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Question

Difficulty: HardHandling Hazardous and Infectious Materials

A nurse accidentally drops a glass specimen container filled with bronchoalveolar lavage (BAL) fluid from a client with suspected active pulmonary tuberculosis. The container shatters on the clinical unit's hallway floor, splashing the fluid over a wide area. Which of the following is the nurse's priority action?

  1. A
    Immediately don a fit-tested N95 respirator, protective gown, and heavy-duty utility gloves.
  2. B
    Place dry, absorbent pads over the spilled fluid to prevent it from spreading down the hallway.
  3. Instruct all personnel and visitors to immediately clear the area and restrict access.Answer
  4. D
    Contact the environmental services department to perform a specialized biohazard decontamination.

Answer

The correct action is to instruct all personnel and visitors to immediately clear the area and restrict access.
When a container holding a fluid contaminated with an airborne pathogen (such as Mycobacterium tuberculosis) shatters, it generates highly infectious aerosols. The most critical immediate danger is the inhalation of these airborne particles by the nurse and any bystanders in the hallway. The correct protocol for an aerosolizing biological spill is to immediately evacuate the area, restrict access, and allow the aerosols to settle (typically for 30 to 60 minutes) before trained personnel return with appropriate airborne and contact PPE to decontaminate the spill.

Step-by-Step Solution

1
Analyze the transmission risk of the suspected pathogen.
Mycobacterium tuberculosis is transmitted via airborne droplet nuclei.
Understanding the pathogen's transmission route dictates the required safety precautions and the immediate threat level.
2
Evaluate the physical impact of the incident.
Shattering a glass container of fluid generates infectious aerosols.
Mechanical disruption of biological fluids suspends infectious particles in the air, creating a high-risk inhalation hazard over a wide area.
3
Determine the highest priority intervention.
Evacuate and secure the immediate area.
The most urgent action is to prevent inhalation exposure to bystanders and the nurse. The area must be cleared and aerosols allowed to settle before any cleanup is attempted.

Key Concept

Management of airborne biological hazard spills
Estimated Time:1m 15s
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Topics

Handling Hazardous and Infectious Materials

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