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Difficulty: HardStandard and Transmission-Based Precautions

A client with active pulmonary tuberculosis and a draining methicillin-resistant Staphylococcus aureus (MRSA) wound on the right calf requires transport to the radiology department for an urgent diagnostic scan. Which set of actions should the practical nurse (PN) implement to maintain appropriate infection control during this transport?

  1. Apply a standard surgical mask to the client, ensure the MRSA wound is covered with a clean dressing, and notify the radiology department of the isolation precautions.Answer
  2. B
    Place a fit-tested N95 respirator on the client, ensure the current wound dressing is intact, and don a clean isolation gown and gloves before pushing the wheelchair.
  3. C
    Apply a standard surgical mask to the client, leave the draining wound exposed to allow for immediate radiologic visualization, and cover the wheelchair seat with an impermeable pad.
  4. D
    Cancel the transport order and request a portable imaging exam, because clients with active pulmonary tuberculosis are strictly prohibited from entering hospital hallways.

Answer

The practical nurse should apply a standard surgical mask to the client, ensure the MRSA wound is securely covered with a clean dressing, and notify the receiving department of the required precautions.
During the transport of a client on combined airborne and contact precautions, the primary infection control strategy is source control. Applying a standard surgical mask to the client effectively traps exhaled mycobacteria, preventing airborne environmental contamination. Covering the draining MRSA wound with a clean, dry dressing prevents the shedding of infectious bacteria onto transport equipment or hospital surfaces. Finally, notifying the receiving department in advance is a mandatory safety standard so they can prepare appropriate personal protective equipment and arrange for immediate environmental decontamination following the procedure.

Step-by-Step Solution

1
Identify the transmission-based precautions required for the client's current diagnoses.
The client requires Airborne Precautions for active pulmonary tuberculosis and Contact Precautions for the draining MRSA wound.
Accurate identification of isolation requirements dictates the necessary source control measures during transport.
2
Determine the appropriate source control interventions required before the client leaves the negative-pressure room.
The client must wear a standard surgical mask to contain respiratory droplets, and the draining wound must be covered with a clean, dry dressing to contain the MRSA.
During transport, the primary goal is source control—containing the pathogens at the source to prevent environmental contamination and exposure to others.
3
Establish communication with the receiving department.
The radiology department is notified of the client's Airborne and Contact precaution status prior to transport.
Advance notification allows the receiving department to prepare appropriate PPE, clear the waiting area if necessary, and arrange for immediate post-procedure environmental cleaning.

Key Concept

Infection Control during Client Transport
Estimated Time:1m 30s
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Topics

Standard and Transmission-Based Precautions

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