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Difficulty: MediumStandard and Transmission-Based Precautions

Before entering the isolation room of a client diagnosed with measles (rubeola) who also has a heavily draining leg wound, a nurse must apply full personal protective equipment (PPE) due to the combination of precautions required. Place the following steps for preparing and donning the required PPE in the correct sequential order.

  1. 1Perform hand hygiene using an alcohol-based hand sanitizer or soap and water.
  2. 2Fasten the isolation gown securely at the neck and waist.
  3. 3Apply an N95 respirator and perform a user seal check.
  4. 4Position the face shield or goggles over the eyes.
  5. 5Don clean gloves, extending them over the cuffs of the gown.

Answer

The correct sequence for donning full personal protective equipment is to first perform hand hygiene, then don the isolation gown, followed by the N95 respirator, then the face shield or goggles, and finally the clean gloves.
According to standard infection control guidelines provided by the Centers for Disease Control and Prevention (CDC), the sequence for donning full personal protective equipment is strict to minimize contamination risk. The nurse must begin with hand hygiene to ensure clean hands. The gown is put on first to cover the torso and arms. Next, the mask or N95 respirator is applied to protect the respiratory tract and establish a face seal, followed by goggles or a face shield for eye protection. Finally, gloves are donned last and pulled directly over the gown cuffs to establish a continuous, unbroken barrier against infectious agents.

Step-by-Step Solution

1
Perform hand hygiene using an alcohol-based hand sanitizer or soap and water.
Hands are clean and ready to handle uncontaminated PPE.
Hand hygiene is the foundational step to prevent the transfer of pathogens to the clean equipment being donned.
2
Fasten the isolation gown securely at the neck and waist.
The torso, arms, and uniform are covered and protected.
The gown is the first article of PPE donned to provide the largest surface area of protection before applying facial gear.
3
Apply an N95 respirator and perform a user seal check.
The respiratory tract is protected with a secure seal against airborne pathogens.
The respirator is applied prior to eye protection to ensure a tight, unimpeded seal against the face.
4
Position the face shield or goggles over the eyes.
The mucous membranes of the eyes are protected from exudate or respiratory secretions.
Eye protection is placed over the respirator straps to guard against potential splashes or sprays of infectious material.
5
Don clean gloves, extending them over the cuffs of the gown.
A continuous protective barrier is created over the hands and wrists.
Gloves must be donned last so they can cover and overlap the gown cuffs, preventing any exposure of the wrists during client care.

Key Concept

Standard donning sequence for personal protective equipment (PPE)
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Topics

Standard and Transmission-Based Precautions

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