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NCLEX: Isolation precautions

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NCLEX EXAM PREVIEW

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amyb1218Preview CH 29 16 terms jen contact precautions patients have a condition that can be contracted through touching or contact examples of illnesses that require contact precautions?

MRSA RSV HSV Scabies C-diff major wound infections What barrier protection is required for contact precautions?

• private room (or cohort patient)
• gloves
• gowns

What is the proper order to don PPE under contact precautions?

• wash hands
• gown (before entering pts room)
• gloves
• enter room

What is the proper order to remove PPE under contact precautions?

• remove gloves
• remove gown ((before leaving pts room)
• then wash hands

Droplet precautions Are for patients who have an illness, which could be spread through contact with secretions from the mouth, nose and lungs when a patient coughs or sneezes.Usually, the droplets can only travel about three feet.

Examples of droplet precaution illnesses include:

large droplets than 5um:

pertussis influenza strep pharyngitis PNA scarlet fever (in children, infants) mumps meningococcal pneumonia sepsis pneumonic plaque What barrier protection is required for droplet precautions?

• private room (or cohort patient)
• gown
• mask (when closer than 3 feet of pt)
• eye protection
• gloves

What is the proper order to don PPE under droplet precautions?

Don:

• wash hands
• gown
• mask
• eye protection
• gloves

all before entering patient's room

What is the proper order to remove PPE under droplet precautions?

Removal:

• gloves
• gown
• wash hands
• mask
• eye protection
• wash hands (again before leaving room)

airborne precautions If a patient has an illness caused by a germ that can travel through the air long distances.Patients should also be placed in a special room called a negative pressure room. Negative pressure rooms prevent the air from flowing into the hallways.examples of illnesses that require airborne precautions?

Small droplets smaller than 5 Um:

TB, varicella, varicella-zoster, measles What barrier protection is required for airborne precautions?

• private room (w/negative airflow of at least
• exchanges/hr)
• N95 respirator
• gown
• gloves

What is the proper order to don PPE under airborne precautions?

Don:

• wash hands
• N95 respirator
• gown
• gloves

*all before entering room What is the proper order to remove PPE under airborne precautions?

Remove:

• gloves
• gown
• wash hands (in room)
• leave room and then remove N95
• wash hands again

Reverse isolation Isolation precautions are usually intended to keep yourself protected from germs the patient may be carrying.The purpose is to protect the patient from any germs the staff or visitors are carrying.Patients who have a decreased immune system, usually from chemotherapy, may be placed in reverse isolation.If you have a patient in reverse isolation, you need to wear gloves, a mask and a gown.PPE for reverse isolation (don)

Don:

• wash hands
• gown
• mask
• gloves

PPE for reverse isolation (remove)

Remove:

• gloves
• gown
• wash hands
• mask
• wash hands again (before leaving room)

What is neutropenic fever?temperature greater than 38.3 C (101 F) & an absolute neutrophil count less than 500 considered a medical emergency How to calculate absolute neutrophil count (ANC)?Measures immune function more accurately than total WBC count or neutrophil count alone.The ANC considers both the circulating mature neutrophils and the immature WBCs, called the bands.ANC = ((% neutrophils+% bands)/100) x 3 WBC count This example shows how to calculate the ANC of a patient with 50% neutrophils, 8% bands, and a WBC count of 4,000.ANC = ((50% + 8%)/100) x 4,000 ANC = (0.50 + 0.08) x 4,000

ANC = 2,320