You are the pediatric unit charge nurse today and is working with a new RN. Which action by the new RN requires the most immediate action on your part?
A. The new RN wears goggles to change linens of a client who has diarrhea caused by C. difficile.
B. The new RN places a child who has chemotherapy-induced neutropenia into a negative-pressure room.
C. The new RN admits a new client with respiratory syncytial virus (RSV) infection to a room with another child who has RSV.
D. The new RN tells the nursing assistant to use an N95 respirator mask when caring for a child who has pertussis.
Correct Answer: B. The new RN places a child who has chemotherapy-induced neutropenia into a negative-pressure room.
Clients who are neutropenic should be placed in positive-airflow rooms; placement of the child in a negative airflow room will increase the likelihood of infection for this client. Clean, filtered air is constantly pumped into the room. This is done to keep contagious diseases out of the room. With this type of isolation room, the client may be able to feel air blowing out of the room under a closed door.
Option A: Goggles are not needed for changing the linens of clients infected with C. difficile; however, these protections do not increase the risk to the clients. Healthcare providers will put on gloves and wear a gown over their clothing while taking care of clients with C. diff. Visitors may also be asked to wear a gown and gloves. When leaving the room, hospital providers and visitors remove their gown and gloves and clean their hands.
Option C: Although private rooms are preferred for clients who need droplet precautions, such as clients with RSV infection, they can be placed in rooms with other clients who are infected with the same microorganism.
Option D: The use of an N95 respirator is not necessary for pertussis. Wearing a surgical mask within 3 feet of the client provides protection from the spread of pertussis. Oftentimes, close household contacts are the source of the child’s infection; therefore, providers should also wear masks when within 3 feet of symptomatic parents or siblings.