Which type of mask or respirator is used for airborne precautions?

Contact precautions are used when caring for clients with infections that can be transmitted by direct or indirect contact with infectious material, such as wound drainage, feces, or contaminated surfaces.

Rationale for correct answer:

C. Follow standard precautions in all interactions with the client: Standard precautions (e.g., hand hygiene, glove use, avoiding contact with body fluids) are applied to all clients regardless of infection status, and they form the foundation of contact precautions.

Rationale for incorrect answers:

A. Wear a mask during dressing changes: Masks are not routinely required for contact precautions unless there is a risk of splashes or if the infection is also droplet or airborne in nature.

B. Provide disposable meal trays and silverware: This is unnecessary for contact precautions unless the client is also under enteric precautions (e.g., C. difficile) or severely immunocompromised.

D. Use surgical aseptic technique for all direct contact with the client: Surgical aseptic (sterile) technique is reserved for invasive procedures (e.g., catheter insertion, central line dressing changes), not general client interactions.

Take home points:

• Standard precautions are the baseline infection control practices applied to all clients and are always used.
• Contact precautions specifically focus on preventing transmission via direct or indirect contact.

Postoperative clients with diabetes mellitus are at increased risk for infection, poor wound healing, and complications such as pneumonia or sepsis.

Rationale for correct answer:

B. Temperature 38.5°C (101.4°F): A postoperative fever (≥38.5°C) in a client with diabetes mellitus is a significant red flag for infection. Due to impaired immune response and delayed wound healing in diabetics, a fever can indicate a developing or ongoing infection.

Rationale for incorrect answers:

A. Vesicular breath sounds in the lung bases are normal findings in the peripheral lung fields. This is not concerning and indicates that the lung bases are clear and the client does not have adventitious sounds which could indicate fluid overload or pneumonia.

C. Incision pain rating of 6 out of 10: While a pain rating of 6/10 suggests moderate pain and should be managed appropriately, pain is expected after major abdominal surgery. Unless the pain is associated with signs of infection or dehiscence it is not the most concerning finding.

D. Blood glucose of 164 mg/dL is slightly elevated for a postoperative diabetic patient but is not critically high. Mild hyperglycemia can occur postoperatively due to stress and corticosteroid use.

Take home points:

• Postoperative fever in a diabetic patient is a potential sign of infection.
• Routine postoperative pain and slightly elevated glucose levels are expected findings.