An emergency department triage nurse is establishing immediate isolation measures for multiple newly arriving clients. Match each client's clinical presentation with the most appropriate transmission-based precaution protocol.
- Client reporting a persistent cough, unexplained weight loss, and hemoptysis.Airborne infection isolation room (AIIR) and fit-tested N95 respirator.
- Client with frequent, foul-smelling liquid stools and a recent history of broad-spectrum antibiotic therapy.Private room, gown, gloves, and strict hand hygiene using soap and water.
- Client presenting with sudden onset of high fever, nuchal rigidity, and a purpuric rash.Private room and application of a surgical mask upon room entry.
- Client with a large, uncontained abdominal wound that is heavily draining purulent fluid.Private room, gown, and gloves for all interactions involving patient or environmental contact.
Answer
Hemoptysis/weight loss matches with Airborne isolation (AIIR/N95). Liquid stools/antibiotic use matches with Contact-Enteric (soap and water). Nuchal rigidity/rash matches with Droplet (surgical mask). Uncontained draining wound matches with Standard Contact (gown and gloves).
Appropriate transmission-based precautions are dictated by the pathogen's mode of transmission. Airborne precautions (AIIR, N95) protect against aerosolized droplet nuclei (e.g., TB). Droplet precautions (surgical mask) protect against larger respiratory droplets (e.g., meningitis). Contact precautions (gown, gloves) prevent transmission via direct or indirect contact with the patient or environment. Enteric precautions are a strict subset of contact precautions requiring soap and water to physically remove alcohol-resistant spores.
Step-by-Step Solution
Key Concept
Selection of appropriate transmission-based precautions based on presenting symptoms and suspected pathogen transmission routes.