A nurse educator is reviewing infection control protocols with a staff nurse who is assigned to care for a mechanically ventilated client. The client has an active multidrug-resistant *Acinetobacter baumannii* infection in a sacral pressure injury and is newly diagnosed with influenza A. The staff nurse is preparing to perform open endotracheal suctioning. Which statements by the staff nurse indicate a correct understanding of the required precautions? Select all that apply.
- I will wear a fit-tested N95 respirator during the suctioning procedure.Answer
- I will don a fluid-resistant gown and clean gloves prior to entering the client's room.Answer
- CI will request a transfer to a positive-pressure isolation room for this client.
- I will put on goggles or a disposable face shield before initiating the suctioning.Answer
- EI will remove my respirator inside the room immediately after disposing of my gown and gloves.
Answer
The staff nurse must wear a fit-tested N95 respirator, don a fluid-resistant gown and clean gloves prior to entry, and put on goggles or a face shield before initiating suctioning.
The client presents a complex infection control scenario requiring combined precautions. The multidrug-resistant *Acinetobacter baumannii* necessitates strict Contact Precautions (gown and gloves upon entry). The influenza A necessitates Droplet Precautions; however, because the nurse is performing open endotracheal suctioning—an aerosol-generating procedure (AGP)—the Droplet Precautions must be escalated to Airborne Precautions. Therefore, a fit-tested N95 respirator or PAPR is mandatory. Furthermore, Standard Precautions dictate that eye protection (goggles or face shield) must be worn when splashes or sprays of body fluids are anticipated, which is guaranteed during open airway suctioning.
Step-by-Step Solution
Key Concept
Escalation of precautions during aerosol-generating procedures (AGPs) and proper PPE utilization for clients with concurrent Contact and Droplet/Airborne infections.