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Zorluk: Çok zorStandard and Transmission-Based Precautions

A practical nurse (PN) is preparing to transport a client to the radiology department for a prescribed scan. The client is diagnosed with active pulmonary tuberculosis and has an uncontained, draining methicillin-resistant Staphylococcus aureus (MRSA) wound on the right lower leg. Which action by the PN represents the safest standard of practice?

  1. Secure a clean dressing over the draining wound, place a standard surgical mask over the client's nose and mouth, and notify the radiology department.Cevap
  2. B
    Place a properly fitted N95 particulate respirator on the client, wrap the affected extremity in a sterile drape, and proceed immediately to the radiology department.
  3. C
    Don a personal N95 respirator, an isolation gown, and clean gloves before navigating the client's wheelchair through the public corridors.
  4. D
    Administer a prescribed, as-needed intravenous (IV) push opioid medication to suppress the client's severe cough reflex prior to leaving the isolation room.

Cevap

The most appropriate action is to ensure source control by placing a standard surgical mask on the client to contain respiratory secretions and securely covering the draining wound with a clean dressing, followed by notifying the receiving department of the required precautions.
When transporting a client on simultaneous airborne and contact precautions, the focus is on source control to protect the environment and others. Placing a standard surgical mask on the client effectively traps expelled respiratory droplets, and covering the draining wound contains the infectious exudate. Notifying the receiving department allows them to prepare the necessary isolation protocols before the client arrives.

Adım Adım Çözüm

1
Analyze the required isolation precautions based on the client's active diagnoses.
Tuberculosis requires airborne precautions; an uncontained MRSA wound requires contact precautions.
Identifying the transmission routes is essential to determine the appropriate protective measures required during transport outside the negative pressure room.
2
Determine the appropriate method for client transport under airborne precautions.
The client must wear a standard surgical mask to filter expelled droplets.
A surgical mask provides effective source control for a coughing client. An N95 respirator is intended for staff inhalation protection and increases the client's work of breathing unnecessarily.
3
Determine the appropriate method for client transport under contact precautions.
The uncontained, draining wound must be covered with a clean, secure dressing.
Covering the wound prevents the physical transfer of MRSA to the environment or to other individuals during movement through public facility corridors.
4
Evaluate the distractors regarding staff actions and professional scope of practice.
Staff do not wear PPE in hallways to avoid environmental cross-contamination, and PNs do not administer IV push medications.
Adhering to both facility transport policies and the legal PN scope of practice ensures comprehensive clinical safety.

Anahtar Kavram

During transport of clients on airborne and contact precautions, the primary goal is source control (e.g., the client wears a surgical mask, wounds are covered), rather than the nurse wearing full PPE in public areas. Additionally, PNs must remain within their scope of practice, which excludes administering IV push medications.
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Standard and Transmission-Based Precautions

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