A nurse is caring for a group of clients on a medical surgical unit. Which client is most at risk for contracting a nosocomial infection? A)51-year-old client who received a permanent pacemaker 48 hours ago B)60-year-old client who had a myocardial infarction 24 hours ago C)74-year-old client with stroke and an indwelling urinary catheter for 3 days D)75-year-old client with dementia and dehydration who is on IV fluids

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A nosocomial infection occurs in a hospital (hospital-acquired) or other health care setting and is not the reason for the client's admission. Many nosocomial infections are caused by multidrug resistant organisms. These infections occur 48 hours or more after admission or up to 90 days after discharge. Clients at greater risk include young children, the elderly, and those with compromised immune systems. Other risk factors include long hospital stays, being in the intensive care unit, the use of indwelling catheters, failure of health care workers to wash their hands, and the overuse of antibiotics. The most common nosocomial infection is urinary tract infection, followed by surgical site infections, pneumonia, and bloodstream infections. The 74-year-old client is most at risk due to age and the presence of the urinary catheter. The nurse will need to be on high alert for this complication and should follow infection control procedures diligently. (Option A) This client does have a surgical incision, which poses a risk for infection. However, this client is younger and does not have any underlying chronic condition to compromise the immune system. (Option B) This client does not fall in the category of elderly and has no surgical incision or indwelling catheters other than a possible IV site. (Option D) This client is at risk due to age and presence of an IV catheter. However, the risk is not as high as the client with the urinary catheter. Educational objective: The nurse should be aware of the risk for nosocomial infections in young children, elderly, and immunocompromised clients, especially those with long hospital stays, indwelling catheters, and surgical incisions.

A Nurse Is Caring for a Group of Clients on a Medical