Re: any nclex takers in NOVEMBER-share study tips
Here are some very important facts. I got it from Random Facts thread. Very helpful for our review. Check the thread for other contents review. Good luck guys!!!
For contact precautions
diseases/conditions include: C. diff, E. coli, scabies
Room needs to be private unless room has another patient infected with the same organism
For droplet precautions
diseases/conditions include: meningitis, pneumonia, pertussis (whooping cough), rubella, mumps
Room needs to be private unless room has another patient infected with the same organism. Maintain spacial distance of 3 feet when near patient.
Also remember standard precautions apply to ALL PATIENTS regardless of diagnosis when in contact with any bodily fluid, blood, secretions/excretions, nonintact skin, and mucous membranes
1.
Varicella (chickenpox) requires use of airborne precautions and contact precautions as well.
2. If a patient is on contact precautions, have family members and other visitors wear a gown and gloves as outlined by your facility (hospital
1. When wearing gown and/or gloves, make sure to take them off and properly dispose of them, before leaving the patien'ts room.
#2. Pt's with herpes zooster (shingles) that is active should have the same precautions as a patient with chicken pox---airborne and contact
#3. Pt's on droplet precaution can have their room door left open.
#4. Instruct visitors for pt's with droplet precautions to try to keep a distance of three feet between them and the pt.
#5. Pt's with croup should be on contact precautions
Measles, chicken pox (varicella), disseminated varicella zoster, Tuberculosis
Barrrier Protection: single room maintained under negative pressure
door kept closed except when someone is entering
exiting the room
Negative airflow pressure used in room, (min of 6 - 12 air exchanges per hour depending on the facility
Ultraviolet germicide irradiation or high-efficiency
particulate air filter used in the room
Mask or personal respiratory protection device used
Mask placed on the client when client needs to
leave the room; client only leaves only if necessary!
RSV is contact precautions. So wear gloves and a gown. It is a respiratory infection that is transmited through contact with the secretions.
When you put your protective gear on start from top to bottom : mask-> gown-> and gloves. When you take them off start from bottom to top: gloves->gown->mask. (I tried to research this part just to make sure it is what I remember it to be, but found nothing so Im not 100% certain)
Wash hands between patients and whenever visibly soiled.
This is what I found on CDC web site (Guideline for Isolation
Precautions:Preventing Transmission of Infectious Agents in Healthcare Settings 2007 pdf doc) pp 129-130. There are even pictures showing the procedures
DONNING PPE (Personal Protective Equipment)
GOWN
Fully cover torso from neck to knees, arms to end of wrist, and wrap around the back
Fasten in back at neck and waist
MASK OR RESPIRATOR
Secure ties or elastic band at middle of head and neck
Fit flexible band to nose bridge
Fit snug to face and below chin
Fit-check respirator
GOGGLES/FACE SHIELD
Put on face and adjust to fit
GLOVES
Use non-sterile for isolation
Select according to hand size
Extend to cover wrist of isolation gown
SAFE WORK PRACTICES
Keep hands away from face
Work from clean to dirty
Limit surfaces touched
Change when torn or heavily contaminated
Perform hand hygiene
REMOVING PPE
Remove PPE at doorway before leaving patient room or in anteroom
GLOVES
Outside of gloves are contaminated!
Grasp outside of glove with opposite gloved hand; peel off
Hold removed glove in gloved hand
Slide fingers of ungloved hand under remaining glove at wrist
GOGGLES/FACE SHIELD
Outside of goggles or face shield are contaminated!
To remove, handle by “clean” head band or ear pieces
Place in designated receptacle for reprocessing or in waste container
GOWN
Gown front and sleeves are contaminated!
Unfasten neck, then waist ties
Remove gown using a peeling motion; pull gown from each shoulder toward the same hand
Gown will turn inside out
Hold removed gown away from body, roll into a bundle and discard into waste or linen receptacle
MASK OR RESPIRATOR
Front of mask/respirator is contaminated – DO NOT TOUCH!
Grasp ONLY bottom then top ties/elastics and remove
Discard in waste container
HAND HYGIENE
Perform hand hygiene immediately after removing all PPE!
Chicken pox(13-17 days)--prodromal, child have malaise, fever, anorexia.
Rash is pruritic, and starts out as a macule then papule then a vesicle.
Spread by direct contact, droplet and contaminated object.
ISOLATE till all vesicles are crusted; it can be spread from 2 days before the rash begins.
Avoid use of aspirin due to Reye's syndrome, use tylenol.
Airborn--door can be closed..measles (RUBEOLA), M. tuberculosis, disseminated zoster(shingles), varicella(chicken pox)--again can cohort and place in same room with the same infective organism.
Droplet--door may be open---Streptococcus pharyngitis, meningitis, pnemonia...private room or pt with same infection--involves contact with mucous membranes of nose or mouth...happens during talking, coughing, suctioning. MAINTAIN 3FEET between infected patients and visitors.
Tuberculosis, pt is on isolation for 2-4 weeks (until there are 3 negative sputum cultures.)
Syphilis--painless chancre that fades within 6 weeks...on palms and soles there is a copper colored rash...spread by contact with mucous membranes and also congenitally...tx with penicillin G IM
AIRBORNE
Anthrax
Chickenpox/ Shingles
Influenza
Measles
Rubeola
Smallpox
TB
PPE: N95/Mask; room is (-) pressure; pt must wear mask when transported
DROPLET
Bacterial Meningitis
Mumps
Pertussus
Pneumonia
Rubella
PPE: Mask; pt must wear mask when transported
CONTACT
Chickenpox
Croup
Cdif
Ecoli
RSV
Scabies
VRE
PPE: Gown, gloves
Transmission-based Precautions: ADC
A - Airborne
D - Droplet
C - Contact
AIRBORNE PRECAUTION (credit goes to the one who posted this on April thread, sorry can't remember your name)
My - Measles
Chicken - Chickenpox
Hez - Herpes Zoster (Disseminated)
TB - TB
Private room
Negative pressure with 6-12 air exchanges per hour
UV
Mask
N95 Mask for TB
DROPLET PRECAUTION
think of SPIDERMAN!
S - Sepsis
S - Scarlet fever
S - Streptococcal pharyngitis
P - Parvovirus B19
P - Pertussis
P - Pneumonia
I - Influenza
D - Diptheria (Pharyngeal)
E - Epiglottitis
R - Rubella
M - Mumps
M - Meningitis
M - Mycoplasma or meningeal pneumonia
An - Adenovirus
Private room
Mask
CONTACT PRECAUTION
MRS.WEE
M - Multidrug resistant organism
R - Respiratory infection - RSV
S - Skin infections
W - Wound infections
E - Enteric infections - clostridium defficile
E - Eye infections
Skin Infections:
V - Varicella zoster
C - Cutaneous diptheria
H - Herpes simplex
I - Impetigo
P - Pediculosis
S - Scabies, Staphylococcus
Private room
Gloves
Gown
Mumps is respiratory precautions.
Rubella is keep away from pregnant women.
Scarlet Fever is respiratory precautions till 24 hr after therapy is started.
German Measles ( Rubella ) requires standard precautions and droplet precautions
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I'm taking it about that time too. 2nd time, I failed the first time with 75 questions. 
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