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Question

Difficulty: MediumStandard and Transmission-Based Precautions

A practical nurse is preparing a client with active pulmonary tuberculosis for transport to the radiology department for a prescribed computed tomography (CT) scan. Which of the following infection control actions is the most appropriate for the nurse to take?

  1. Place a standard surgical mask over the client's nose and mouth before they leave the isolation room.Answer
  2. B
    Apply a fitted N95 respirator on the client to ensure maximal filtration of exhaled respiratory droplets.
  3. C
    Remove the personal N95 respirator inside the client's room immediately before opening the door.
  4. D
    Put a clean isolation gown and gloves on the client to prevent environmental contamination.

Answer

The most appropriate action is to place a standard surgical mask over the client's nose and mouth before they leave the isolation room.
For clients on airborne precautions, such as those with active pulmonary tuberculosis, a standard surgical mask should be placed over their nose and mouth when they are transported outside of their negative-pressure room. This acts as essential source control by trapping large respiratory droplets and preventing the aerosolization of infectious droplet nuclei into the ambient environment.

Step-by-Step Solution

1
Identify the mode of transmission for the client's diagnosis.
Active pulmonary tuberculosis is transmitted via the airborne route through infectious droplet nuclei.
Knowing the transmission route dictates the required infection control precautions.
2
Determine the correct protocol for transporting a client on airborne precautions.
The client must wear a standard surgical mask when outside the airborne infection isolation room (AIIR).
The surgical mask acts as source control, trapping the client's exhaled respiratory secretions before they can become aerosolized in the hospital environment.
3
Evaluate the distractors for common errors in PPE selection and doffing sequence.
Options involving N95 application on the client, doffing the nurse's N95 inside the room, or placing contact PPE on the client are identified as incorrect procedures.
N95s are for staff inhalation protection, doffing an N95 inside an AIIR exposes the nurse to suspended airborne particles, and gowns/gloves do not prevent airborne transmission.

Key Concept

Airborne Precautions and Client Transport Protocols
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Topics

Standard and Transmission-Based Precautions

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