What is the most appropriate reply by the nurse for the following client?
The nurse cares for clients in the student health center. A client confides to the nurse that the client's boyfriend informed her that he tested positive for hepatitis B.
A. That must have been a real shock to you. B. You should be tested for hepatitis B. C. You'll receive the hepatitis B immune globulin (HBIG). D. Have you had unprotected sex with your boyfriend?
A nurse at a student health center has to face numerous questions and student problems. She must know how to deal with them appropriately. In this case, the nurse can’t simply start an immunoglobulin course without prior proof that the student is indeed Hepatitis B positive.
Likewise, she cannot portray feelings by mentioning or inquiring about feelings. After all, the student is a patent and must be dealt with professionally. Moving on, simply stating that the patient requires a hep B test wouldn’t be the first thing expected off a nurse. A simple way to unravel the problem is to ask questions. Asking whether they had unprotected sex should be the first management protocol.
"Have you had unprotected sex with your boyfriend?"
Strategy: Answers are a mix of assessments and implementations. Does this situation require assessment? Yes. Is there an appropriate assessment? Yes.
(1) nurse is interjecting own feelings
(2) will require testing; not best response initially
(3) implementation; receive HBIG for postexposure prophylaxis; may also receive HBV vaccine
(4) correctassessment; transmitted through parenteral drug abuse and sexual contact; determine exposure before implementing