Never substitute a surgical mask for an N95 for staff caring for an airborne-isolation patient.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client with a productive cough is suspected of having measles (rubeola). In addition to standard precautions, which precautions should the nurse initiate?
Answer: C. Measles is transmitted by the airborne route, requiring an airborne infection isolation room (negative pressure) and N95 respirator for caregivers. Only immune staff should enter. Droplet or contact precautions alone would not contain an airborne virus. The mnemonic MTV (Measles, Tuberculosis, Varicella) flags airborne pathogens.
Question 2 of 5
A client is admitted with suspected active tuberculosis. Which room and PPE are correct?
Answer: B. TB is airborne: place the client in a negative-pressure (airborne isolation) room and wear an N95 respirator. A surgical mask is not sufficient for airborne organisms.
Question 3 of 5
Which of the following clients should the charge nurse assign to a private negative-pressure airborne isolation room?
Answer: B. Measles (rubeola) is transmitted by the airborne route and requires a negative-pressure room. Pertussis and influenza are droplet, and MRSA wound infection is contact.
Question 4 of 5
A client with active pulmonary tuberculosis is admitted to the medical unit. Which type of isolation precaution should the nurse implement?
Answer: B. Active pulmonary TB requires airborne precautions: a negative-pressure (airborne infection isolation) room and an N95 respirator for staff. Droplet precautions (surgical mask, no special room) are insufficient because TB droplet nuclei remain suspended in air. Contact and standard-only precautions do not address airborne transmission.
Question 5 of 5
Which client requires both contact AND airborne precautions?
Answer: B. Disseminated varicella/herpes zoster requires airborne AND contact precautions (the lesions are infectious by contact and the virus is airborne). TB is airborne only; MRSA is contact only.
Keep the streak going with more questions like these, each with a full rationale.
What is airborne precautions?
They require a negative-pressure airborne infection isolation room and a fit-tested N95 respirator or PAPR. Remember the mnemonic My Chicken Hez TB: Measles, Chickenpox (varicella), Herpes zoster (disseminated), and Tuberculosis.
Key points to remember
- Patient is placed in a negative-pressure room with the door kept closed at all times.
- Staff wear a fit-tested N95 respirator or a PAPR, not a standard surgical mask.
- The room exchanges air at least 6 to 12 times per hour and vents outside or through HEPA filtration.
- Conditions include measles (rubeola), varicella, disseminated herpes zoster, and pulmonary tuberculosis.
- Immune (history of disease or vaccination) staff are preferred to care for measles and varicella patients.
Nursing priorities
- Place the patient in a negative-pressure airborne isolation room and keep the door closed.
- Don a fit-tested N95 respirator before entering the room.
- Mask the patient with a surgical mask if transport off the unit is unavoidable.
- Verify the room maintains negative pressure each shift.
Patient teaching
- The patient must wear a surgical mask any time they leave the negative-pressure room.
- Active TB patients need adherence to the full multidrug regimen to become noninfectious.
Red flags: report now
- Never substitute a surgical mask for an N95 for staff caring for an airborne-isolation patient.
- Do not leave the isolation room door open; it defeats negative pressure.
- Report any door-open or pressure-alarm event immediately.
References
Clinical references for this topic
