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Difficulty: HardStandard and Transmission-Based Precautions

A client diagnosed with active pulmonary tuberculosis and a concurrent Clostridioides difficile infection requires an urgent abdominal computed tomography (CT) scan. Which actions should the nurse implement when preparing for and facilitating this client's transport? Select all that apply.

  1. Place a standard medical-surgical mask on the client before exiting the isolation room.Answer
  2. B
    Place a fit-tested N95 particulate respirator on the client to prevent airborne transmission in the corridors.
  3. Perform hand hygiene using soap and water immediately after removing gloves.Answer
  4. D
    Disinfect the transport stretcher using a standard quaternary ammonium germicidal wipe after the procedure.
  5. Cover the client with a clean sheet or blanket over their hospital gown prior to entering the hallway.Answer
  6. F
    Postpone the urgent CT scan until the client has received at least 24 hours of antitubercular and antibiotic therapy.

Answer

The correct actions are placing a standard medical-surgical mask on the client, performing hand hygiene with soap and water, and covering the client with a clean sheet or blanket during transport.
Transporting a client with multiple infections requires layering protective strategies. A standard surgical mask on the client effectively contains tuberculosis respiratory secretions without compromising the client's breathing. Covering the client with a clean sheet contains C. diff organisms to the stretcher environment. Finally, because C. diff forms spores that are resistant to alcohol, staff must strictly use soap and water for hand hygiene.

Step-by-Step Solution

1
Identify the transmission-based precautions required for the client's concurrent infections.
The client requires Airborne Precautions for active pulmonary tuberculosis and Contact/Enteric Precautions for Clostridioides difficile.
Accurate identification of required isolation categories dictates the specific interventions needed during transport.
2
Apply Airborne Precaution guidelines for client transport.
The client must wear a standard medical-surgical mask to contain respiratory secretions.
Airborne pathogens are expelled through coughing or exhaling. A standard mask effectively traps these source droplets before they evaporate into airborne nuclei.
3
Apply Contact/Enteric Precaution guidelines for client transport and environmental cleaning.
The client must be covered with a clean sheet, hand hygiene must be performed with soap and water, and equipment must be cleaned with sporicidal wipes.
Contact precautions require preventing environmental contamination during transport. Enteric precautions specifically mandate soap and water and bleach-based disinfectants because spores are resistant to alcohol and standard germicides.
4
Evaluate the clinical priority of the diagnostic test against infection control risks.
The urgent CT scan must proceed with strict precautions in place.
An urgent medical need supersedes the general preference to limit movement of isolated clients, provided transmission risks are mitigated.

Key Concept

Managing Dual Transmission-Based Precautions During Client Transport
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Topics

Standard and Transmission-Based Precautions

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