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Zorluk: ZorStandard and Transmission-Based Precautions

A practical nurse (PN) is preparing to irrigate the widespread skin lesions of an immunocompromised client diagnosed with disseminated herpes zoster. Which of the following describes the correct sequence and selection of personal protective equipment (PPE) the PN must don before entering the client's airborne infection isolation room (AIIR)?

  1. Fasten a disposable gown, apply an N95 respirator and perform a user seal check, place a face shield over the face, and pull clean gloves over the cuffs of the gown.Cevap
  2. B
    Fasten a disposable gown, apply a standard surgical mask, place a face shield over the face, and pull clean gloves over the cuffs of the gown.
  3. C
    Apply an N95 respirator and perform a user seal check, fasten a disposable gown, place a face shield over the face, and pull clean gloves over the cuffs of the gown.
  4. D
    Fasten a disposable gown, pull clean gloves over the cuffs of the gown, apply an N95 respirator and perform a user seal check, and place a face shield over the face.

Cevap

The correct action is to first put on the gown, followed by the N95 respirator, then the face shield, and finally the gloves.
The scenario requires the integration of three critical infection control concepts. First, disseminated herpes zoster requires both Airborne and Contact precautions, necessitating an N95 respirator, a gown, and gloves. Second, the act of irrigating lesions introduces a splash risk, which means a face shield or goggles must be added under Standard Precautions. Finally, the Centers for Disease Control and Prevention (CDC) strictly outlines the donning sequence to ensure maximum protection and minimize contamination: the gown is put on first, followed by the respirator, then the face shield, and lastly the gloves, which must extend over the cuffs of the gown.

Adım Adım Çözüm

1
Identify the required transmission-based precautions for the client's diagnosis.
Disseminated herpes zoster requires both Airborne and Contact precautions.
The virus can be transmitted through both aerosolized airborne particles and direct contact with the vesicular fluid.
2
Determine if additional PPE is needed based on the planned nursing procedure.
Irrigating lesions poses a risk for splashes or sprays of infectious fluid.
Standard precautions dictate that eye and face protection (like a face shield) must be added when splashes are anticipated.
3
Apply the required PPE in the standardized CDC sequence for donning.
The correct order is: Gown -> Mask/Respirator (N95) -> Goggles/Face Shield -> Gloves.
This specific sequence ensures all protective barriers are securely in place, with gloves applied last to cover the gown's cuffs and prevent cross-contamination during the donning process.

Anahtar Kavram

Selection and sequencing of Personal Protective Equipment (PPE) for complex isolation scenarios.
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