An emergency department triage nurse evaluates an ambulatory individual presenting with a progressive three-week history of severe cough, night sweats, and hemoptysis. To ensure proper standard and transmission-based precautions, arrange the following nursing actions in the correct chronological sequence from first to last.
- 1Apply a standard surgical mask over the client's mouth and nose.
- 2Escort the client to a negative-pressure airborne infection isolation room (AIIR).
- 3Perform a seal-check on a personal N95 respirator prior to entering the isolation room.
- 4Obtain a targeted sputum specimen for acid-fast bacilli (AFB) testing.
- 5Administer the initial doses of prescribed first-line anti-tuberculosis medications.
Answer
The correct chronological sequence is to first apply a standard surgical mask to the client, second escort them to a negative-pressure room, third don an N95 respirator for staff protection, fourth obtain the sputum diagnostic specimen, and finally administer the prescribed medications.
The fundamental principle of infection control prioritization is to protect the greatest number of people as quickly as possible. Placing a surgical mask on the client provides immediate source control in a public triage space. Moving them to an AIIR secures the facility's environment. Once the public threat is contained, the nurse protects themselves by donning an N95 respirator before re-engaging with the client. Clinical protocols then dictate that diagnostic cultures (sputum for AFB) must always precede the administration of antimicrobial medications to ensure accurate organism identification.
Step-by-Step Solution
Key Concept
Prioritization of Airborne Precautions demands immediate source control (masking the patient) and environmental isolation (AIIR placement) before proceeding with staff PPE adjustments, diagnostic procedures, and therapeutic interventions.