Question

Difficulty: MediumStandard and Transmission-Based Precautions

A client presents to the emergency department with a sudden onset of high fever, severe headache, photophobia, and nuchal rigidity. The healthcare provider suspects bacterial meningitis. Which of the following actions should the nurse include in the client's plan of care? Select all that apply.

  1. Place the client in a single-patient private room.Answer
  2. B
    Wear a fit-tested N95 respirator when providing direct client care.
  3. Apply a surgical mask to the client during transport to the radiology department.Answer
  4. D
    Maintain the client in a room with negative-pressure directional airflow.
  5. Instruct visitors to wear a surgical mask while in the client's room.Answer
  6. F
    Assign the unlicensed assistive personnel (UAP) to perform the initial neurological checks.

Answer

The correct interventions include placing the client in a single-patient private room, applying a surgical mask to the client during transport, and instructing visitors to wear a surgical mask.
Bacterial meningitis is transmitted through large respiratory droplets, requiring the implementation of droplet precautions. Essential droplet precautions include placing the client in a single-patient room, requiring healthcare workers and visitors to wear a surgical mask when entering the room, and having the client wear a surgical mask when transport outside the room is necessary to contain secretions.

Step-by-Step Solution

1
Analyze the client's clinical presentation.
The symptoms (high fever, severe headache, photophobia, nuchal rigidity) strongly suggest bacterial meningitis.
Identifying the suspected pathogen determines the necessary isolation precautions.
2
Determine the required transmission-based precautions.
Bacterial meningitis requires droplet precautions.
The pathogen is transmitted via large respiratory droplets generated by coughing, sneezing, or talking.
3
Evaluate each intervention against droplet precaution standards and scope of practice.
Providing a private room, masking the client during transport, and masking visitors are correct actions. N95 respirators and negative-pressure rooms are for airborne pathogens. Initial assessments cannot be delegated.
This ensures evidence-based infection control and safe, legal delegation of tasks.

Key Concept

Droplet Precautions and Safe Delegation
Rate this question