Question

Difficulty: MediumStandard and Transmission-Based Precautions

While providing care in a continuous care facility, a practical nurse collaborates with registered nurses and unlicensed assistive personnel to manage clients in isolation. Which clinical actions by the practical nurse demonstrate correct application of precautions and scope of practice? Select all that apply.

  1. Donning an isolation gown, followed by a surgical mask, face shield, and clean gloves before entering a droplet precautions room.Answer
  2. Leaving dedicated reusable equipment, such as a stethoscope and pulse oximeter, inside the room of a client with a Vancomycin-resistant enterococci (VRE) infection.Answer
  3. C
    Creating the primary infection control care plan for a newly admitted client who has active pulmonary tuberculosis.
  4. D
    Taking off the N95 respirator before exiting the room of a client who requires airborne infection isolation.
  5. Reinforcing previous education with family members about the necessity of keeping the door completely closed for a client on airborne precautions.Answer
  6. F
    Delegating the initial evaluation of a client's wound to the unlicensed assistive personnel before applying a new contact precaution dressing.

Answer

The correct actions include following the proper sequence for donning personal protective equipment, dedicating reusable equipment to clients on contact precautions, and reinforcing established teaching regarding airborne isolation.
The appropriate actions adhere to CDC infection control guidelines by correctly sequencing the donning of personal protective equipment, restricting reusable equipment to a single contaminated room, and properly operating within the scope of practice by reinforcing established client education.

Step-by-Step Solution

1
Evaluate each option against the standard sequence for donning and doffing personal protective equipment.
Donning sequence (gown, mask, shield, gloves) is correct. Doffing the N95 inside an airborne room is incorrect.
Correct sequence and location of removal prevent cross-contamination and pathogen exposure.
2
Analyze the transmission-based precaution rules for the specific pathogens mentioned.
VRE requires contact precautions with dedicated equipment. Airborne precautions require a closed door to maintain negative pressure.
Pathogen-specific protocols disrupt the chain of infection.
3
Assess each nursing action against the practical nurse scope of practice.
Reinforcing education is within scope. Creating initial care plans and delegating assessments to unlicensed personnel are out of scope.
Maintaining practice boundaries ensures safe and legal client care.

Key Concept

Application of Infection Control Protocols and Nursing Scope of Practice
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