The nurses recognize that which of the following would be most appropriate to wear when providing direct care to a client with a cough?

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

The primary risk associated with a coughing patient is the generation of infectious respiratory droplets.
Droplet Precautions are indicated for patients who are coughing to prevent the spread of infection.
A surgical mask is the specific PPE designed to act as a barrier against these large-particle droplets, protecting the nurse's mucous membranes of the nose and mouth.
According to CDC guidelines, a surgical mask is effective for droplets that travel short distances (e.g., 3 feet).

Option B: A gown's primary purpose is to protect the nurse's skin and clothing from splashes or sprays of body fluids, not to prevent the inhalation of respiratory droplets.
Option C: Gloves protect the hands from direct contact with infectious materials or body fluids. They offer no protection against inhaling airborne or droplet-transmitted pathogens.
Option D: Shoe covers are not required for routine patient care, even with a cough. They are used to prevent contamination of or from the floor in specialized areas.

Clinical Relevance

Nursing practice connection: Use the key finding related to Personal Protective Equipment (PPE) for Droplet Precautions to guide bedside assessment, documentation, and the next nursing action.
Correctly selecting and using PPE is a fundamental competency in nursing to prevent healthcare-associated infections (HAIs) and protect both healthcare workers and patients.
Implementing respiratory hygiene and cough etiquette (e.g., instructing the patient to cover their mouth, use tissues, and perform hand hygiene) is a crucial complementary strategy to PPE use.
What if? If the patient's cough was associated with suspected or confirmed tuberculosis (TB), a surgical mask would be insufficient. The nurse would need to implement Airborne Precautions and wear a fit-tested N95 respirator mask for adequate protection from smaller airborne particles.

How to Approach the Question

First, identify the key information in the question stem: the patient has a 'cough'.
Recognize that a cough is a mechanism for transmitting respiratory infections.
Recall the modes of transmission. A cough that generates large particles that travel short distances is associated with 'Droplet' transmission.
Consider the function of each piece of PPE listed in the options.
A mask protects the nose and mouth from droplets. A gown protects clothing from splashes. Gloves protect hands from contact. Shoe covers protect footwear.
Match the primary risk (droplets from a cough) with the PPE designed to mitigate that specific risk. In this case, the mask is the most direct and appropriate protection.

Concept Tested & Keywords

Concept Tested: Personal Protective Equipment (PPE) for Droplet Precautions
Stem keywords: direct care, client with a cough, appropriate to wear
Lead-in keywords: most appropriate
Clinical cues: The presence of a cough is a key clinical sign indicating the risk of respiratory droplet transmission.
Negative lead-in flag: false

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E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 237-239

E6 Nursing Vital Signs p. 43-45

Practise the full DHS Staff Nurse - 2018 (Shift-2nd)

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