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Difficulty: MediumStandard and Transmission-Based Precautions

A nurse is providing care for a hospitalized client who is incontinent of stool and has just been diagnosed with a *Clostridioides difficile* infection. Which of the following infection control interventions should the nurse implement? (Select all that apply.)

  1. Put on a fluid-resistant isolation gown and clean gloves prior to crossing the threshold of the client's room.Answer
  2. Cleanse hands thoroughly using soap and warm water immediately after removing personal protective equipment.Answer
  3. C
    Ensure the client is placed in a specialized infection isolation room equipped with negative air pressure ventilation.
  4. D
    Apply a designated alcohol-based hand rub vigorously to hands for 30 seconds after emptying the bedside commode.
  5. Utilize a bleach-based disinfectant solution to clean the client's high-touch environmental surfaces.Answer
  6. F
    Secure a medical face mask over the client's nose and mouth during transport to the diagnostic imaging department.

Answer

The correct interventions are donning a gown and gloves prior to entering the room, washing hands with soap and water after removing protective equipment, and utilizing a bleach-based disinfectant for environmental surfaces.
Contact precautions require healthcare workers to wear a gown and gloves upon entering the room to prevent contamination. Because the causative pathogen produces resilient spores, alcohol-based sanitizers are ineffective; hands must be washed with soap and water to physically rinse the spores away. Furthermore, environmental surfaces must be cleaned with a specialized sporicidal agent, such as a bleach-based solution, to effectively eliminate the organisms.

Step-by-Step Solution

1
Identify the pathogen and its specific mode of transmission.
The client has Clostridioides difficile, which is an enteric pathogen transmitted via direct contact and the fecal-oral route. It produces highly resilient spores.
Understanding the pathogen's characteristics dictates the level of isolation required.
2
Determine the appropriate isolation category and required personal protective equipment (PPE).
Contact (Enteric) precautions are indicated, requiring the nurse to don a gown and gloves before entering the client's room.
This prevents the transfer of pathogens from the client's environment to the nurse's uniform and hands.
3
Evaluate post-care hand hygiene and environmental cleaning protocols.
Alcohol is ineffective against spores. Hands must be washed with soap and water. Surfaces must be disinfected with a sporicidal bleach solution.
Mechanical friction is required to wash spores down the drain, and specific chemical agents are needed to destroy them on surfaces.

Key Concept

Enteric Contact Precautions for Spore-Forming Pathogens
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Topics

Standard and Transmission-Based Precautions

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