Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which of the following medical conditions?
A. A diagnosis of AIDS and cytomegalovirus
B. A positive PPD with an abnormal chest x-ray
C. A tentative diagnosis of viral pneumonia
D. Mycoplasma pneumonia
Correct Answer: B. A positive PPD with an abnormal chest x-ray
The client who must be placed in airborne precautions is the client with a positive PPD (purified protein derivative) who has a positive x-ray for a suspicious tuberculin lesion. Airborne precautions are required whenever entering a patient’s room or environment who has been diagnosed with or is being tested for with high suspicion of anthrax, tuberculosis, measles, chickenpox, or disseminated herpes zoster or other pathogens that can be transmitted through airflow that are 5 micrometers or smaller in size and remain in the environment for long periods of time.
Option A: According to the OSHA database, HIV, hepatitis B and C, tuberculosis, malaria, measles, herpes, chickenpox, and various other bacterial infections are known for being transmitted through blood-containing fluids and products. Blood-borne precautions include wearing gloves, face mask, protective eyewear or goggles, and proper handling of sharp objects with appropriate disposal.
Option C: Prevention, especially in the form of immunization against influenza and measles, can significantly decrease the incidence of viral pneumonia. The traditional role of viral pneumonia was as a disease found predominantly in the very young, the elderly, and those exposed to influenza. In the past, the diagnosis of viral pneumonia was predicated on it being somewhat a diagnosis of exclusion.
Option D: Smoking is the most common cause of lung cancer. It is estimated that 90% of the cases of lung cancer are attributable to smoking. The risk is highest in males who smoke. The risk is further compounded with exposure to other carcinogens, such as asbestos. It is hypothesized that repeated exposure to carcinogens, cigarette smoke, in particular, leads to dysplasia of lung epithelium.