The nurse in charge is evaluating the infection control procedures on the unit. Which finding indicates a break in technique and the need for education of staff?
A. The nurse puts on a mask, a gown, and gloves before entering the room of a client in strict isolation.
B. A nurse with open, weeping lesions of the hands puts on gloves before giving direct client care.
C. The nurse aide is not wearing gloves when feeding an elderly client.
D. A client with active tuberculosis is asked to wear a mask when he leaves his room to go to another department for testing.
Correct Answer: B. A nurse with open, weeping lesions of the hands puts on gloves before giving direct client care.
Persons with exudative lesions or weeping dermatitis should not give direct client care or handle client-care equipment until the condition resolves. Strict isolation requires the use of a mask, gown, and gloves. Personnel involved in treating high-risk infections should be specialized in isolation work and be healthy, not immunosuppressed, and if possible should be vaccinated, if a vaccine is available.
Option A: Strict isolation refers to suspected highly infectious and transmissible virulent and pathogenic microbes, highly resistant bacterial strains and agents that are not accepted in any form of distribution in the society or in the environment. Patients in need of strict isolation should be placed in a separate isolation ward or building.
Option C: There is no need to wear gloves when feeding a client. However, universal precautions (treating all blood and body fluids as if they are infectious) should be observed in all situations.
Option D: A client with active tuberculosis should be on respiratory precautions. Airborne precautions are used in addition to standard precautions to prevent disease transmission from individuals known or suspected to have diseases spread by fine particles, including, TB.