QLexNursing

When removing personal protective equipment, remove gloves first.

🦠 Gloves are the most contaminated piece of PPE because they directly touch the client, stool, sputum, and contaminated surfaces.

🦠 Removing gloves first reduces the chance of spreading organisms, especially C. difficile spores, to other parts of the PPE, the environment, or the nurse’s skin.

🦠 Standard PPE removal sequence typically begins with gloves, then face/eye protection, gown, and mask last, to reduce self-contamination.

🦠 With C. diff and influenza, meticulous removal of highly contaminated items (gloves) first is essential to controlling contact and droplet spread.

🦠 Therefore, removing gloves first is an appropriate and required part of correct isolation precautions for this client.

Don a gown when entering the client's room.

🦠 Clostridium difficile spreads via spores that contaminate stool, skin, and the environment, especially with diarrhea and frequent bathroom use.

🦠 Contact precautions for C. diff include the use of gown and gloves when entering the room, to prevent contamination of the nurse’s clothing and skin.

🦠 Because the client has diarrhea for several days and stool positive for C. diff, the risk of contact with contaminated surfaces is very high.

🦠 Wearing a gown helps prevent carrying spores on clothing to other patients, staff, or surfaces.

🦠 Thus, donning a gown when entering the client’s room is a correct and necessary isolation action.

Provide a mask for the client when they are outside their room.

🦠 The client’s sputum culture is positive for influenza, which is transmitted primarily via respiratory droplets produced by coughing, sneezing, and talking.

🦠 When the client leaves their room (e.g., for tests or procedures), they should wear a surgical mask to contain droplets and reduce the risk of infecting others.

🦠 This is a core element of droplet precautions, placing a barrier at the source (the client).

🦠 Staff and visitors may wear masks near the client, but it is equally important that the client wears a mask outside the room to minimize spread.

🦠 Therefore, providing a mask for the client when outside their room is a correct part of isolation precautions for influenza.

Perform hand hygiene with at least 4 to 5 mL of hand sanitizer when leaving the client's room.

🦠 Alcohol-based hand sanitizer is not effective against C. difficile spores, which have a protective coating that resists alcohol.

🦠 For clients with C. diff, guidelines require washing hands with soap and water, which physically removes spores via friction and rinsing.

🦠 Using only hand sanitizer after caring for this client could leave spores on the hands, allowing spread to other patients or surfaces.

🦠 While sanitizer is acceptable for many infections, it is not sufficient when caring for clients with spore-forming organisms like C. diff.

🦠 Therefore, this statement is incorrect—hand hygiene should be done with soap and water, not just alcohol sanitizer.

Place the client in a room with positive air flow.

🦠 A positive airflow room is designed so that air flows out of the room, protecting the client from outside contaminants; it is typically used for protective isolation, e.g., neutropenic clients.

🦠 For a client with C. diff and influenza, we are concerned about containing organisms, not pushing room air out into the hallway.

🦠 Influenza requires droplet precautions in a standard private room, and some respiratory pathogens require negative pressure, not positive.

🦠 Positive airflow could inadvertently increase the risk of spreading infectious particles into shared areas.

🦠 Thus, placing this client in a positive airflow room is not appropriate and not part of proper isolation precautions.