2.1 Transmission-Based Precautions & PPE Protocols
Master Airborne, Droplet, and Contact precautions, target organisms, room ventilation standards, and correct PPE sequences.
🎯 Key NCLEX-RN® Clinical Takeaways
- Airborne (TB, measles, chickenpox): Negative-pressure AIIR room with door closed, fit-tested N95 respirator.
- Droplet (meningitis, influenza, pertussis): Private room, surgical mask within 3 to 6 feet.
- Contact (MRSA, VRE, C. diff): Gown and gloves upon entry, dedicated disposable equipment.
- Clostridioides difficile mandate: Wash hands with SOAP AND WATER (alcohol sanitizers do NOT kill spores); clean with BLEACH.
Transmission-based precautions supplement standard precautions for clients with documented or suspected infections with highly transmissible pathogens.
Airborne precautions are required for pathogens with particle sizes < 5 microns that float on air currents. An Airborne Infection Isolation Room (AIIR) with negative pressure (>= 6-12 air changes/hour) and N95 respiratory protection is mandatory.
Doffing PPE proceeds from most contaminated to least contaminated: Gloves first, then eye protection, then gown, and finally mask/respirator, followed immediately by hand hygiene.
⚠️ Common Pearson VUE / NCLEX Traps
- Using alcohol hand sanitizer after caring for a client with C. difficile; only soap and water physically removes spores.
- Removing the surgical mask or N95 respirator before removing soiled gloves during PPE doffing.
Knowledge Checkpoint
A client is admitted to the pulmonary unit with productive hemoptysis, night sweats, weight loss, and acid-fast bacilli (AFB) detected in sputum. Which infection control measures must the nurse implement?