A SARS epidemic is suspected in a community of 10,000 people. As clients with SARS are admitted to the hospital, what type of precautions should the nurse institute?

1. A

   Enteric precautions

2. B

   Handwashing precautions

3. C

   Reverse isolation precautions

4. D

   Airborne precautions

Appeared in: NHM MP Staff Nurse-2022

Explanation

• Severe Acute Respiratory Syndrome (SARS) is transmitted by airborne particles, which are small enough to remain suspended in the air for extended periods.
• According to CDC guidelines, diseases transmitted via the airborne route require Airborne Precautions to prevent transmission.
• This level of precaution mandates placing the patient in an Airborne Infection Isolation Room (AIIR), which has negative air pressure to prevent contaminated air from escaping.
• Healthcare providers must wear a high-efficiency particulate air (HEPA) filter respirator or a fitted N95 respirator when entering the patient's room to filter inspired air.

Why Other Options Were Wrong

• Option A: Enteric precautions are for pathogens transmitted via the fecal-oral route.
• Option B: Handwashing is a component of Standard Precautions and is used for all patients, but it is not sufficient by itself for a disease transmitted through the air.
• Option C: Reverse isolation, or protective isolation, is used to protect a patient with a compromised immune system from acquiring infections from others.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Infection control and transmission-based precautions for Severe Acute Respiratory Syndrome (SARS) to guide bedside assessment, documentation, and the next nursing action.
• Rapidly identifying and implementing the correct transmission-based precautions is a critical nursing responsibility to prevent healthcare-associated infections (HAIs) and protect staff, other patients, and visitors.
• Nurses must be proficient in the correct donning (putting on) and doffing (taking off) of PPE to ensure its effectiveness and prevent self-contamination.
• What if? If an Airborne Infection Isolation Room (AIIR) is not immediately available, the patient should be placed in a private room with the door closed, and all staff must wear N95 respirators. The patient should wear a surgical mask if transport is unavoidable, and transfer to a facility with an AIIR should be arranged as soon as possible.

How to Approach the Question

• First, identify the key diagnosis in the question: Severe Acute Respiratory Syndrome (SARS).
• Recall the mode of transmission for SARS. It is a respiratory virus known for its potential for airborne spread.
• Match the mode of transmission to the corresponding type of infection control precaution.
• Airborne transmission requires Airborne Precautions.
• Evaluate the given options. 'Airborne precautions' is listed as an option.
• Eliminate the other options by recalling their specific indications: Enteric (fecal-oral), Handwashing (standard, not specific), and Reverse isolation (protecting the patient, not containing their infection).

Concept Tested & Keywords

• Concept Tested: Infection control and transmission-based precautions for Severe Acute Respiratory Syndrome (SARS).
• Stem keywords: SARS epidemic, precautions, admitted to the hospital
• Lead-in keywords: what type
• Clinical cues: The diagnosis of a suspected SARS epidemic is the key clinical cue, indicating a highly contagious respiratory virus.

Question ID

QgsdHEcRy3FQ028xQV4i0y

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 43-45

E6 Nursing Fundamentals Taylor p. 175-177

E6 Microbiology Applied AnjuDhir 3e Part 2 p. 143-145