A client arrives at a community clinic triage desk exhibiting a high fever, cough, coryza, and a diffuse maculopapular rash. The triage nurse suspects rubeola (measles). Arrange the following nursing interventions in the correct chronological sequence to effectively implement transmission-based precautions.
- 1Provide a standard surgical mask and instruct the client to cover their nose and mouth.
- 2Escort the client immediately to an airborne infection isolation room (AIIR).
- 3Ensure the door to the airborne infection isolation room is securely closed.
- 4Don a fit-tested N95 respirator before re-entering the client's room.
- 5Proceed with the comprehensive clinical assessment and admission interview.
Answer
The correct sequence is to first apply a surgical mask to the client for source control, escort them to an airborne infection isolation room, secure the door to establish negative pressure, don an N95 respirator for self-protection, and finally proceed with the clinical assessment.
For highly contagious airborne pathogens like rubeola (measles), immediate containment is the primary goal. Source control (masking the client) is the fastest, most effective first action. Moving the client to a negative-pressure room and sealing the door establishes environmental control. Finally, ensuring the nurse is protected with an N95 respirator allows for safe, sustained close contact during the physical assessment.
Step-by-Step Solution
Key Concept
Prioritization of source control and sequential implementation of airborne precautions for highly infectious respiratory diseases.
Estimated Time:1m 30s