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Zorluk: OrtaStandard and Transmission-Based Precautions

A registered nurse is monitoring an unlicensed assistive personnel (UAP) who is providing morning care to a client isolated for active pulmonary tuberculosis. Which observed action by the UAP requires immediate intervention by the nurse?

  1. Removing the N95 respirator just before leaving the client's isolation roomCevap
  2. B
    Placing a standard surgical mask on the client prior to transport for a diagnostic test
  3. C
    Performing hand hygiene with an alcohol-based hand rub immediately after removing gloves
  4. D
    Donning a fluid-resistant gown and clean gloves before assisting the client with a bed bath

Cevap

The action requiring immediate intervention is removing the N95 respirator just before leaving the client's isolation room.
For a client on airborne precautions, such as one with active pulmonary tuberculosis, the healthcare worker must wear a fit-tested N95 respirator. To prevent inhalation of infectious airborne particles, the respirator must not be removed until after the worker has completely exited the negative-pressure room and closed the door. Therefore, removing it while still inside the room is a critical error requiring immediate intervention.

Adım Adım Çözüm

1
Identify the transmission-based precaution required for the client's specific diagnosis.
Active pulmonary tuberculosis requires airborne precautions in addition to standard precautions.
Tuberculosis is transmitted via small airborne droplet nuclei that can remain suspended in the air over long distances and time.
2
Determine the proper personal protective equipment (PPE) and doffing sequence for airborne precautions.
Airborne precautions require the use of a fit-tested N95 or higher-level respirator. The protocol dictates that the respirator must only be removed after exiting the negative-pressure room and closing the door.
Removing the respirator while still inside the room exposes the healthcare worker to the infectious airborne particles circulating in the patient's environment.
3
Evaluate the UAP's actions against established infection control guidelines to determine which action is incorrect.
Removing the N95 respirator before leaving the room violates airborne precaution protocols and poses a direct infection risk, thus requiring immediate intervention.
The other actions (masking the client for transport, performing alcohol-based hand hygiene, and using a gown/gloves for a bed bath) represent correct clinical applications of standard and transmission-based precautions.

Anahtar Kavram

Airborne Precautions and Proper PPE Doffing Sequence
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Konular

Standard and Transmission-Based Precautions

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