After administering an intramuscular injection, the nurse had a needle stick injury. Which of the following actions by the nurse is inappropriate?

Appeared in: BHU NO - 12 April 2024

Explanation

Squeezing the finger to let out blood is an inappropriate action following a needlestick injury.
This action is contraindicated because it can cause further tissue trauma and does not reduce the risk of transmission of bloodborne pathogens.
Manipulating the wound may theoretically increase the risk by pushing contaminants deeper into the tissue.

Option B: This is a correct and essential action. Consulting a physician is necessary to evaluate the risk of transmission and determine the need for post-exposure prophylaxis (PEP) against pathogens like HIV, HBV, and HCV.
Option C: This is the correct immediate first-aid action. The wound should be washed gently with soap and running water to clean the area.
Option D: This is a correct and necessary action. The infection control team or occupational health department must be contacted as part of the institutional protocol for reporting, documentation, and follow-up care.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Management of Needlestick Injury in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Proper management of needlestick injuries is a critical patient and healthcare worker safety issue. Immediate and correct action can significantly reduce the risk of acquiring serious bloodborne infections like HIV, Hepatitis B, and Hepatitis C.
All healthcare institutions have a strict protocol for managing occupational exposures. Failure to report a needlestick injury can have serious health, professional, and legal consequences.
What if the source patient is known to be positive for Hepatitis B? The urgency for post-exposure prophylaxis increases. The nurse would require Hepatitis B Immune Globulin (HBIG) and potentially a booster dose of the Hepatitis B vaccine, ideally within 24 hours of exposure.

How to Approach the Question

First, identify that the question is asking for the 'inappropriate' action. This means you are looking for the incorrect step among the options.
Recall the standard protocol for managing a needlestick injury in a healthcare setting.
Evaluate each option against this protocol.
Step 1: Wash the area. Therefore, 'Washing hands under tap water' is an appropriate action.
Step 2: Report the incident and seek medical evaluation. Therefore, 'Consulting with physician' and 'Contacting infection control team' are appropriate actions.
Consider the remaining option: 'Squeezing the finger'. This action is not part of the standard protocol and is actively discouraged because it can cause tissue damage.

Concept Tested & Keywords

Concept Tested: Management of Needlestick Injury
Stem keywords: intramuscular injection, needle stick injury, nurse
Lead-in keywords: inappropriate
Negative lead-in flag: The question asks for the INAPPROPRIATE action, meaning three options are correct procedures and one is incorrect.

Q5ISZSDCF1RgcTadwGWPlY

E6 Microbiology OneStop Sastry p. 54-56

E6 Nursing Fundamentals Taylor p. 199-201

Practise the full BHU NO - 12 April 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.