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Difficulty: HardStandard and Transmission-Based Precautions

During a unit census update, a practical nurse collaborates with the charge nurse to determine safe room placements and infection control measures for several infectious clients. Which proposed strategy represents the correct application of transmission-based precautions?

  1. Assigning a private room to a client with confirmed pertussis and ensuring that healthcare personnel don a surgical mask prior to room entryAnswer
  2. B
    Assigning a client with active varicella to a negative-pressure room and directing personnel to wear a standard surgical mask, gown, and gloves
  3. C
    Cohorting a client with Haemophilus influenzae type b (Hib) and a client with influenza A in a shared room since both require droplet precautions
  4. D
    Placing a client with Clostridioides difficile in a private room under contact precautions and utilizing an alcohol-based hand rub immediately after glove removal

Answer

The correct strategy is assigning a private room to a client with confirmed pertussis and ensuring staff wear a surgical mask upon entry.
Pertussis (whooping cough) is transmitted through large respiratory droplets. The correct application of droplet precautions requires placing the client in a private room and ensuring that all healthcare personnel wear a surgical mask upon entering the room to prevent the inhalation of infectious droplets. This strategy fully adheres to established infection control standards.

Step-by-Step Solution

1
Analyze the transmission route and required precautions for a client with pertussis.
Pertussis (whooping cough) is spread through large respiratory droplets, necessitating Droplet Precautions.
Identifying the correct isolation category is the first step in determining appropriate room placement and PPE.
2
Verify the required interventions for Droplet Precautions.
Droplet Precautions require a private room (or cohorting with the exact same infection) and the use of a standard surgical mask by healthcare personnel upon room entry.
Large droplets typically travel 3 to 6 feet before falling to the ground, so a surgical mask provides adequate mucosal protection.
3
Evaluate the alternative strategies to identify specific infection control violations.
The other strategies contain critical errors regarding airborne PPE requirements (varicella), cohorting rules (mixed pathogens), and enteric hand hygiene protocols (C. difficile).
Ruling out distractors confirms that the pertussis strategy is the only one fully compliant with transmission-based precautions.

Key Concept

Transmission-Based Precautions: Pathogen-Specific Protocols
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Topics

Standard and Transmission-Based Precautions

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