A charge nurse on a medical-surgical unit is planning care for a newly admitted client who is receiving immunosuppressive therapy and has a confirmed diagnosis of disseminated herpes zoster. Which of the following interventions should the nurse include in the client's plan of care? Select all that apply.
- Assign the client to a negative-pressure isolation room and keep the door closed.Answer
- Dedicate reusable medical equipment, such as a stethoscope and thermometer, solely for this client's use.Answer
- Require all healthcare personnel to wear an N95 respirator, gown, and gloves when entering the room.Answer
- DInstruct the client to wear an N95 respirator if transport outside the room is medically necessary.
- EDelegate the application of a prescribed soothing topical ointment for the lesions to an unlicensed assistive personnel (UAP).
- FDiscontinue transmission-based precautions 24 hours after the initiation of intravenous antiviral therapy.
Answer
The appropriate interventions include assigning the client to a negative-pressure room with the door closed, dedicating reusable medical equipment solely for this client, and requiring all personnel to wear an N95 respirator, gown, and gloves.
Disseminated herpes zoster occurs when the varicella-zoster virus spreads beyond a specific dermatome, a condition frequently seen in immunocompromised individuals. Because the virus can be transmitted through both the air and direct contact with lesion exudate, dual Airborne and Contact precautions are mandatory. A negative-pressure room with the door closed safely exhausts contaminated air. Healthcare workers must wear an N95 respirator, gown, and gloves to protect against both transmission routes. Additionally, dedicating reusable medical equipment prevents the transfer of pathogens to other vulnerable clients.
Step-by-Step Solution
Key Concept
Disseminated herpes zoster in immunocompromised clients requires strict adherence to both Airborne and Contact precautions until all lesions are fully dry and crusted.