To make an instrument free of HIV virus, it is kept in

RRB Staff Nurse Jaipur-6th June 2018

Applied Microbiology & Infection control

Easy

Appeared in: RRB Staff Nurse Jaipur-6th June 2018

Explanation

2% glutaraldehyde is a high-level disinfectant and chemical sterilant used for medical instruments.
It is virucidal, meaning it effectively kills viruses, including the Human Immunodeficiency Virus (HIV).
Its mechanism involves alkylation, which damages the proteins and nucleic acids of pathogens.
It is particularly useful for heat-sensitive instruments that cannot be sterilized by autoclaving.

Option A: Spirit (alcohol) is an intermediate-level disinfectant. It evaporates too quickly to guarantee the necessary contact time for high-level disinfection and is not effective against bacterial spores.
Option C: Savlon is an antiseptic containing chlorhexidine and cetrimide. It is designed for cleaning skin and minor wounds, not for high-level disinfection of medical instruments.
Option D: While specific concentrations of hydrogen peroxide are used for high-level disinfection, 2% glutaraldehyde is the more established and standard choice for this purpose, especially in the context of board exam questions.

Visual 1: Diagram: A chart comparing levels of disinfection (low, intermediate, high) with examples of chemicals and their targets (e.g., bacteria, viruses, spores).
Visual 2: Image: A tray of surgical instruments fully submerged in a glutaraldehyde solution (e.g., Cidex) in a well-ventilated room.
Visual 3: Infographic: Step-by-step process of instrument decontamination: 1. Cleaning, 2. Disinfection/Sterilization, 3. Rinsing, 4. Drying & Storage.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain High-level disinfection and sterilization of medical instruments as background academic context rather than a clinical decision trigger.
Proper instrument disinfection is a critical nursing responsibility to prevent healthcare-associated infections (HAIs) and the transmission of bloodborne pathogens like HIV, Hepatitis B, and Hepatitis C.
Nurses must adhere strictly to infection control protocols, including using the correct disinfectant for the specific instrument and pathogen, and wearing appropriate Personal Protective Equipment (PPE).
What if the instrument was a metal, heat-resistant one like a surgical forceps? In that case, autoclaving (steam sterilization) would be the preferred method over chemical disinfection because it is faster, more reliable, and does not involve toxic chemicals.

How to Approach the Question

Identify the key terms in the question: 'instrument' and 'free of HIV virus'. This points to a need for high-level disinfection or sterilization.
Evaluate each option based on its classification as a disinfectant or antiseptic.
Recall that 'spirit' (alcohol) is an intermediate-level disinfectant and 'Savlon' is an antiseptic, making them unsuitable for this purpose.
Compare the remaining options. 2% glutaraldehyde is the classic, textbook answer for high-level chemical disinfection of heat-sensitive instruments.
Select the option that represents the standard of care for achieving high-level disinfection against robust pathogens like viruses on medical equipment.

Concept Tested & Keywords

Concept Tested: High-level disinfection and sterilization of medical instruments.
Stem keywords: instrument, free of HIV virus
Lead-in keywords: kept in

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