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Difficulty: MediumStandard and Transmission-Based Precautions

Upon completing routine hygienic care for a client under strict contact and droplet protocols for an adenovirus infection, a practical nurse must remove all worn personal protective equipment (PPE). The nurse is currently wearing a surgical mask, a face shield, a fluid-resistant gown, and gloves. To adhere to standard infection control practices, in what chronological order should the nurse remove these items?

  1. A
    Unfasten and remove the gown, peel off the gloves, carefully remove the face shield, and lastly take off the surgical mask.
  2. B
    Take off the surgical mask, carefully remove the face shield, peel off the gloves, and lastly unfasten and remove the gown.
  3. Peel off the gloves, carefully remove the face shield, unfasten and remove the gown, and lastly take off the surgical mask.Answer
  4. D
    Carefully remove the face shield, unfasten and remove the gown, peel off the gloves, and lastly take off the surgical mask.

Answer

The correct sequence is to peel off the gloves, carefully remove the face shield, unfasten and remove the gown, and lastly take off the surgical mask.
According to standard CDC infection control guidelines, the correct sequence for removing personal protective equipment (PPE) is to remove the most contaminated items first. Gloves are considered the most contaminated and must be removed first. Next, the face shield or goggles should be removed by handling the clean headband or earpieces. The gown is then unfastened and pulled away from the body, rolling it inside out. Finally, the surgical mask is removed by handling only the ties or elastic bands to protect the respiratory tract throughout the process. Hand hygiene must be performed immediately after PPE removal.

Step-by-Step Solution

1
Identify the primary principle of PPE removal.
The most heavily contaminated items must be removed first to prevent self-contamination.
Pathogens are most concentrated on the items that had direct physical contact with the client or their immediate environment.
2
Determine the most contaminated item.
Gloves touch the client and environment directly, making them the most contaminated.
Therefore, gloves must be removed first.
3
Determine the subsequent order based on contamination levels and anatomical safety.
After gloves, the face shield is removed, followed by the gown, and finally the mask.
The mask protects the respiratory tract and should be removed last, handling only the ties, to minimize the risk of inhaling pathogens during the doffing process.

Key Concept

Personal Protective Equipment (PPE) Doffing Sequence
Estimated Time:1m 0s
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Topics

Standard and Transmission-Based Precautions

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