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Zorluk: ZorStandard and Transmission-Based Precautions

A client is admitted to the intensive care unit with suspected Neisseria meningitidis infection and is initially placed on standard and droplet precautions. The client's respiratory status rapidly deteriorates, necessitating an emergent endotracheal intubation. Which combination of personal protective equipment (PPE) must the nurse wear while assisting the healthcare provider with this procedure?

  1. N95 respirator, eye protection, clean gown, and non-sterile glovesCevap
  2. B
    Surgical mask, eye protection, clean gown, and non-sterile gloves
  3. C
    N95 respirator, eye protection, sterile gown, and sterile gloves
  4. D
    Surgical mask, clean gown, and non-sterile gloves

Cevap

The nurse must wear an N95 respirator, eye protection, a clean gown, and non-sterile gloves.
Endotracheal intubation is an aerosol-generating procedure (AGP). According to evidence-based infection control guidelines, when an AGP is performed on a client with a pathogen typically transmitted via droplets (such as Neisseria meningitidis), precautions must be temporarily escalated to airborne precautions. This requires the use of an N95 respirator (or PAPR) instead of a standard surgical mask. Furthermore, because of the high risk of fluid splashing and aerosol dispersion, full barrier protection including a clean gown, non-sterile gloves, and eye protection (goggles or face shield) is mandatory.

Adım Adım Çözüm

1
Identify the baseline precautions for the client's suspected infection.
Neisseria meningitidis requires standard and droplet precautions (surgical mask).
Transmission of this pathogen occurs primarily through large respiratory droplets.
2
Analyze the impact of the scheduled procedure on precaution levels.
Endotracheal intubation is an aerosol-generating procedure (AGP).
AGPs mechanically disperse fine droplet nuclei (aerosols) into the surrounding air.
3
Determine the necessary PPE modifications based on the procedure.
Escalate to airborne precautions (N95 respirator or PAPR) and ensure full barrier protection (eye protection, clean gown, non-sterile gloves).
AGPs bypass standard droplet distances, requiring specialized particulate filtration to ensure healthcare worker safety.

Anahtar Kavram

Escalation of droplet precautions to airborne precautions during aerosol-generating procedures (AGPs).
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