Examkin

Question

Difficulty: HardStandard and Transmission-Based Precautions

A nurse is assigned to care for a newly admitted client who recently traveled internationally and presents with a severe acute respiratory infection, fever, and a persistent cough. The client has a suspected case of Middle East Respiratory Syndrome (MERS) and requires concurrent airborne and contact precautions. The nurse has gathered all required supplies in the anteroom outside the client's negative-pressure isolation room. Arrange the following actions in the correct sequence for donning personal protective equipment (PPE) before entering the client's room.

  1. 1Perform thorough hand hygiene using an alcohol-based hand rub or antimicrobial soap and water.
  2. 2Put on the isolation gown, fastening all ties securely at the neck and waist.
  3. 3Don a fit-tested N95 particulate respirator and perform a user seal check.
  4. 4Place the face shield over the face and eyes, adjusting the headband for a snug fit.
  5. 5Put on clean, non-sterile gloves, extending them completely over the cuffs of the isolation gown.

Answer

The correct sequence for donning PPE is: perform hand hygiene, put on the isolation gown, don the N95 respirator, apply the face shield, and finally put on the gloves.
The correct sequence for donning PPE ensures that the healthcare worker builds their protective barrier systematically without contaminating the gear. Hand hygiene must occur first to ensure clean hands are manipulating the clean PPE. The gown is applied first due to its bulk and the need to secure ties behind the back. The N95 respirator is applied and sealed next because it must sit directly on the face and head for an airtight fit. This is followed by the face shield, which protects both the eyes and the exterior of the respirator. Gloves are applied last so they can be stretched over the cuffs of the gown, establishing a continuous, unbroken barrier necessary for contact precautions.

Step-by-Step Solution

1
Perform hand hygiene.
Hands are rendered clean and free of transient pathogens.
This establishes a clean baseline, preventing the transfer of microorganisms to the clean PPE during the donning process.
2
Put on the isolation gown.
The nurse's torso and arms are fully covered, and ties are secured.
The gown's ties require fine motor skills that are easiest to manage before donning gloves.
3
Don the N95 respirator and perform a seal check.
The respirator is properly fitted, creating an airtight seal over the nose and mouth.
Applying the respirator before eye protection ensures the straps are positioned correctly without obstruction, offering optimal protection against airborne particles.
4
Place the face shield.
The eyes and the exterior of the respirator are shielded.
The shield provides a barrier against droplets and splashes, sitting comfortably over the pre-secured respirator.
5
Put on gloves, pulling them over the gown cuffs.
Hands and wrists are fully protected by a continuous barrier.
Pulling the gloves over the cuffs seals the potential gap at the wrists, completing the required contact precautions.

Key Concept

The CDC standard sequence for donning personal protective equipment ensures maximum barrier protection and prevents inadvertent contamination of the equipment prior to entering an isolation environment.
Rate this question

Topics

Standard and Transmission-Based Precautions

More questions from this topic