An oncology nurse is caring for a 55-year-old client who underwent a hematopoietic stem cell transplant two weeks ago. During the morning assessment, the nurse discovers a weeping, clustered vesicular rash strictly following the T10 dermatome on the client's right side. Based on these clinical findings, which infection control and care actions are required? Select all that apply.
- Coordinate a transfer to an isolation room equipped with negative-pressure directional airflow.Answer
- Assign a dedicated stethoscope, sphygmomanometer, and thermometer for exclusive use in this client's care area.Answer
- Secure a standard surgical mask over the client's nose and mouth if leaving the clinical unit for imaging.Answer
- DImplement standard and contact isolation measures exclusively, given the rash is confined to one specific nerve pathway.
- EFit the client with an N95 particulate respirator prior to any transport through hospital corridors.
- FInstruct the unlicensed assistive personnel (UAP) to apply the prescribed topical antiviral ointment to the affected dermatome after bathing.
Answer
The required actions are transferring the client to a negative-pressure room, assigning dedicated medical equipment, and placing a surgical mask on the client during transport.
The correct interventions reflect strict adherence to Airborne and Contact Precautions. Severely immunocompromised clients with localized herpes zoster must be treated as having disseminated disease, necessitating a negative-pressure room. Dedicated equipment prevents contact transmission from weeping lesions, and placing a surgical mask on the client during transport provides necessary source control.
Step-by-Step Solution
Key Concept
In severely immunocompromised clients, localized herpes zoster requires both Airborne and Contact Precautions due to the high risk of dissemination. Furthermore, clients on airborne precautions wear standard surgical masks for transport, not N95 respirators.