A nursing supervisor is evaluating unit assignments and isolation protocols. Select the correct transmission-based precaution and required personal protective equipment (PPE) for each of the following patient presentations.
- An immunocompromised client presenting with a painful, vesicular rash extending across multiple dermatomes.Airborne and Contact Precautions: Requires an N95 respirator, gown, gloves, and an airborne infection isolation room.
- A client with a persistent paroxysmal cough, post-tussive emesis, and a suspected Bordetella infection.Droplet Precautions: Requires a surgical mask upon room entry and for any close contact with the client.
- A client experiencing profuse, foul-smelling diarrhea following a 14-day course of broad-spectrum intravenous antibiotics.Contact (Enteric) Precautions: Requires gown and gloves for room entry, and mandatory handwashing with soap and water upon exit.
- A client admitted with fever, coryza, conjunctivitis, and a generalized maculopapular rash.Airborne Precautions: Requires an N95 respirator and negative-pressure room; gown/gloves only per Standard Precautions.
Cevap
The correct pairings align the disseminated herpes zoster presentation with Airborne/Contact precautions, the pertussis presentation with Droplet precautions, the suspected C. difficile presentation with Contact (Enteric) precautions, and the measles presentation with Airborne precautions.
Assigning the correct transmission-based precautions requires first recognizing the suspected pathogen from the clinical presentation. Disseminated zoster demands both airborne and contact isolation; pertussis requires droplet isolation; C. difficile demands contact isolation with soap-and-water hand hygiene; and measles requires strict airborne isolation.
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Transmission-Based Precautions based on Pathogen and Clinical Presentation
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