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Zorluk: ZorStandard and Transmission-Based Precautions

A client with an uncontained, heavily draining abdominal wound infected with Vancomycin-resistant Enterococcus (VRE) has just tested positive for Bordetella pertussis. The client is experiencing worsening respiratory distress and requires immediate transfer to the intensive care unit (ICU) for closer monitoring. Which infection control interventions are necessary for this client's care and transport? Select all that apply.

  1. Place a standard medical-surgical mask on the client prior to exiting the room for transport.Cevap
  2. B
    Wear a fit-tested N95 respirator, gown, and gloves while disconnecting the client's bedside monitoring equipment.
  3. C
    Request that the ICU receiving nurse prepare an airborne infection isolation room (AIIR) with negative directional airflow.
  4. Wear a clean, fluid-resistant gown and nonsterile gloves when transferring the client from the bed to the transport stretcher.Cevap
  5. E
    Delay the client's transfer to the ICU until the infection control department approves a designated travel route.
  6. Ensure that noncritical patient-care items, such as blood pressure cuffs and stethoscopes, remain dedicated exclusively to this client in the ICU.Cevap

Cevap

The correct interventions include placing a standard surgical mask on the client for transport, wearing a gown and gloves during physical contact, and dedicating noncritical equipment to the client's exclusive use.
The client requires concurrent Contact precautions (for uncontained VRE) and Droplet precautions (for Bordetella pertussis). Contact precautions mandate the use of a gown and gloves during physical interaction with the client and the dedication of noncritical equipment to prevent environmental transmission. Droplet precautions require the client to wear a standard medical-surgical mask during transport to effectively contain respiratory secretions at the source.

Adım Adım Çözüm

1
Analyze the client's infectious diagnoses to determine the required isolation tiers.
The uncontained VRE wound necessitates Contact precautions, while Bordetella pertussis requires Droplet precautions.
Accurate identification of the pathogen's mode of transmission is the foundation of appropriate infection control.
2
Determine the necessary personal protective equipment (PPE) for healthcare personnel.
Staff must wear a gown and gloves (Contact) as well as a standard medical-surgical mask (Droplet) when providing direct care.
An N95 respirator is incorrect because pertussis is not an airborne pathogen.
3
Determine the environmental and transport restrictions required to prevent cross-contamination.
The client needs a private room (but not negative pressure), dedicated noncritical equipment, and must wear a surgical mask during transport.
These measures contain the pathogens at their source without utilizing inappropriate resources like an AIIR.
4
Evaluate the clinical situation against prioritization principles.
The emergency transfer for respiratory distress takes precedence over administrative infection control tasks.
Acute physiological needs (ABCs) must always be prioritized over routine logistical procedures.

Anahtar Kavram

Concurrent application of Contact and Droplet precautions alongside clinical prioritization during emergency client transport.
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