A patient with tuberculosis (TB) requires which type of precautions?

Airborne Precautions. Tuberculosis (TB) requires Airborne Precautions because TB spreads through tiny particles that remain suspended in the air. Patients must be in a negative pressure room, and caregivers need N95 respirators.

What type of mask is required for Airborne Precautions?

N95 respirator. Airborne Precautions require an N95 respirator (or PAPR) that filters tiny airborne particles. Regular surgical masks do not provide adequate protection against airborne pathogens like TB and measles.

Which infection requires Contact Precautions AND soap and water hand hygiene (not ABHR)?

Clostridium difficile (C. diff). C. difficile (C. diff) requires Contact Precautions AND soap and water for hand hygiene. ABHR does not kill C. diff spores - only the friction of handwashing can physically remove them.

4.5 Transmission-Based Precautions | CNA (Certified Nursing Assistant) | Free Exam Prep

Transmission-Based Precautions

Transmission-Based Precautions are additional measures used for patients with known or suspected infections that require more than Standard Precautions alone. They are based on how the infection spreads.

Three Types of Transmission-Based Precautions

Type	How Infection Spreads	Examples of Diseases
Contact	Direct or indirect contact	MRSA, C. diff, scabies, lice
Droplet	Large respiratory droplets (>5 microns)	Flu, COVID-19, pertussis, mumps
Airborne	Tiny particles (<5 microns) that float	TB, measles, chickenpox, disseminated shingles

Contact Precautions

Used when infection spreads by touching:

Requirement	Specifics
Room	Private room preferred; cohort if needed
PPE	Gown and gloves for all contact
Equipment	Dedicated (don't share between patients)
Transport	Limit; contain infected areas
Sign	Posted on door

Common Contact Precaution infections:

MRSA (Methicillin-resistant Staph aureus)
VRE (Vancomycin-resistant Enterococcus)
C. difficile (C. diff)
Scabies
Lice
Wound infections with drainage

Droplet Precautions

Used when infection spreads by large respiratory droplets:

Requirement	Specifics
Room	Private room preferred; cohort if needed
PPE	Surgical mask within 6 feet of patient
Transport	Patient wears mask if leaving room
Distance	Maintain 6 feet if possible
Sign	Posted on door

Common Droplet Precaution infections:

Influenza (flu)
COVID-19 (may also require airborne for some procedures)
Pertussis (whooping cough)
Mumps
Rubella
Strep throat (Group A Strep)

Airborne Precautions

Used when tiny particles remain suspended in air:

Requirement	Specifics
Room	Airborne Infection Isolation Room (AIIR) with negative pressure
PPE	N95 respirator or PAPR
Door	Keep closed at all times
Transport	Patient wears mask; limit transport
Fit testing	Required annually for N95
Sign	Posted on door

Common Airborne Precaution infections:

Tuberculosis (TB)
Measles
Chickenpox (Varicella)
Disseminated shingles (Herpes Zoster)
COVID-19 (for aerosol-generating procedures)

Special Considerations

C. difficile (C. diff):

Contact precautions
Soap and water for hand hygiene (ABHR doesn't kill spores)
Bleach-based disinfectant for cleaning

MRSA:

Contact precautions
May be in nares, wounds, or urine
Strict hand hygiene between patients

COVID-19:

Droplet + Contact precautions for standard care
Airborne precautions for aerosol-generating procedures
N95 or higher respirator

Isolation Room Requirements

Precaution Type	Room Features
Contact	Private room preferred
Droplet	Private room preferred
Airborne	Negative pressure room with 6-12 air changes/hour

CNA Responsibilities in Isolation

Responsibility	Action
Check signs	Know which precautions before entering
Don PPE	Proper sequence before entry
Provide care	Follow all precaution requirements
Doff PPE	Proper sequence in room or anteroom
Hand hygiene	Immediately after leaving room
Report	If you lack proper equipment

Cohorting Patients

When private rooms are not available:

Cohort = grouping patients with same infection
Same PPE requirements apply
Change gloves and hand hygiene between patients
Avoid cross-contamination

Isolation and Patient Well-being

Isolation can negatively affect patients:

Loneliness and depression
Less frequent staff visits
Feeling "contagious" or "dirty"

CNA support:

Visit as often as safely possible
Provide emotional support
Explain why precautions are needed
Ensure call light is accessible
Report psychological concerns to nurse

CNA

1Introduction to the CNA Exam

2Role and Responsibilities

3Communication and Interpersonal Skills

4Infection Control

5Safety and Emergency Procedures

6Personal Care Skills

7Basic Nursing Skills

8Mental Health and Cognitive Care

9Legal and Ethical Considerations

Key Takeaways