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Difficulty: HardStandard and Transmission-Based Precautions

A practical nurse (PN) is reviewing infection control protocols and room assignments for a group of clients on a medical-surgical unit. Which of the following actions indicate a correct application of standard and transmission-based precautions? (Select all that apply.)

  1. Assigning a client with meningococcal meningitis to a private room and wearing a standard surgical mask when providing direct careAnswer
  2. Placing a client with disseminated herpes zoster in a private room with negative-pressure airflow and keeping the room door closedAnswer
  3. C
    Applying a face shield prior to securing the N95 respirator mask when donning personal protective equipment (PPE) before entering a negative-pressure room
  4. Dedicating reusable medical equipment, such as a blood pressure cuff, for single-client use in a room with vancomycin-resistant enterococci (VRE)Answer
  5. E
    Delegating the initial education of family members regarding isolation protocols for a client with Clostridioides difficile to an unlicensed assistive personnel (UAP)
  6. F
    Instructing a client with active pulmonary tuberculosis to wear an N95 respirator mask while being transported to the radiology department

Answer

The correct actions include placing the client with meningococcal meningitis in a private room with a surgical mask for staff, placing the client with disseminated herpes zoster in a negative-pressure room with the door closed, and dedicating reusable equipment for the client with VRE.
The correct actions demonstrate a comprehensive understanding of infection control across various scenarios. Meningococcal meningitis is transmitted via large droplets, requiring a private room and a surgical mask. Disseminated herpes zoster necessitates both airborne and contact precautions, requiring a private, negative-pressure room with the door closed to contain airborne particles. Finally, caring for a client with VRE requires contact precautions, which mandates the use of dedicated, single-client reusable medical equipment to prevent cross-contamination to other clients or the environment.

Step-by-Step Solution

1
Analyze the required precautions for each pathogen mentioned in the options (Meningococcal meningitis, Disseminated herpes zoster, VRE, C. difficile, Tuberculosis).
Meningitis requires droplet precautions; Zoster requires airborne and contact precautions; VRE and C. diff require contact precautions; TB requires airborne precautions.
Determining the correct transmission route is the foundation of applying the proper infection control measures.
2
Evaluate room assignments and environmental controls for the identified precautions.
Droplet precautions require a private room. Airborne precautions require a private, negative-pressure room with the door continuously closed.
Environmental controls are essential to contain the spread of infectious particles to other areas of the facility.
3
Evaluate personal protective equipment (PPE) donning sequence and transport requirements.
The correct PPE donning sequence is gown, mask/respirator, face shield/goggles, then gloves. Transporting an airborne-precaution client requires the client to wear a standard surgical mask, not an N95.
Proper sequencing and transport containment prevent cross-contamination and ensure the equipment functions as designed.
4
Evaluate the delegation of tasks related to infection control.
Initial education and assessment of isolation compliance cannot be delegated to an unlicensed assistive personnel (UAP).
The PN must adhere to the legal scope of practice, which restricts teaching and clinical assessment to licensed nurses.

Key Concept

Standard and transmission-based precautions dictate specific PPE usage, room assignments, transport protocols, and delegation boundaries based on the mode of pathogen transmission.
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Standard and Transmission-Based Precautions

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