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Difficulty: EasyStandard and Transmission-Based Precautions

A registered nurse is reviewing the transmission-based precaution requirements for clients on a medical-surgical unit. Which of the following clients require the nurse to don a fit-tested N95 respirator and ensure placement in a negative-pressure room? Select all that apply.

  1. A client presenting with hemoptysis, night sweats, and suspected pulmonary tuberculosis.Answer
  2. B
    A client admitted with a stiff neck, photophobia, and suspected Neisseria meningitidis.
  3. A client with an active, disseminated varicella-zoster virus (chickenpox) infection.Answer
  4. D
    A client with frequent, foul-smelling liquid stools testing positive for Clostridioides difficile.
  5. A client diagnosed with rubeola (measles) presenting with Koplik spots and a maculopapular rash.Answer
  6. F
    A client with a severe paroxysmal cough newly diagnosed with Bordetella pertussis.

Answer

The clients who require airborne precautions (N95 respirator and negative-pressure room) are the ones with suspected pulmonary tuberculosis, disseminated varicella-zoster virus, and rubeola (measles).
Airborne precautions are specifically indicated for infectious agents that remain infectious over long distances when suspended in the air. The classic mnemonic 'MTV' (Measles, Tuberculosis, Varicella) helps recall the primary conditions requiring an N95 respirator and an airborne infection isolation room (negative-pressure room).

Step-by-Step Solution

1
Analyze the prompt to determine the required level of precautions.
The requirement for a 'fit-tested N95 respirator' and a 'negative-pressure room' clearly indicates the need for Airborne Precautions.
Identifying the tier of transmission-based precautions specified in the question is necessary to evaluate each client's condition appropriately.
2
Evaluate each client's diagnosis against standard infection control guidelines.
Tuberculosis, varicella (chickenpox), and rubeola (measles) require airborne precautions. Neisseria meningitidis and Bordetella pertussis require droplet precautions. Clostridioides difficile requires contact precautions.
Matching the pathogen to its mode of transmission ensures safe and effective care environment practices.
3
Select all options that match the airborne transmission route.
The clients with tuberculosis, varicella-zoster, and rubeola are selected.
These three conditions generate small infectious particles that remain suspended in the air, necessitating respiratory protection (N95) and specialized ventilation.

Key Concept

Airborne precautions must be implemented for pathogens that are transmitted via small droplet nuclei (less than 5 microns), which include Tuberculosis, Varicella-zoster, and Rubeola (measles).
Estimated Time:1m 0s
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Standard and Transmission-Based Precautions

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