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Difficulty: MediumStandard and Transmission-Based Precautions

An infection control nurse is conducting a compliance audit on a pediatric unit. The nurse observes staff entering client rooms to perform routine vital signs. For which client presentation is it mandatory for the staff to don an N95 respirator, a disposable gown, and clean gloves before crossing the threshold into the room?

  1. A
    A child with a confluent maculopapular rash and bluish-white spots on the buccal mucosa.
  2. A child with generalized, pruritic, fluid-filled vesicles on the trunk and extremities.Answer
  3. C
    A child experiencing severe paroxysmal coughing episodes with a high-pitched inspiratory sound.
  4. D
    A child with bilateral parotid gland swelling and a low-grade fever.

Answer

The client with generalized, pruritic, fluid-filled vesicles requires both Airborne and Contact precautions, meaning an N95 respirator, gown, and gloves are mandatory.
The clinical presentation of generalized, fluid-filled vesicles indicates varicella (chickenpox). Varicella is highly contagious and transmits through both aerosolized respiratory droplets and direct contact with vesicular fluid. Therefore, the Centers for Disease Control and Prevention (CDC) mandates both Airborne and Contact precautions. This requires staff to don an N95 respirator (or powered air-purifying respirator), an isolation gown, and clean gloves before crossing the threshold into the client's room.

Step-by-Step Solution

1
Identify the disease processes described in each of the clinical presentations.
Vesicles indicate Varicella; a maculopapular rash with buccal spots indicates Measles; a paroxysmal cough indicates Pertussis; and parotid swelling indicates Mumps.
Accurate disease recognition is required to determine the correct transmission-based precautions.
2
Determine the required isolation category for each identified pathogen based on CDC guidelines.
Varicella requires Airborne + Contact precautions. Measles requires Airborne precautions. Pertussis and Mumps require Droplet precautions.
Different modes of pathogen transmission dictate different barrier requirements for healthcare staff.
3
Match the specified PPE (N95, gown, gloves) to the isolation categories.
An N95 is required for Airborne precautions. A gown and gloves are required for Contact precautions. Only the client with Varicella requires both categories.
This ensures adherence to mandatory infection control protocols for room entry and prevents cross-contamination.

Key Concept

Transmission-Based Precautions: Airborne and Contact
Estimated Time:1m 15s
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Topics

Standard and Transmission-Based Precautions

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