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Difficulty: HardStandard and Transmission-Based Precautions

An adult client with a confirmed diagnosis of disseminated varicella-zoster requires an urgent transfer from the medical-surgical unit to the intensive care unit. Which action by the practical nurse is most appropriate regarding infection control during this transport?

  1. A
    Apply a fitted N95 respirator to the client to prevent airborne transmission and wear a standard surgical mask while pushing the transport stretcher.
  2. Place a standard surgical mask on the client, cover all active fluid-filled lesions with clean linens, and alert the receiving unit about the isolation status.Answer
  3. C
    Attach a highly visible isolation warning sign stating the client's specific diagnosis to the transport stretcher to alert bystanders in the hospital corridors.
  4. D
    Don an N95 respirator, an isolation gown, and clean gloves before leaving the room, and wear this protective equipment throughout the public hallways.

Answer

Place a standard surgical mask on the client, cover all active fluid-filled lesions with clean linens, and alert the receiving unit about the isolation status.
The correct answer safely addresses both the airborne and contact transmission risks of disseminated varicella. A standard surgical mask provides adequate source control for the client's respiratory secretions, and covering the lesions prevents direct contact transmission. Alerting the receiving unit ensures they can prepare a negative-pressure room and don appropriate personal protective equipment before the client arrives.

Step-by-Step Solution

1
Identify the required transmission-based precautions for disseminated varicella-zoster.
Airborne and Contact precautions are required.
The virus is transmitted through respiratory aerosols and direct contact with fluid from open lesions.
2
Determine the appropriate source control for the respiratory (Airborne) component during transport.
The client must wear a standard surgical mask.
Surgical masks trap large expelled droplets and reduce aerosol emission from the source. Clients do not wear N95 respirators because they require specialized fit testing and significantly increase the work of breathing.
3
Determine the appropriate source control for the physical (Contact) component during transport.
All active, fluid-filled skin lesions must be covered with clean linens or dressings.
Covering the lesions prevents direct contact transmission and prevents environmental contamination of the stretcher and hallways.
4
Evaluate the nurse's transport requirements.
The nurse communicates with the receiving unit and avoids wearing contaminated gowns/gloves in the hallway.
Advance notification allows the intensive care unit to prepare a negative-pressure room. Wearing contaminated PPE in public areas violates infection control standards.

Key Concept

Standard and Transmission-Based Precautions
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Topics

Standard and Transmission-Based Precautions

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