The charge nurse in the medical unit is preparing a bed assignment for a stable client diagnosed with necrotizing fasciitis. The client has a history of diabetes and hepatitis. There are four beds available. The nurse knows that the best roommate for this client is which of the following?

  1. a client with gout in the large toe
  2. a client with fever, vomiting, and diarrhea
  3. a client with MRSA
  4. a client with severe dementia with a tendency to wander
Number 1 is correct.
Rationale: The best roommate for this client is a client with gout in the large toe. Necrotizing fasciitis is worse in immunocompromised clients, and this client has a history of diabetes and hepatitis. This leaves the client vulnerable to worsening the infection or developing a new infection on top of the necrotizing fasciitis. Gout is not a communicable illness, so this is the best roommate choice for this client. A client with fever, vomiting, and diarrhea may potentially have a contagious condition that can worsen the outcome for the client. The client with MRSA is not a good choice because there is a chance that the MRSA could infect the client with necrotizing fasciitis. The client with severe dementia and the tendency to wander is at risk of cross-contamination and further infecting the client with necrotizing fasciitis because of her inability to perform hand hygiene. Clients with necrotizing fasciitis are generally not contagious to healthy persons, but contact and universal precautions, along with hand hygiene, prevents them from further colonization by bacteria.