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Difficulty: Very hardStandard and Transmission-Based Precautions

A practical nurse (PN) is preparing to transport a client diagnosed with active pulmonary tuberculosis and a draining Methicillin-resistant Staphylococcus aureus (MRSA) wound infection to the radiology department. The client currently resides in an airborne infection isolation room (AIIR). Which set of actions by the PN represents the correct application of transmission-based precautions for this transport?

  1. Place a standard surgical mask on the client, apply a clean dressing to completely cover the wound, discard all personal protective equipment (PPE) worn by the PN, and perform hand hygiene prior to exiting the client's room.Answer
  2. B
    Place an N95 respirator on the client, cover the wound with a clean dressing, and the PN dons a new isolation gown, gloves, and an N95 respirator for the duration of the transport.
  3. C
    Place a standard surgical mask on the client, leave the draining wound exposed to the air, discard all PN personal protective equipment (PPE), and perform hand hygiene prior to exiting the room.
  4. D
    Place a standard surgical mask on the client, apply a clean dressing to completely cover the wound, and the PN wears clean gloves while pushing the wheelchair to prevent cross-contamination.

Answer

Place a standard surgical mask on the client, apply a clean dressing to completely cover the wound, discard all personal protective equipment (PPE) worn by the PN, and perform hand hygiene prior to exiting the client's room.
To safely transport a client on both Airborne and Contact Precautions, the source of the infection must be fully contained. The client must wear a standard surgical mask (not an N95) to contain respiratory droplets, and any infectious wounds must be securely covered with a clean dressing. Additionally, the transporting nurse must remove and discard all PPE and perform hand hygiene before leaving the isolation room to avoid contaminating environmental surfaces in the hospital corridors.

Step-by-Step Solution

1
Identify the transmission-based precautions required for the client's specific diagnoses.
Active pulmonary tuberculosis requires Airborne Precautions. A draining MRSA wound requires Contact Precautions.
Establishing the required precautions dictates the necessary source control measures for a safe transport.
2
Determine the correct source control method for the client during the transport.
The client must wear a standard surgical mask to contain respiratory secretions and have the MRSA wound covered with a clean, secure dressing.
During transport, the primary infection control goal is to contain the pathogen at the source. Clients do not wear N95 respirators, as they are not filtering inhaled air, but rather containing exhaled droplets.
3
Determine the appropriate PPE protocol for the practical nurse (PN) during the transport process.
The PN must remove and discard all PPE and perform hand hygiene before leaving the isolation room.
Wearing PPE (such as gowns and gloves) in public hospital hallways violates infection control protocols because it risks transferring pathogens from the contaminated PPE to clean environmental surfaces.

Key Concept

During client transport, transmission-based precautions focus heavily on source containment (masking the client and covering infectious lesions). Transporting staff should not wear PPE in public hallways to prevent widespread environmental contamination.
Estimated Time:1m 30s
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Topics

Standard and Transmission-Based Precautions

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