Uttarakhand CHO - 2021: An AIDS patient in the final stage needs suctioning. What must the Nurse/CHO wear when performing this task?

Uttarakhand CHO - 2021

Nursing Foundation

Medium

Appeared in: Uttarakhand CHO - 2021

Explanation

Suctioning is an aerosol-generating procedure (AGP) that creates a high risk of splashing bodily fluids.
A mask and eye protection are required under Standard Precautions to protect the nurse's mucous membranes (nose, mouth, eyes) from exposure to infectious droplets.
Suctioning the lower airway is an aseptic technique, requiring sterile gloves to prevent introducing pathogens into the patient's respiratory tract.
An AIDS patient is severely immunocompromised, making the use of sterile technique and sterile gloves critically important to prevent a secondary infection like pneumonia.
Therefore, the combination of a mask, eye protection, and sterile gloves provides complete protection for both the healthcare provider and the vulnerable patient.

Option A: This option omits sterile gloves. While a mask and eye protection protect the nurse, failing to use sterile gloves violates aseptic technique and puts the immunocompromised patient at high risk for a respiratory infection.
Option B: This option omits a mask. Suctioning generates aerosols that can be inhaled. Without a mask, the nurse is unprotected from inhaling infectious particles.
Option C: This option omits eye protection. Suctioning frequently induces coughing, which can spray secretions directly into the nurse's face. Without eye protection, the nurse's eyes are vulnerable to splashes.

Clinical Relevance

Nursing practice connection: Use the key finding related to Personal Protective Equipment (PPE) for Aerosol-Generating Procedures to guide bedside assessment, documentation, and the next nursing action.
This question highlights the principle of selecting PPE based on the specific procedure's risk (splashes, aerosols, need for sterility), not just the patient's diagnosis.
Standard Precautions assume all patients are potentially infectious. The choice of PPE is determined by the anticipated interaction with blood and body fluids.
For immunocompromised patients, protecting them from nosocomial (hospital-acquired) infections is as important as protecting the healthcare worker. This is the rationale for using sterile gloves.

How to Approach the Question

First, identify the clinical procedure: suctioning.
Next, analyze the risks associated with this procedure. Suctioning involves two main risks: 1) It generates aerosols and splashes, posing a risk to the nurse. 2) It involves entering the lower airway, a sterile area, posing an infection risk to the patient.
Determine the PPE needed to mitigate the risk to the nurse. To protect against splashes and aerosols, a mask and eye protection are necessary.
Determine the PPE needed to mitigate the risk to the patient. To prevent introducing infection during an aseptic procedure, sterile gloves are required.
Combine these requirements. The nurse needs a mask, eye protection, and sterile gloves.
Select the option that includes all three required items.

Concept Tested & Keywords

Concept Tested: Personal Protective Equipment (PPE) for Aerosol-Generating Procedures
Stem keywords: AIDS patient, final stage, suctioning, Nurse/CHO
Lead-in keywords: What must...wear
Negative lead-in flag: false

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E6 Nursing Fundamentals Potter Perry 12e Part 2 pp. 238-240, 237-239

E6 Nursing Vital Signs p. 43-45