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Difficulty: MediumStandard and Transmission-Based Precautions

A newly admitted pediatric client requires airborne and contact precautions due to a diagnosis of disseminated varicella-zoster. Which actions by the practical nurse are appropriate regarding this client's care? Select all that apply.

  1. Remove the disposable gown and gloves inside the client's room prior to exiting.Answer
  2. Keep the N95 respirator on until after leaving the room and closing the door.Answer
  3. C
    Remove the N95 respirator first, followed by the gown and gloves, before leaving the room.
  4. D
    Perform the initial admission assessment to establish the isolation care plan.
  5. E
    Post a sign on the client's door stating the specific diagnosis to ensure visitors wear proper PPE.
  6. Dedicate reusable medical equipment, such as a stethoscope, exclusively for this client's use.Answer

Answer

The correct actions are removing the gown and gloves inside the room, keeping the N95 respirator on until after leaving the room, and dedicating reusable equipment exclusively to the client.
Disseminated varicella-zoster requires both airborne and contact precautions. To maintain infection control, the nurse must remove contact PPE (gown and gloves) inside the isolation room to avoid spreading pathogens into the hallway. The N95 respirator must remain in place until the nurse has fully exited the room and closed the door to prevent inhalation of airborne droplet nuclei. Additionally, dedicating reusable medical equipment to the client is a standard contact precaution that prevents cross-contamination.

Step-by-Step Solution

1
Analyze the transmission-based precaution requirements for the diagnosis.
Disseminated varicella-zoster requires strict adherence to both airborne and contact precautions.
The virus is transmitted via airborne droplet nuclei and through direct contact with active lesions.
2
Evaluate the correct donning and doffing procedures for the required PPE.
Contact PPE (gowns and gloves) should be removed inside the room, while airborne PPE (N95 respirator) must be removed outside the room.
Removing contact PPE inside prevents spreading pathogens to the hallway, while keeping the respirator on until outside prevents inhalation of suspended infectious particles.
3
Assess the remaining interventions against safety, confidentiality, and scope of practice standards.
Dedicating reusable equipment is a correct safety measure. Initial assessments and posting diagnoses on doors are incorrect.
Dedicating equipment prevents cross-contamination. However, initial care planning is strictly an RN responsibility, and posting a diagnosis violates client privacy laws.

Key Concept

Management of Airborne and Contact Precautions
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Topics

Standard and Transmission-Based Precautions

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