The nurse is evaluating whether a nonprofessional staff understands how to prevent the transmission of HIV. Which of the following behaviors indicates the correct application of universal precautions?
A. An aide wears gloves to feed a helpless client.
B. A pregnant worker refuses to care for a client known to have AIDS.
C. A lab technician rests his hand on the desk to steady it while recapping the needle after drawing blood.
D. An assistant puts on a mask and protective eyewear before assisting the nurse to suction a tracheostomy.
Correct Answer: D. An assistant puts on a mask and protective eyewear before assisting the nurse to suction a tracheostomy.
Masks and protective eyewear are indicated anytime there is great potential for splashing of body fluids that may be contaminated with blood. Suctioning of a tracheostomy almost always stimulates coughing, which is likely to generate droplets that may splash the health care worker. Clients who are suctioned frequently or have had an invasive procedure like a tracheostomy are likely to have blood in the sputum.
Option A: Gloves are not necessary when feeding, since there is no contact with mucous membranes. Although saliva may have small amounts of HIV in it, the virus does not invade through unbroken skin. There is no evidence in the question to indicate broken skin.
Option B: There is no reason to restrict pregnant workers from caring for persons with AIDS as long as they utilize universal precautions. Use new gloves for every patient. Wear protective eyewear, masks, or face shields (with safety glasses or goggles) during procedures likely to generate droplets of blood or body fluids. In general, protective eyewear, masks, and clothing are not needed for routine care of AIDS virus-infected persons.
Option C: Needles that have been used to draw blood should not be recapped. If it is necessary to recap them, an instrument such as a hemostat should be used to recap. The hand should never be used.