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Difficulty: MediumStandard and Transmission-Based Precautions

During morning rounds, a practical nurse empties a urinary drainage bag for a resident who is on contact precautions for a vancomycin-resistant enterococci (VRE) infection. After emptying the bag, the nurse notices that their gloves are visibly soiled with urine. The nurse still needs to measure the resident's vital signs using the dedicated equipment inside the room. Which action should the nurse take next?

  1. Remove the soiled gloves, perform hand hygiene, and don a new pair of clean gloves before touching the vital signs equipment.Answer
  2. B
    Wash the gloved hands vigorously with antimicrobial soap and warm water before assessing the vital signs.
  3. C
    Clean the soiled gloves with an alcohol-based hand rub until they are visibly dry and free of urine.
  4. D
    Doff the gown and gloves, step out of the room to perform hand hygiene, and don fresh protective equipment.

Answer

The correct action is to remove the soiled gloves, perform hand hygiene, and put on a new pair of clean gloves before handling the vital signs equipment.
When a nurse moves from a highly contaminated task (like emptying urine) to a cleaner task (like taking vital signs) on the exact same client, standard and contact precautions require the nurse to safely remove the soiled gloves, perform hand hygiene, and put on a fresh pair of clean gloves. This prevents the transfer of pathogens from the concentrated infectious source to the client's cleaner skin and the room's dedicated equipment.

Step-by-Step Solution

1
Identify the contamination level of the current personal protective equipment.
The nurse recognizes that the gloves are heavily contaminated with infectious bodily fluids (urine with VRE).
Handling clean equipment or interacting with other parts of the client's environment with soiled gloves spreads the multidrug-resistant organism.
2
Determine the appropriate protocol for continuing care within the same isolation room.
The nurse decides that the gloves must be changed immediately without necessarily leaving the room or removing the gown.
Standard precautions dictate that gloves must be changed between tasks on the same client if moving from a contaminated body site to a cleaner site or task.
3
Execute the mid-care glove change procedure safely.
The nurse safely removes the gloves, uses an in-room alcohol-based hand rub or sink for hand hygiene, and dons fresh gloves.
Hand hygiene is strictly required after removing any gloves to eliminate transient pathogens before donning a new pair.

Key Concept

Continuous Infection Control and Mid-Care Glove Changing
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Topics

Standard and Transmission-Based Precautions

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