All potential victims of exposure to agents of bioterrorism, whether symptomatic or not, should be managed with standard precautions. Of the following, which possible agents of bioterrorism would necessitate extra precautionary measures?

Pneumonic Plague


•Smallpox and Pneumonic Plague require extra precautions because they are contagious.

•Many agents of bioterrorism are not transmitted person to person. The risk of exposure with these non-contagious agents comes from re-aerosolization of the spores, which is why decontamination is done in isolation and the client’s clothing is disposed of and skin and hair are washed. The agents that require further precautions are those that are infective agents.

•For Pneumonic Plague, Droplet Precautions should be used in addition to Standard Precautions. Droplet Precautions require a mask when within 3 feet of the infected patient. Based on local policy, some facilities require a mask to enter the room.  Droplet Precautions should be maintained until patient has completed 72 hours of antimicrobial therapy.

•For patients with suspected or confirmed Smallpox, both Airborne and Contact Precautions should be used in addition to Standard Precautions. Airborne Precautions require respiratory protection when entering the patient room; N95 at a minimum. Contact precautions require:  Wear clean gloves upon entry into the patient room.  Wear gown for all patient contact and for all contact with the patient’s environment. Based on local policy, some facilities require a gown be worn to enter the room of a patient on Contact Precautions. Gown must be removed before leaving the patient’s room.  Wash hands using an antimicrobial agent. Clients with suspected Smallpox must also be in a monitored negative air pressure room.

Incorrect options:

•Patients with Anthrax or Botulism poisoning are not contagious and can only transmit the toxin by re-aerosolization, which is why the toxin is removed from their body by washing and clothing is disposed of.

Visit our website for other NCLEX topics now!