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Question

Difficulty: MediumStandard and Transmission-Based Precautions

Pair the following admitted clients and their diagnoses with the specific infection control precaution category required by current guidelines.

  • A client with disseminated herpes zoster (shingles) across multiple dermatomesAirborne and Contact Precautions
  • A child experiencing paroxysmal coughing fits from confirmed Bordetella pertussisDroplet Precautions
  • A client with a draining sacral pressure injury colonized with vancomycin-resistant Enterococcus (VRE)Contact Precautions
  • A client with advanced HIV admitted for treatment of Pneumocystis jirovecii pneumonia (PJP)Standard Precautions

Answer

Disseminated herpes zoster matches with Airborne and Contact Precautions. Bordetella pertussis matches with Droplet Precautions. VRE wound colonization matches with Contact Precautions. Pneumocystis jirovecii pneumonia (PJP) matches with Standard Precautions.
Each pathogen or clinical condition dictates specific isolation measures based on its primary mode of transmission. Disseminated herpes zoster can spread via aerosols and direct contact. Pertussis spreads through large respiratory droplets. VRE is a multidrug-resistant organism spread by direct contact with the patient or contaminated surfaces. PJP is an opportunistic infection that is not communicable between humans, meaning routine standard precautions are sufficient.

Step-by-Step Solution

1
Analyze the transmission route of disseminated herpes zoster.
Requires both airborne and contact isolation.
The virus can be aerosolized and transmitted via contact with vesicular fluid.
2
Identify the transmission route for Bordetella pertussis.
Requires droplet isolation.
The pathogen is expelled in large respiratory droplets during coughing paroxysms.
3
Determine the precautions for a VRE-colonized draining wound.
Requires contact isolation.
Multidrug-resistant organisms in wounds are easily spread via direct contact or fomites.
4
Evaluate the infectivity of Pneumocystis jirovecii.
Requires only standard precautions.
It is an environmental fungus that causes opportunistic infection in immunocompromised hosts, but does not spread from person to person.

Key Concept

Transmission-based precaution categorization based on pathogen spread mechanism
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Topics

Standard and Transmission-Based Precautions

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