OUD)These opioids include tramadol, oxycodone, fentanyl, methadone, dextromethorphan, meperidine, codeine, and buprenorphine.Prescription opioid analgesics are used to treat pain from surgery, injury, and health conditions such as cancer.What makes opioid medications effective for treating pain can also make them dangerous. At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death.To learn more about opioid analgesic refers to:
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a primary health care provider has prescribed oxygen as needed for a 10-month-old infant with heart failure (hf). in which situation would the nurse administer the oxygen to the child?
The situation would the nurse administer the oxygen to the child When drawing blood for electrolyte level testing.
What is electrolyte level testing?An electrolyte test is a blood test that determines whether the body has an electrolyte imbalance. Electrolytes are salts and minerals found in the blood, including sodium, potassium, chloride, and bicarbonate. They can carry electrical signals throughout the body. The purpose of Elosia's at-home urine test strips is to offer you confidence in your body's electrolyte levels and, if necessary, provide you advice on how to raise them. By being aware of your levels, you may take the appropriate action to address any imbalances. When electrolytes are dissolved in water, cations (plus-charged ions) and anions are formed (minus-charged ions).When blood is drawn for electrolyte level testing, the nurse would next give the youngster oxygen.To learn more about electrolyte level testing refer to:
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a nursing student is planning care for a client with paraplegia who is at risk for injury because of spasticity of their leg muscles. the nurse intervenes if the student plans to include which intervention to minimize the risk of injury to the client?
Provide frequent position changes, range of motion exercises, and skin care to reduce the risk of skin breakdown.
What is paraplegia?Paraplegia is a neurological disorder which affects the lower part of the body, most commonly manifested as a complete or partial paralysis of the lower body. It is usually caused by damage to the spinal cord or the nerves which are connected to it. Symptoms of paraplegia can include complete or partial loss of feeling or movement in the lower body, as well as problems with bladder and bowel control, sexual dysfunction, and chronic pain. Treatment of paraplegia usually involves physical and occupational therapy, medications, assistive devices, and lifestyle modifications. In some cases, surgical options may be available. The outlook for individuals with paraplegia depends on the severity of the spinal cord injury and the type of treatment received.To learn more about paraplegia refer to:
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which equipment does the nurse gather when preparing to initiate a peripheral vascular access device
The equipment that the nurse gather when preparing to initiate a peripheral vascular access device includes:
antiseptic swabs or sponges, gauze, a needle-free bung, a prepared flush of sterile normal saline, and a sterile transparent moisture-permeable dressing.What is a peripheral vascular access device?A peripheral vascular access device is described a a device used to draw blood and give treatments, including intravenous fluids, drugs, or blood transfusions.
The working process is that inside the dialyzer, the blood flows through thin fibers that filter out wastes and extra fluid and the machine returns the filtered blood to the body through a different tube.
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the nurse is caring for a client who may have a lice infestation. the nurse is using a bright light focused on an area of the head to confirm the presence of lice. in which manner is it easiest to differentiate nits from dandruff?
Nits are difficult to move from hair shafts is it easiest to differentiate nits from dandruff.
What exactly are hair shafts?
The visible portion of the hair that protrudes from the skin is called the shaft. The hair root is located in the skin and extends into the skin's deeper layers. The hair follicle, which is encased in a sheath of connective tissue and skin, surrounds it and is joined to a sebaceous gland.
What three sorts of hair shafts are there?
There are three layers in the shaft of your hair.
Cuticle which is made up of overlapping cells and is oriented downward like fish scales or roof tiles, is its protective coat. "The Cortex," The primary volume and pigment (color) of your hair are formed by the cortex.
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"the healthcare provider prescribe pitocin 6 milliunits/min to induce labor for a client at 41 weeks gestation. the nurse initiates an infusion of lactated ringer 1000 ml with pitocin 20 units. how many ml/hr should the nurse program the infusion pump? "
Using the child's BSA, 0.7 m2, calculate the mg/dose, 600 mg x 0.7 m2 = 420 mg/day/3 doses = 140 mg/dose.
In order to administer a saline drip IV, nurses must determine the best IV site, hang the main IV bag, and determine the IV rates. Additionally, they make the appropriate adjustments while keeping an eye on the success of the IV therapy given to the patients.
To decide when to stop an infusion or hang an IV bag, nurses frequently compute IV flow rates in addition to the completion date of an infusion. Your chance of developing hyperkalemia may rise if you have a lactated Ringer's injection (high potassium level in the blood).
If you experience stomach pain, confusion, an irregular heartbeat, tingling or numbness in your hands, feet, or lips, trouble breathing, or stiffness or heaviness in your legs, consult a doctor straight once.
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which factors threatens the prognosis of a patient with a serious mental illness even when the patient initially ddoes well?
Factors that threaten the prognosis of patients with serious mental illness are traumatic events that occur to them.
What is mental illness?Mental illness also known as a mental disorder, is a health condition that affects thinking, feeling, behavior, mood, or a combination of these. This condition can occur occasionally or last for a long time (chronic).
This disorder can be mild to severe, which can affect a person's ability to carry out daily life. This includes carrying out social activities, work, and relationships with family. Factors that affect the client even though at that time he was fine was the trauma that occurred to the client, causing his mental illness to reappear.
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a 62-year-old man with hypertension and diabetes is discharged home from the hospital, following a viral upper respiratory tract infection. he is prescribed several medications, including low dose aspirin. the patient asks you why he is taking aspirin along with the other medications. what is the reasoning behind your response?
Aspirin helps decrease the risk of myocardial infarction in men.
What is myocardial infarction?A myocardial infarction (commonly called a heart attack) is an extremely dangerous condition that happens because of a lack of blood flow to your heart muscle. The lack of blood flow can occur because of many different factors but is usually related to a blockage in one or more of your heart's arteriesA heart attack, also called a myocardial infarction, happens when a part of the heart muscle doesn't get enough blood. The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle. Coronary artery disease (CAD) is the main cause of heart attack.To learn more about myocardial infarction refers to:
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a client in active labor is admitted to the birthing room. a vaginal examination reveals that her cervix is dilated 6 to 7 cm. in light of this finding, which would the nurse expect?
The nurse expect the client will have longer and more frequent contractions.
What cervical dilation is active labor?A full cervical dilation diagnosis was used to define "active labour" as the initiation of the clinical criteria frequently regarded as prospective evidence of the beginning of the active phase. The majority of researchers defined the start of the active phase of labour as between 3-5 cm dilatation in the presence of contractions.(Contractions during the active phase of the initial stage of labour fit this description of how they feel.) During the transition stage of the first stage of labour, nausea and vomiting happen. The transitional period of the first stage of labour is when there is a greater amount of copious bloody show and uncontrolled trembling of the legs.)To learn more about "active labour" refer to:
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which reason is the most important for prescribing inhaled, rather than oral, corticosteroids for patients with asthma?
One of the most important reasons for prescribing inhaled corticosteroids rather than oral corticosteroids for patients with asthma is to minimize systemic side effects.
Inhaled corticosteroids deliver the medication directly to the airways, reducing the amount of medication that enters the bloodstream and minimizing the risk of systemic side effects.
Systemic side effects of oral corticosteroids can include weight gain, osteoporosis, diabetes, cataracts, and mood changes. These side effects are less likely to occur with inhaled corticosteroids because the majority of the medication stays in the lungs, reducing the amount that enters the bloodstream.
Additionally, inhaled corticosteroids have been shown to be more effective than oral corticosteroids in controlling asthma symptoms and preventing exacerbations. They can also be used in combination with other medications such as bronchodilators to achieve optimal control of asthma symptoms.
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you are transporting a patient who experienced a right-sided head injury after a large refrigerator fell and pinned his head between the appliance and the floor. on scene, the patient was responsive to verbal stimuli with the following vital signs: pulse, 96 beats/min; respirations, 16 breaths/min; blood pressure, 134/66 mmhg; and spo2, 95%. during transport, as you reassess the patient, what would be the clearest sign that the head injury is worsening?
The only instance where an EMT will remove an impaled object is when it is blocking a patient's airway.
Which patient requires the EMT to remove an impaled object in the field?All forms of acute illness and trauma patients can have their level of impaired consciousness measured objectively using the Glasgow Coma Scale (GCS). The scale rates patients based on their eye-opening, muscular, and verbal responses—the three components of responsiveness. The skull shields the brain from harm. The skull is the collective name for the bones that guard the face, including the cranium. The meninges, which are composed of three layers of tissue and cover and protect the brain and spinal cord, are located between the skull and the brain. A tourniquet must be applied tightly enough to fully stop arterial blood flow distal to the tourniquet.To learn more about patient requires refer to:
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the client's dosage of lanoxin (digoxin) was changed from 0.125 mg to 0.5 mg. what percentage was the dosage increased?
The percentage increase in the dosage of lanoxin will be equal to the value 300%.
Percentage is defined as the mathematical expression that is used to represent the quantity of any object present with respect to the other object. Percentage is represented by the symbol %. For example If there are 60 boys out of 100 students present in a class then the percentage of boys present in the class will be equal to 60%. Now in this case the dosage of lanoxin was 0.125 mg and then it changed to 0.5 mg. Now increase in percentage is expressed as
% increase = [(Final value - initial value)/Initial value]×100
% increase = [(0.5 - 0.125)/0.125]×100
% increase = (0.375/0.125)×100
% increase = 300% which is the required value.
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an infant is suspected to be human immunodeficiency virus (hiv) positive, and the nurse provides information to the parents about the care of their infant. which indicates to the nurse that the parents need further teaching about the care of their hiv-positive infant?
If the parents express confusion or ask questions about the care of their HIV-positive infant, this would indicate to the nurse that further teaching is needed.
what are HIV baby symptoms?Babies who are HIV positive may not show any signs at all or they may show a variety of symptoms. Rashes, swollen lymph nodes, fevers, recurring infections, and failure to flourish are a few of these signs that may be present.
Jaundice and low birth weight are other potential complications for newborns. Babies who have the condition may get pneumonia, chronic diarrhea, and wasting syndrome as it worsens.
Last but not least, certain infants may develop epilepsy, learning impairments, and other neurologic problems. Babies born with HIV must receive early diagnosis and treatment. Infants with HIV may pass away before turning two if they are not treated.
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a client with acute glomerulonephritis is admitted to the nursing unit. the nurse would plan to do which action immediately upon admission?
The main nursing plan which should be immediately given to the patient suffering from acute glomerulonephritis is remove the water pitcher from the bedside.
Patients with acute glomerulonephritis is not allowed to consume enough protein because its assimilation and removal from the body can be a difficult task as the kidneys are not in state to function effectively. Acute glomerulonephritis is the inflammation of the glomerulus which is present inside the kidney. It affects filtration of waste product due to which conditions such as proteinuria, hematuria, and azotemi may arise. In such cases, the patient has to take utmost care of their diet and do not put any undue pressure on the kidney. Water pitcher is removed to make the space more hygienic and spacious.
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an 8-month-old is irritable with a skin rash and a cough. which comment by the telenurse is appropriate?
Make sure to give a small dose of vaccine to child.
What is vaccine?A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified.A preparation that is used to stimulate the body's immune response against diseases. Vaccines are usually administered through needle injections, but some can be administered by mouth or sprayed into the nose.When you get a vaccine, your immune system responds to the vaccine the same way it would to the real germ. It: Recognizes the germ in the vaccine as being foreign. Responds by making antibodies to the germ in the vaccine, just as it would for the real germ.
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what nutrient, supplement, pr type of food can you teach the patient to use to enhance the absorption of iron
We can enhance your body's capacity to absorb iron by ingesting citrus juice or other meals high in vitamin C concurrently with high-iron diets.
Foods like whole grains, cereals, soy, nuts, and legumes contain phytate, also known as phytic acid. It's crucial to remember that adequate soaking can get rid of the phytic acid in beans and lentils. Phytate can drastically reduce the absorption of iron, even in tiny doses. But eating foods that improve the absorption of non-heme iron, like vitamins or meat, can offset the harmful effects of phytate.
Our body's ability to absorb iron from diet can be improved by consuming foods high in vitamin C, vitamin A, or beta-carotene. Eating fish, poultry, or meat with other foods can also be beneficial.
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which would the nurse do to prepare a client in her third trimester who is scheduled for an amniocentesis
The nurse intervention is to prepare a client in her third trimester who is scheduled for an amniocentesis, should be emotionally available for the patient firstly and advise patient to immediately void before test.
She should understand the commons of amniocentesis, the procedure to follow and how to treat them after , before and within their treatment .
The nurse usually instructs the patient to void before the test as it can cause damage to bladder when needle is introduced to amniotic sac.
The position for injecting the needle should be supline positions.
water before the test is only taken if the test is performed in the early stages of pregnancy.
The nurse should ensure it happens in a hassle free way.
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the nurse leader is focused on recognizing the dynamic, complex, and interdependent | nature of systems in an organization. which nursing action indicates an effective implementation of this principle of systems thinking theory?
Nursing actions that demonstrate effective implementation of the systems thinking theory principles are identifying and understanding the relationships between clients, families, communities, and the local economy.
System thinking is one of the approaches needed so that humans can view the world's problems more comprehensively and thus decision-making and action choices can be made more directed to the sources of problems that will change the system effectively.
The application of systems thinking in the health sector accelerates a more realistic understanding of what works, for whom, and in what situations, system building directly or in general (e.g., human resources for health), rather than health issues specifically.
This question is option:
Focusing on the measuring of morale, working relationship, teamwork, and the number of clientsRecognizing the consequences of actions taken on the long-term effect of the organization or client careIdentifying and understanding the relationships between clients, families, communities, and local economiesFocusing on the needs of all the residents in a long-term care facility or the complications of emergency department overcrowdingThe correct answer is 3
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the nurse is admitting a toddler with the diagnosis of near-drowning in a neighbor's heated swimming pool to the emergency department. the nurse should assess the child for which complication?
A nurse carries a toddler diagnosed as nearly drowning in a neighborhood heated swimming pool to the emergency room. A nurse should examine the child for hypoxia.
What is Hypoxemia and causes?Hypoxia is low oxygen levels in body tissues. It causes symptoms such as confusion, restlessness, difficulty breathing, increased heart rate, and bluish skin. Many chronic heart and lung conditions can put you at risk for hypoxia. Hypoxia can be life threatening
Cardiac and lung function problems can lead to 5 categories of conditions that cause hypoxemia: Ventilation - perfusion (V/Q) imbalance, diffusional impairment, hypoventilation, low ambient oxygen, and right-to-left shunt.
At what oxygen levels does hypoxia occur?Values below 75 mmHg are called hypoxemia. Another value reported by the ABG test is oxygen saturation. This is a measure of the amount of oxygen carried to red blood cells by hemoglobin. Normal oxygen saturation is 95-100%.
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the nurse is preparing to administer a prescribed medication to the pregnant client. which order should the nurse question?
The sequence that the nurse must ask before giving medicine to a pregnant client is the gestational age and the condition of the pregnancy.
What is the effect of drugs on pregnant women?The use of drugs in pregnant women must be based on the prescription given by the doctor because not all drugs are safe for use by pregnant women. So if you are going to give medicine to pregnant women, you need to ensure the age of your pregnancy and the condition of your pregnancy.
In addition, it is necessary to ensure that pregnant women do not have allergies to certain drugs so they don't feel the side effects of these drugs.
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discharge planning for a client with chronic pancreatitis includes dietary education. which client statement indicates to the nurse that further teaching is needed?
The client's assertion that it is okay to eat meals heavy in fat needs to be followed up on by the nurse. To prevent diarrhea, a low-fat diet should be followed.
Is there a cure for chronic pancreatitis?To reduce their symptoms, slow the pancreas's degeneration, and handle any complications that may emerge, people with chronic pancreatitis require continual medical care. In most circumstances, a treatment only manages the symptoms rather than curing the underlying issue.
What is the course of action for persistent pancreatitis?Steroid medication is advised for those with chronic pancreatitis brought on by immune system issues because it reduces pancreatic inflammation. However, long-term steroid use might have negative effects like osteoporosis and weight gain.
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the patient protection and affordable care act will impact the healthcare delivery system in many ways. one change was allowing states to amend their medicaid program. which change did the patient protection and affordable care act program support?
The legislation establishes various rights and safeguards to make health care more equitable and understandable, as well as subsidies (through "premium tax credits" and "cost-sharing reductions") to make it cheaper. The measure also increases the Medicaid program to include additional low-income people.
The ACA's goal is to overhaul how insurance and healthcare systems function in order to enhance healthcare access, quality, and individual and public costs. If implemented well, the ACA has the potential to enhance both individual and public health.
Representative Charles Rangel introduced the measure. The 111th Congress spent most of its time, at the request of the Obama administration, reforming the United States healthcare system. Without affordable coverage, more Americans would avoid or postpone vital medical treatment, putting millions of lives at risk and pushing up system costs. Since 2010, the Affordable Care Act (ACA) has made health insurance more accessible and affordable for many Americans. Your children may remain on your health plan until they reach the age of 26 according to the ACA. Health insurance companies cannot refuse you coverage because you have a pre-existing ailment.
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the nurse employed in a primary health care provider's office is collecting data on a client who is taking ergotamine tartrate. the nurse evaluates the effectiveness of therapy by asking which question?
She might inquire as to if you experience headaches that might be extremely painful, throbbing, or pulsating, usually on one side of the head.
What is headaches work?Any area of the head can experience a headache. One or both sides of the head may experience headaches, as well as headaches that are localised, radiate throughout the head from a single site, or feel like a vice.A headache may feel like a dull ache, a sharp pain, or a throbbing agony.Any portion of the head may experience an acute or dull ache, which may coexist with other symptoms.To learn more about Headaches refer:
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you are caring for a 5-month-old infant who was accidentally electrocuted by an exposed wire. the scene is safe, and you have been performing cpr. someone has brought you an aed which does not have a pediatric setting or pads. what do you do?
We have to attach the AED and use it.
Moderate chest compressions at a rate of 100–120 per minute should be given. Use two to three fingers to press down beneath the nipples in the middle of the chest. Put pressure on your chest about one-third of the way down (about 1 and a half inches).
When two rescuers are performing CPR, the 2-thumb-encircling-hands approach (Figure 4) is advised. Put both hands around the infant's chest, extending your fingers around the thorax, and bringing your thumbs together to cover the lower third of the sternum. With your thumbs, firmly pressure the sternum.
At a rate of two compressions per second, perform 30 compressions. The chest should descend by roughly one-third with each compression. Hold the infant's head up so their chin doesn't droop.
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a nurse enters the operating room (or) with artificial fingernails in place. what should the charge nurse explain to the nurse?
The charge nurse should explain to the nurse that artificial fingernails are not allowed in the operating room (OR) due to the potential for contamination and infection.
The charge nurse should also explain the importance of maintaining aseptic technique in the OR, which is a set of guidelines and procedures that are followed to minimize the risk of contamination and infection. This includes strict adherence to hand hygiene, wearing appropriate personal protective equipment, and adhering to the facility's policies and procedures regarding the use of artificial nails.
The charge nurse should also inform the nurse that they should remove the artificial nails before entering the OR or if the nurse does not remove the artificial nails, she should not be allowed to enter the OR. They should also remind the nurse that, if they have any questions or concerns, they should speak with their supervisor or the infection control nurse.
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