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Difficulty: MediumStandard and Transmission-Based Precautions

A registered nurse is preparing to provide care for a client admitted with a confirmed diagnosis of Middle East Respiratory Syndrome (MERS). The client is in a negative-pressure room requiring airborne and contact precautions. Arrange the following steps for donning the required personal protective equipment (PPE) in the correct chronological sequence prior to entering the client's room.

  1. 1Perform hand hygiene using an alcohol-based hand rub or soap and water.
  2. 2Put on a fluid-resistant isolation gown and fasten the ties securely.
  3. 3Apply a fit-tested N95 respirator and perform a user seal check.
  4. 4Place a face shield or goggles over the face and adjust to fit.
  5. 5Don clean gloves and extend them over the cuffs of the isolation gown.

Answer

The correct sequence is: Perform hand hygiene, Put on isolation gown, Apply N95 respirator, Place face shield or goggles, Don clean gloves.
The correct sequence for donning personal protective equipment (PPE) for airborne and contact precautions follows CDC guidelines designed to prevent contamination of the equipment and the healthcare worker. Hand hygiene must be performed first. The gown is put on next to cover the torso and uniform. The N95 respirator is then applied and seal-checked. Eye protection (face shield or goggles) is placed over the face and respirator. Finally, gloves are donned last and pulled over the gown cuffs to ensure a complete barrier.

Step-by-Step Solution

1
Identify the foundational first step prior to handling any clean personal protective equipment.
Select performing hand hygiene.
Hand hygiene prevents the transfer of pathogens to the clean PPE before it is applied to the body.
2
Determine the first item of PPE to be put on to protect the torso and clothing.
Select putting on the fluid-resistant isolation gown.
The gown is the largest piece of equipment and forms the base layer for subsequent PPE. It is placed before facial protection.
3
Identify the next item needed to secure the airway before applying eye protection.
Select applying the fit-tested N95 respirator.
The respirator must be applied directly to the face and seal-checked without interference from eyewear straps.
4
Determine the appropriate step for applying eye protection.
Select placing the face shield or goggles.
Eye protection is placed over or alongside the respirator to protect the mucous membranes of the eyes without breaking the respirator seal.
5
Identify the final step to complete the protective barrier.
Select donning clean gloves.
Gloves are donned last and pulled over the gown cuffs to secure the sleeves and ensure the hands are freshly covered before any patient contact.

Key Concept

Donning sequence for Personal Protective Equipment (PPE)
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Topics

Standard and Transmission-Based Precautions

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