Standard And Transmission-Based Precautions
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NCLEX-PN › Standard And Transmission-Based Precautions
In a hospital medical-surgical unit, a 72-year-old client with a draining wound culture positive for methicillin-resistant Staphylococcus aureus (MRSA) has a temperature of 37.9°C (100.2°F) and WBC 13,200/mm³. The dressing is saturated with serosanguinous drainage. What is the priority action to prevent infection spread?
Use sterile gloves only when changing the dressing; no gown is needed
Implement contact precautions and wear gown and gloves for room entry
Use droplet precautions and wear a surgical mask when within 3 feet (1 meter)
Place the client in an airborne infection isolation room and wear an N95 respirator
Explanation
This question tests the application of infection control precautions. The key factor in determining the appropriate precaution is the contact transmission mode of MRSA through direct contact with the draining wound. Implementing contact precautions with gown and gloves for room entry is the priority because it prevents the spread of resistant bacteria via hands or clothing. Airborne precautions are for airborne pathogens like TB, droplet precautions address respiratory droplets, and sterile gloves without a gown do not fully protect against contact transmission, making them incorrect. Infection control principles emphasize using barrier precautions to interrupt contact transmission of multidrug-resistant organisms. Guidelines from the CDC recommend dedicating equipment and thorough cleaning to prevent cross-contamination. A transferable strategy is to don PPE before entering rooms of clients with known resistant infections and perform hand hygiene after removal to protect other clients and staff.