During handoff at a subacute care facility, a practical nurse receives an assignment that includes a client recovering from disseminated herpes zoster. The client's medical record indicates a new, concurrent infection with *Clostridioides difficile*. Which of the following care interventions should the practical nurse implement? Select all that apply.
- Perform hand hygiene strictly with soap and water after removing personal protective equipment.Answer
- Don a fit-tested N95 respirator, gown, and clean gloves prior to entering the client's isolation room.Answer
- CInstruct the assistive personnel to disinfect the client's bedside commode using standard quaternary ammonium wipes.
- Apply a standard surgical mask over the client's mouth and nose when transport to another department is required.Answer
- ESecure a fit-tested N95 respirator on the client prior to transporting them through the facility corridors.
- Verify that all healthcare staff entering the room have documented immunity to the varicella-zoster virus.Answer
Answer
The correct interventions include washing hands strictly with soap and water, wearing an N95 respirator along with a gown and gloves to enter the room, applying a standard surgical mask to the client during transport, and ensuring all entering staff have documented varicella immunity.
The client's dual diagnosis necessitates the synthesis of Airborne and enteric Contact precautions. Therefore, the nurse must don an N95 respirator, gown, and gloves prior to entry. Because C. difficile spores resist alcohol, hand hygiene must exclusively be performed with soap and water. During transport, clients on Airborne precautions must wear a standard surgical mask to contain respiratory secretions. Furthermore, only healthcare workers with documented immunity to varicella should provide care to prevent viral transmission.
Step-by-Step Solution
Key Concept
Synthesizing multiple transmission-based protocols requires integrating Airborne precautions (N95 for staff, standard mask for client transport, immune staff only) with enteric Contact precautions (gown, gloves, soap and water handwashing, bleach disinfection).