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Question

Difficulty: HardHandling Hazardous and Infectious Materials

A nurse sustains an accidental needlestick injury with a contaminated hollow-bore needle after drawing blood from a client who is positive for the human immunodeficiency virus (HIV). Arrange the following nursing actions in the correct sequence of priority.

  1. 1Wash the puncture site thoroughly with soap and running water.
  2. 2Notify the charge nurse and the facility's occupational health coordinator.
  3. 3Report to the employee health department or emergency room for a medical evaluation.
  4. 4Provide a personal blood sample for baseline serological testing.
  5. 5Initiate the prescribed antiretroviral post-exposure prophylaxis (PEP) regimen.

Answer

The correct sequence is to first wash the puncture site, then notify the charge nurse, report for a medical evaluation, provide a baseline blood sample, and finally initiate post-exposure prophylaxis.
The correct sequence prioritizes immediate physiological safety (first aid), followed by administrative communication to transfer patient care, seeking medical evaluation, obtaining legal and medical baseline testing, and finally initiating pharmacological intervention.

Step-by-Step Solution

1
Wash the puncture site thoroughly with soap and running water.
The wound is cleansed and viral load is minimized.
Local first aid is the absolute highest priority to physically remove infectious material from the broken skin boundary.
2
Notify the charge nurse and the facility's occupational health coordinator.
The incident is officially reported and patient care is handed over.
Informing leadership ensures the nurse is relieved of clinical duties to seek immediate care and triggers the institutional exposure protocol.
3
Report to the employee health department or emergency room for a medical evaluation.
A formal risk assessment is conducted.
A trained provider must evaluate the severity of the exposure and the source patient's specific infectious risk.
4
Provide a personal blood sample for baseline serological testing.
The nurse's pre-exposure HIV, HBV, and HCV status is documented.
Establishing a negative baseline is required before starting medications, to prove any future seroconversion was caused by this specific occupational injury.
5
Initiate the prescribed antiretroviral post-exposure prophylaxis (PEP) regimen.
Prophylactic pharmacological treatment begins.
PEP must be started promptly (ideally within 2 hours) after evaluation and testing to maximally suppress potential viral replication.

Key Concept

Prioritizing physiological first aid before administrative actions and baseline testing before medical treatment in occupational biohazard exposures.
Estimated Time:1m 30s
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Topics

Handling Hazardous and Infectious Materials

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