An oncology unit nurse is initiating care for a client undergoing induction chemotherapy for acute myeloid leukemia. The client has just developed a painful, newly erupted vesicular rash that is strictly localized to the right thoracic dermatome. Which infection control measures must the nurse implement? Select all that apply.
- Place the client in a private room with monitored negative air pressure.Cevap
- Don a fit-tested N95 respirator, disposable gown, and clean gloves prior to room entry.Cevap
- Apply a standard surgical mask to the client if transport to the radiology department is required.Cevap
- DMaintain standard precautions as long as the lesions are completely covered by a dry, sterile dressing.
- EAllow the room door to remain partially open to facilitate frequent monitoring of the client.
- FCohort the client in a standard private room with another client who has documented immunity to varicella.
Cevap
The correct measures are placing the client in a negative-pressure room, donning an N95 respirator with a gown and gloves before entry, and placing a surgical mask on the client during transport.
The correct choices accurately reflect the required Airborne and Contact precautions. Although the client has a localized rash (shingles), their severely immunocompromised state (undergoing induction chemotherapy) places them at a high risk for disseminated disease. Therefore, strict Airborne and Contact precautions are mandatory. This includes placing the client in a negative-pressure isolation room, donning an N95 respirator along with a gown and gloves for all room entries, and placing a standard surgical mask on the client to contain secretions during any essential transport outside the room.
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Anahtar Kavram
While localized herpes zoster in an immunocompetent client requires only standard precautions (with lesions covered), an immunocompromised client with localized herpes zoster requires strict Airborne and Contact precautions due to the high risk of viral dissemination.