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Difficulty: MediumStandard and Transmission-Based Precautions

While working in an infectious disease unit, a licensed practical nurse must apply full personal protective equipment (PPE) before entering the isolation room of a client suspected of having avian influenza (H5N1). Arrange the following actions in the correct chronological order for applying the required PPE, from first to last.

  1. 1Perform thorough hand hygiene using soap and water or an alcohol-based hand rub.
  2. 2Fasten the ties of a fluid-resistant isolation gown at the neck and waist.
  3. 3Apply a fit-tested N95 respirator and perform a user seal check.
  4. 4Position a face shield over the eyes and adjust it for a secure fit.
  5. 5Pull clean, non-sterile gloves completely over the cuffs of the isolation gown.

Answer

The correct sequence is: Perform hand hygiene, don the isolation gown, apply the N95 respirator, position the face shield, and finally don the gloves.
According to standardized infection control guidelines, the correct sequence for applying personal protective equipment (PPE) ensures maximum safety and prevents self-contamination. Hand hygiene is always performed first. The gown is applied next to cover the torso and arms. Respiratory protection (such as an N95 respirator) is applied and seal-checked before eye protection to ensure the respirator straps lie flat and the seal is unobstructed. Eye protection (face shield or goggles) is then placed. Finally, gloves are donned last so they can be pulled directly over the cuffs of the isolation gown, ensuring continuous coverage of the wrists.

Step-by-Step Solution

1
Select 'Perform thorough hand hygiene using soap and water or an alcohol-based hand rub.' as the first action.
Hands are clean before touching any clean PPE.
Hand hygiene prevents contamination of the clean PPE items during the donning process.
2
Select 'Fasten the ties of a fluid-resistant isolation gown at the neck and waist.' as the second action.
The torso and clothing are covered and protected.
The gown is the foundational piece of PPE and provides the largest coverage area.
3
Select 'Apply a fit-tested N95 respirator and perform a user seal check.' as the third action.
The respiratory system is protected against airborne pathogens.
The respirator must be placed and sealed directly against the face before eye protection is added.
4
Select 'Position a face shield over the eyes and adjust it for a secure fit.' as the fourth action.
The mucous membranes of the eyes are protected from potential splashes or droplets.
Eye protection goes on over the respirator to ensure it does not interfere with the N95 seal.
5
Select 'Pull clean, non-sterile gloves completely over the cuffs of the isolation gown.' as the final action.
Hands are protected and the gap between the gown and gloves is sealed.
Gloves are donned last so they can securely overlap the gown cuffs, ensuring continuous protection.

Key Concept

Standardized donning sequence for personal protective equipment (PPE)
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Topics

Standard and Transmission-Based Precautions

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