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Difficulty: MediumStandard and Transmission-Based Precautions

A client admitted with a severe novel respiratory virus is placed on airborne, contact, and eye precautions requiring full personal protective equipment (PPE). A practical nurse is at the dedicated donning station outside the client's room. Place the following steps for donning PPE in the correct chronological sequence.

  1. 1Perform hand hygiene using an alcohol-based hand sanitizer.
  2. 2Put on the isolation gown and secure the ties at the neck and waist.
  3. 3Apply the N95 respirator and perform a proper user seal check.
  4. 4Place the face shield or goggles over the face and eyes.
  5. 5Don clean gloves, ensuring they extend over the cuffs of the gown.

Answer

The correct sequence for donning full PPE is: hand hygiene, gown, N95 respirator, face shield/goggles, and finally gloves.
According to the Centers for Disease Control and Prevention (CDC) guidelines, the safest chronological sequence for donning full PPE begins with hand hygiene to prevent contamination. Next, the gown is applied to cover the torso and arms. The mask or respirator is then placed and sealed to protect the airway, followed by eye protection to prevent mucous membrane exposure. Finally, gloves are donned last so they can be securely pulled over the gown's cuffs, creating a continuous barrier.

Step-by-Step Solution

1
Perform hand hygiene.
Hands are clean and ready to handle uncontaminated PPE.
Prevents the transfer of pathogens from the nurse's hands onto the clean protective equipment.
2
Don the isolation gown.
The torso and arms are protected.
The gown requires tying at the neck and waist, which is easiest to do without gloves or face gear in the way.
3
Apply the N95 respirator.
The respiratory tract is protected.
The respirator must sit directly against the skin to form a tight seal; applying it before eye protection ensures the straps are correctly positioned.
4
Apply the face shield or goggles.
The eyes and mucous membranes are protected from splashes.
Eye protection sits over the bridge of the nose and the respirator straps, completing facial protection.
5
Don gloves.
Hands are protected and the wrist gap is sealed.
Gloves are placed last so they can be pulled up and over the cuffs of the isolation gown, leaving no skin exposed.

Key Concept

Standard Sequence for Donning Personal Protective Equipment (PPE)
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Topics

Standard and Transmission-Based Precautions

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