which kind of precautions would you use for each disease? what would you wear / do for each type of precaution?--start wih basic rules card, then do random
chickenpox
(airborne and contact)
The nurse supervises care of a client with a stage III pressure ulcer of the sacrum with foul-smelling, purulent drainage. The nurse should intervene in which situation? 1. The LPN/LVN enters the room wearing a gown and gloves. 2. The nursing assistive personnel enters the room wearing a mask. 3. The client's family brings the client a milkshake. 4. The staff lifts the client to reposition him.
(1) contact precautions required for infected decubitus ulcer; private room if possible (2) correct—masks not needed and doors do not need to be closed (3) maintain positive nitrogen balance, should offer high-protein diet with protein supplements (4) lifting prevents shearing force
The elderly adult is admitted to a medical unit with shortness of breath. The client is diagnosed with an upper respiratory infection (URI). The client is placed on droplet precautions. The nurse administers oral medications to the client. As the nurse leaves the room, the nurse takes which action? 1. Washes hands, removes the gown and mask, and throws the trash in a container outside of the room. 2. Removes the mask, washes hands, and throws the trash in a container inside the room. 3. Washes hands, removes the mask, and throws the trash in a container inside the room. 4. Removes the gown and gloves, washes hands, removes the mask, and throws the trash in a container inside the room.
Show/hide explanation Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? 1) gown unnecessary, trash should be left inside room 2) wash hands then remove mask, so microbes aren't transferred from hands to face 3) CORRECT — hands should be washed before removing mask to prevent transfer of microbes to face 4) gown unnecessary
The nurse cares for the client diagnosed with schizophrenia. Which statement is most descriptive of the affect of this client? 1. Answers all questions with one word. 2. Laughs while talking about being raped. 3. Exhibits no energy or interest in tasks. 4. Cries while talking about a parent's death.
Show/hide explanation Strategy: Determine how each answer choice relates to schizophrenia. 1) not indicative of schizophrenia 2) CORRECT — inappropriate affect, expression of feelings bizarre for situation 3) describes depression 4) appropriate response
explain standard precations
Standard Precautions Include: Hand hygiene Wearing appropriate PPE as needed How to handle patient equipment Injection safety practices Environmental cleaning Respiratory hygiene/coughing etiquette Handling of laundry Patient room placement PPE (Personal Protective Equipment): use this equipment AS NEEDED to protect skin, clothing, mucous membranes while providing care to patients. Remember we treat all the patient the same, regardless of what they do or don't have. Example: You are going to be suctioning a patient's tracheostomy. The patient is not diagnosed with any infectious disease. However, you know to always follow standard precautions, regardless. So, it is important to select the appropriate PPE. During this procedure there is a risk of splash of mucous (which can contain germs) or blood in the mucous membranes (eyes, nose, mouth) and onto the clothes. So, you will want to wear the following PPE during this procedure: gloves, gown, mask, goggles or face shield. NOTE: Now with certain transmission-based precautions you will be REQUIRED to wear specific PPE at ALL TIMES during patient contact. Therefore, when answering NCLEX questions always ask yourself "Is this person in isolation precautions? If, so what PPE must I wear at all times?'" AND "What type of PPE do I need based on the care I will be providing?" For example, with AIRBORNE precautions you will wear an N95 mask during patient contact, BUT if you are going to be inserting an NG tube or doing a procedure that will have the potential for splashes of body fluids, you will need a gown, googles or face shield, gloves. So, select PPE wisely!
Epiglottitis, what kind of precautions? what are the size of droplets in these kind of precautions vs airborne precautions? how far do the droplets travel compared to airborne? how can hey enter? what do you wear? how far of a distqance should you keep? when would the pt have to wear a mask? does the pts door need to be opened or closed? is special ventilation required?
Transmitted via droplets expelled by the person during sneezing, coughing, talking etc.... the droplets are large (when compared to airborne diseases which are smaller), travel less distance (3 feet and then fall), and can enter through the mucus membranes (eyes, nose, and mouth). In order to infect someone the GERMS MUST COME INTO CONTACT WITH THE MUCOUS MEMBRANES TO INFECT!! Wear a surgical mask during patient contact at all times and follow standard precautions. Select other types of PPE based on the type of care you will be providing. For example: mouth care on a patient in droplet precautions (risk for fluids entering eyes, skin, and clothing) also wear gloves, gown, face shield along with the surgical mask. Keep a distance of 3 feet or more from other patients and visitors. Patient must wear a surgical mask if being transported. Patient's door can stay open. No special ventilation is required.
Meningococcal Disease: Sepsis, Pneumonia, what kind of precautions? what are the size of droplets in these kind of precautions vs airborne precautions? how far do the droplets travel compared to airborne? how can hey enter? what do you wear? how far of a distqance should you keep? when would the pt have to wear a mask? does the pts door need to be opened or closed? is special ventilation required?
Transmitted via droplets expelled by the person during sneezing, coughing, talking etc.... the droplets are large (when compared to airborne diseases which are smaller), travel less distance (3 feet and then fall), and can enter through the mucus membranes (eyes, nose, and mouth). In order to infect someone the GERMS MUST COME INTO CONTACT WITH THE MUCOUS MEMBRANES TO INFECT!! Wear a surgical mask during patient contact at all times and follow standard precautions. Select other types of PPE based on the type of care you will be providing. For example: mouth care on a patient in droplet precautions (risk for fluids entering eyes, skin, and clothing) also wear gloves, gown, face shield along with the surgical mask. Keep a distance of 3 feet or more from other patients and visitors. Patient must wear a surgical mask if being transported. Patient's door can stay open. No special ventilation is required.
meningitiswhat kind of precautions? what are the size of droplets in these kind of precautions vs airborne precautions? how far do the droplets travel compared to airborne? how can hey enter? what do you wear? how far of a distqance should you keep? when would the pt have to wear a mask? does the pts door need to be opened or closed? is special ventilation required?
Transmitted via droplets expelled by the person during sneezing, coughing, talking etc.... the droplets are large (when compared to airborne diseases which are smaller), travel less distance (3 feet and then fall), and can enter through the mucus membranes (eyes, nose, and mouth). In order to infect someone the GERMS MUST COME INTO CONTACT WITH THE MUCOUS MEMBRANES TO INFECT!! Wear a surgical mask during patient contact at all times and follow standard precautions. Select other types of PPE based on the type of care you will be providing. For example: mouth care on a patient in droplet precautions (risk for fluids entering eyes, skin, and clothing) also wear gloves, gown, face shield along with the surgical mask. Keep a distance of 3 feet or more from other patients and visitors. Patient must wear a surgical mask if being transported. Patient's door can stay open. No special ventilation is required.
Herpes Zoster (Varicella Zoster(disseminated)
airborne
Measles (Rubeola)
airborne
Tuberculosis
airborne
shingles
airborne and contact
Chicken Pox (varicella) --what kind of precautions? how are airborne diseases transmitted in comparison to droplet precautions? what must be worn for airborne? what kind of room must be in? can door be kept open? what must pt wear if transported?
airborne and contact Transmitted when the infected person coughs, sneezes etc. which produces respiratory droplets (which contains the germ). Normally, when people expel droplets, like in droplet diseases, the droplets dry out which kills the germ. However, with airborne diseases these germs SURVIVE the drying out process and turn into droplet nuclei. These droplet nuclei are residue particles (SUPER small...can't see them) that can be inhaled and hang out in the air. These particles INFECT a person when the person INHALES THE INFECTIOUS DISEASE into their lungs (different than droplet where it enters into the mucous membranes). Must wear an N95 mask (blocks very small particles) while in the room at all times PLUS follow standard precautions like hand hygiene and use other types of PPE as needed depending on the type of care you will be providing. Single room that is an AIIR room (airborne infection isolation room which is also called negative pressure room). This special room will keep the pressure lower in the patient's room than the outside areas. The room will have 6-12 air changes an hour to decrease infectious particles in the room. Keep room door closed at ALL TIMES! Limit transport unless necessary (have procedures performed at the bedside as much as possible). If patient has to leave the room, the patient must wear a surgical mask (just like droplet).
Shingles
airborne and contact if it's open and disseminated—however, localized, crusted lesions just contact
Wound infections with excessive drainage or staphylococci
contact
skin diphtheria
contact
C. difficile
contact bc diarrhea infection-- need to use soap and water for handwashing and not hand sanitizer for diarrhea infections
noravirus
contact bc diarrhea infection-need to use soap and water for handwashing and not hand sanitizer for diarrhea infections
rotavirus
contact bc diarrhea infection-need to use soap and water for handwashing and not hand sanitizer for diarrhea infections
Klebsiella pnemoniae carbapenemase (KPC)
contact bc medication resistant organism
VRE
contact bc medication resistant organism
extended spectrum beta lactamase producers (ESBLs),
contact bc medication resistant organism
MRSA how are contact precautioned diseases transimitted? what must be worn? what kind of rooom?
contact bc medication resistant organism Transmitted from direct or indirect contact (touching)....from the patient or something the patient has touched...their environment. Must at always wear a gown and gloves PLUS follow standard precautions like hand hygiene and use other types of PPE as needed depending on the type of care you will be providing. Single room the best or group patients together with same infection--on nclex, most often answer will be single room!
RSV
contact bc pulmonary infection
parainfluenza
contact bc pulmonary infection
herpes simplex
contact bc skin infection
impetigo,
contact bc skin infection
scabies
contact bc skin infection
draining abcess
contact precautions
conjunctivitis
contqct bc eye infection
lice
contqct bc skin infection
Parvovirus B19 (erythema infectiosum or 5th disease)
droplet
Pneumonic Plague
droplet
Rhinovirus
droplet
Rubella (German Measles)
droplet
Streptococcal pharyngitis
droplet
scarlet fever
droplet
whooping cough
droplet
Pneumonia
droplet (answer qs on other card)
Mumps (infectious parotitis)
droplet (answer qs on other droplet card)
Adenovirus
droplet and contact
Flu--what kind of precautions? what are the size of droplets in these kind of precautions vs airborne precautions? how far do the droplets travel compared to airborne? how can hey enter? what do you wear? how far of a distqance should you keep? when would the pt have to wear a mask? does the pts door need to be opened or closed? is special ventilation required?
droplet and contact--Transmitted via droplets expelled by the person during sneezing, coughing, talking etc.... the droplets are large (when compared to airborne diseases which are smaller), travel less distance (3 feet and then fall), and can enter through the mucus membranes (eyes, nose, and mouth). In order to infect someone the GERMS MUST COME INTO CONTACT WITH THE MUCOUS MEMBRANES TO INFECT!! Wear a surgical mask during patient contact at all times and follow standard precautions. Select other types of PPE based on the type of care you will be providing. For example: mouth care on a patient in droplet precautions (risk for fluids entering eyes, skin, and clothing) also wear gloves, gown, face shield along with the surgical mask. Keep a distance of 3 feet or more from other patients and visitors. Patient must wear a surgical mask if being transported. Patient's door can stay open. No special ventilation is required.
Pharyngeal Diphtheria--what kind of precautions? what are the size of droplets in these kind of precautions vs airborne precautions? how far do the droplets travel compared to airborne? how can hey enter? what do you wear? how far of a distqance should you keep? when would the pt have to wear a mask? does the pts door need to be opened or closed? is special ventilation required?
droplet precautions Transmitted via droplets expelled by the person during sneezing, coughing, talking etc.... the droplets are large (when compared to airborne diseases which are smaller), travel less distance (3 feet and then fall), and can enter through the mucus membranes (eyes, nose, and mouth). In order to infect someone the GERMS MUST COME INTO CONTACT WITH THE MUCOUS MEMBRANES TO INFECT!! Wear a surgical mask during patient contact at all times and follow standard precautions. Select other types of PPE based on the type of care you will be providing. For example: mouth care on a patient in droplet precautions (risk for fluids entering eyes, skin, and clothing) also wear gloves, gown, face shield along with the surgical mask. Keep a distance of 3 feet or more from other patients and visitors. Patient must wear a surgical mask if being transported. Patient's door can stay open. No special ventilation is required.
Mycoplasma Pneumonia
droplet- answer qs on other card
basic rules:
everything is droplet except: airborne-- herpes zoster (chicken pox/shingles), measles-Rubeola (but german measles(Rubella) is droplet, TB, SARS contact= 1. diarhea infections--C.diff, rotavirus, noravirus 2. medication resistant orgs-- MRSA, VRE, extended spectrum beta lactamase producers (ESBLs), Klebsiella pnemoniae carbapenemase (KPC) 3. Skin infection: impetigo, lice, scabies, herpes simplex, chickenpox (airborne and contact), skin diphtheria, shingles (airborne and contact) 4. Wound infections with excessive drainage or staphylococci 5. Pulmonary infections: RSV, parainfluenza (but regular influenza is droplet!) 6. Eye infection: conjunctivitis if you see answer choices that dont fit under droplet, airborne or contact, just use standard precautions!
Cytomegalovirus
just standard precautions + extra cautionary equipment when dealing with fluids, etc
Hepatitis A--what kind of precautions and what diet for this disease?
usually just standard precautions, but contact if pt is incontinent or diapered bc its spread through stool---read the q carefully!! will only be contat if it specially says that youre dealing with their poo--look to see if the patient is incontinent--ex-a baby with hep A will always be contact because always pooping themselves!! Want a diet high in porteins and ccarbs and low in fat to help with their poops!!