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Difficulty: MediumStandard and Transmission-Based Precautions

An adult client is receiving treatment for a large, heavily draining abdominal wound infected with methicillin-resistant Staphylococcus aureus (MRSA). The practical nurse (PN) is preparing to perform a high-pressure wound irrigation. Which combination of personal protective equipment (PPE) must the PN don before starting this procedure?

  1. Clean gloves, a fluid-resistant gown, a surgical mask, and protective eyewear.Answer
  2. B
    Clean gloves and a fluid-resistant gown only.
  3. C
    Clean gloves, a fluid-resistant gown, and a fitted N95 respirator.
  4. D
    Clean gloves, a surgical mask, and protective eyewear only.

Answer

The PN must don clean gloves, a fluid-resistant gown, a surgical mask, and protective eyewear.
The correct combination ensures full adherence to both Contact Precautions (required for MRSA via gown and gloves) and Standard Precautions (required for splash risk via mask and eyewear).

Step-by-Step Solution

1
Identify the transmission-based precautions required for the specific pathogen.
MRSA requires Contact Precautions, meaning the nurse must wear a fluid-resistant gown and clean gloves.
MRSA is spread through direct and indirect contact with the client and their environment.
2
Evaluate the planned clinical procedure for any additional exposure risks.
High-pressure wound irrigation creates a significant risk of splashing blood or body fluids.
Standard Precautions mandate additional protection based on the specific task being performed.
3
Determine the necessary PPE to mitigate the procedural splash risk.
A standard surgical mask and protective eyewear (or a full face shield) are required.
Mucous membranes of the eyes, nose, and mouth must be protected from contaminated splashes.
4
Combine the requirements from both precaution categories.
The correct PPE ensemble includes gloves, a gown, a mask, and eyewear.
To fully protect against both contact transmission and procedural fluid exposure.

Key Concept

Synthesizing Contact Precautions with Task-Specific Standard Precautions
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Topics

Standard and Transmission-Based Precautions

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