Examkin

Soru

Zorluk: Çok zorStandard and Transmission-Based Precautions

A practical nurse (PN) is reviewing the morning client assignments on a busy medical-surgical unit. Due to a high census, several clients requiring transmission-based precautions are sharing rooms. Which client assignment and planned intervention should the PN accept as safe and within the practical nursing scope of practice?

  1. Performing a sterile wet-to-dry dressing change for a client with a methicillin-resistant Staphylococcus aureus (MRSA) wound infection who is sharing a room with another MRSA-positive client.Cevap
  2. B
    Completing the initial admission assessment and developing the nursing care plan for a newly admitted client placed in an airborne infection isolation room for suspected pulmonary tuberculosis.
  3. C
    Administering oral antiviral medication to a client with laboratory-confirmed influenza A who is cohorted in a semi-private room with a client awaiting viral swab results for suspected influenza.
  4. D
    Administering oral metronidazole to a client with active Clostridioides difficile diarrhea, followed by the use of an alcohol-based hand rub for hand hygiene upon exiting the room.

Cevap

The correct assignment involves performing a sterile dressing change for the client with MRSA who is cohorted with another MRSA-positive client.
The correct assignment involves the MRSA wound care. The practical nursing scope of practice includes performing complex wound care, such as sterile wet-to-dry dressing changes. Additionally, according to CDC infection control protocols, when a private room is unavailable, it is safe and appropriate to cohort clients who are infected with the exact same laboratory-confirmed organism (in this case, MRSA).

Adım Adım Çözüm

1
Analyze the scope of practice for the practical nurse (PN) regarding client assessments and procedures.
The PN can perform complex procedures like sterile dressing changes and administer oral medications, but cannot perform initial admission assessments or formulate new nursing care plans (which are RN responsibilities).
Delegation and acceptance of assignments must strictly adhere to legal scope of practice boundaries.
2
Evaluate the infection control protocols regarding room assignments (cohorting) during a high census.
Clients with the exact same laboratory-confirmed pathogen (e.g., two MRSA-positive clients) can safely share a room. However, a suspected case cannot share a room with a confirmed case due to the risk of exposing the unconfirmed client.
Proper cohorting prevents healthcare-associated cross-infections while managing facility resources.
3
Assess the specific pathogen requirements for hand hygiene.
Clostridioides difficile requires contact/enteric precautions, meaning hand hygiene must be performed with soap and water because alcohol-based rubs cannot destroy the bacterial spores.
Applying the correct hand hygiene method is critical to breaking the chain of infection for spore-forming bacteria.
4
Synthesize the findings to select the single option that satisfies both the legal scope of practice and clinical infection control guidelines.
Only the MRSA client assignment is both legally within the PN's scope (sterile dressing change) and clinically safe (cohorting identical confirmed pathogens).
Safe nursing practice requires simultaneous adherence to both regulatory scope and clinical safety standards.

Anahtar Kavram

Delegation, Scope of Practice, and Complex Transmission-Based Precautions
Bu soruyu puanla

Konular

Standard and Transmission-Based Precautions

Bu konudan daha fazla soru