An AIDS patient in the final stage needs suctioning. What must the Nurse/CHO wear when performing this task?

Raj. CHO -2024

Medical Surgical Nursing

Hard

Appeared in: Raj. CHO -2024

Explanation

Suctioning is an aerosol-generating procedure that creates a high risk of splashing bodily fluids.
Full facial protection, including a mask and eye protection (goggles or face shield), is necessary to shield the nurse's mucous membranes (eyes, nose, mouth) from exposure.
A patient in the final stage of AIDS is severely immunocompromised, so sterile gloves are required to maintain aseptic technique and protect the patient from healthcare-associated infections.
This combination of PPE adheres to the principles of Standard Precautions for protecting the healthcare worker and provides the necessary asepsis to protect the vulnerable patient.

Option A: This option omits gloves, which are essential for any procedure involving contact with bodily fluids. It fails to protect the nurse's hands and does not address the need for asepsis for the patient.
Option B: This option omits a mask, leaving the nurse's nasal and oral mucous membranes exposed to infectious aerosols and splashes generated during suctioning.
Option C: This option omits eye protection. Suctioning can easily cause secretions to splash into the eyes, providing a direct route for infection.

Visual 1: Infographic - A diagram showing a healthcare worker correctly wearing all the necessary PPE for an aerosol-generating procedure: a fitted mask, goggles or a face shield, a gown, and gloves. Each item could be labeled with its purpose.
Visual 2: Chart - A table outlining different clinical procedures (e.g., suctioning, bed bath, injection, wound dressing) and the corresponding required PPE according to standard and transmission-based precautions.

Clinical Relevance

Nursing practice connection: Use the key finding related to Personal Protective Equipment (PPE) for High-Risk Procedures to guide bedside assessment, documentation, and the next nursing action.
Correct PPE selection is a fundamental patient and staff safety principle. Failure to use appropriate PPE during high-risk procedures like suctioning can lead to occupational exposure for the nurse and healthcare-associated infections for the patient.
Nurses must perform a risk assessment before every patient interaction to determine the potential for exposure and select the correct PPE. This is a critical thinking skill, not just a rote task.
What if the procedure was oral care on the same patient without suctioning? The nurse would still wear gloves and likely a mask and eye protection due to the potential for coughing or spitting, but the urgency and risk level might be perceived as slightly lower than with suctioning.

How to Approach the Question

First, identify the key elements of the clinical scenario: the patient's condition (final-stage AIDS) and the procedure (suctioning).
Analyze the risks associated with the procedure. Suctioning is an aerosol-generating procedure with a high risk of splashes.
Analyze the risks associated with the patient's condition. Final-stage AIDS means the patient is severely immunocompromised and needs protection from infection.
Based on the risks, determine the necessary protection. The risk of splashes/aerosols requires a mask and eye protection for the nurse. The patient's immunocompromised status requires sterile technique, including sterile gloves.
Evaluate each option to see which one provides the complete, necessary protection for both the nurse and the patient.
Select the option that includes all required components: a mask, eye protection, and sterile gloves.

Concept Tested & Keywords

Concept Tested: Personal Protective Equipment (PPE) for High-Risk Procedures
Stem keywords: AIDS patient, final stage, suctioning, Nurse/CHO
Lead-in keywords: What must, wear
Clinical cues: The patient's diagnosis of final-stage AIDS indicates severe immunosuppression, requiring strict aseptic technique to prevent secondary infections.
Clinical cues: The procedure is suctioning, which is known to generate aerosols and splashes of bodily fluids, posing a risk to the healthcare provider.

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