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Difficulty: MediumStandard and Transmission-Based Precautions

The clinical flow coordinator is evaluating bed availability across the facility. A specialized negative-pressure isolation room has just been terminally cleaned and is ready for a new admission. Based on transmission-based precaution guidelines, which client must be prioritized for this specific room?

  1. A client presenting with a disseminated vesicular rash and fever who is suspected of having a varicella-zoster virus infectionAnswer
  2. B
    A client presenting with nuchal rigidity and a petechial rash who is suspected of having meningococcal meningitis
  3. C
    A client with a severe, paroxysmal cough and posttussive emesis who is suspected of having pertussis
  4. D
    A client experiencing frequent, watery stools after a recent course of broad-spectrum antibiotics who is suspected of having Clostridioides difficile

Answer

The client with the suspected varicella-zoster virus (chickenpox) infection.
A negative-pressure room is an Airborne Infection Isolation Room (AIIR) designed to prevent small infectious particles from escaping into surrounding areas. The varicella-zoster virus (chickenpox) is transmitted through the air and requires strict airborne (as well as contact) precautions. Therefore, this client mandates the specialized ventilation of a negative-pressure room.

Step-by-Step Solution

1
Identify the primary function of the available room.
The room has negative-pressure airflow, which designates it as an Airborne Infection Isolation Room (AIIR).
Negative pressure prevents contaminated air from flowing out into the hallways, which is necessary to contain pathogens transmitted via tiny, suspended airborne particles.
2
Analyze the suspected pathogens for each client to determine their required transmission tier.
Varicella-zoster requires airborne precautions. Meningococcal meningitis and pertussis require droplet precautions. Clostridioides difficile requires contact precautions.
Different pathogens require specific precaution tiers based on their mode of transmission (airborne, droplet, or contact).
3
Match the client's transmission risk with the room's specific capabilities.
Only the client with varicella-zoster requires the specialized ventilation of an AIIR.
Airborne pathogens require negative-pressure ventilation, whereas droplet and contact pathogens can be safely managed in standard private rooms with normal airflow.

Key Concept

Airborne precautions and indications for negative-pressure isolation rooms
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Topics

Standard and Transmission-Based Precautions

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