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Difficulty: MediumStandard and Transmission-Based Precautions

A nursing house supervisor is allocating inpatient beds for several direct admissions from the emergency department. The hospital currently has only one unoccupied negative-pressure isolation room. Which of the following clients must be prioritized for placement in this room?

  1. A client with suspected measles (rubeola) who is exhibiting a fever, coryza, and a maculopapular rashAnswer
  2. B
    A client diagnosed with Mycoplasma pneumoniae who is experiencing persistent, severe coughing episodes
  3. C
    A client with a heavily draining, uncontained wound that recently cultured positive for methicillin-resistant Staphylococcus aureus (MRSA)
  4. D
    A client with a severe Clostridioides difficile infection who is having frequent, large-volume diarrheal stools

Answer

The client with suspected measles (rubeola) should be prioritized for the negative-pressure isolation room.
Measles (rubeola) is transmitted via aerosolized, airborne droplets that can remain suspended in the air and travel significant distances. Therefore, the client requires airborne precautions, which mandates placement in a negative-pressure isolation room (Airborne Infection Isolation Room). This specialized ventilation system actively pulls air into the room and exhausts it directly to the outside or through a HEPA filter, preventing the pathogen from entering the hospital corridors.

Step-by-Step Solution

1
Identify the mode of transmission for each client's condition.
Measles is airborne; Mycoplasma pneumoniae is droplet; MRSA is contact; C. difficile is enteric contact.
Determining the correct isolation category is the first step in matching the client to the appropriate physical environment.
2
Determine which transmission mode requires a negative-pressure isolation room.
Airborne precautions require an Airborne Infection Isolation Room (AIIR) with negative pressure. Droplet and contact precautions require standard private rooms.
Negative pressure prevents aerosolized particles from drifting into hallways, which is only necessary for airborne pathogens.
3
Assign the room to the client requiring airborne precautions.
The client with measles is prioritized for the single available negative-pressure room.
Failure to place an airborne-pathogen client in a negative-pressure room poses a severe facility-wide exposure risk.

Key Concept

Clients with airborne-transmitted infections (such as measles, tuberculosis, and varicella) require placement in a negative-pressure Airborne Infection Isolation Room (AIIR).

Alternative Method

When evaluating room placement prioritization, always ask: 'Whose infection can drift into the hallway and infect others simply through the air?' This immediately isolates airborne pathogens (measles, TB, varicella) as the highest priority for specialized ventilation.
Estimated Time:1m 0s
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Standard and Transmission-Based Precautions

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