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student assigned pt with respiratory MRSA

Nurses   (8,329 Views 24 Comments)
by jane850 jane850 (New Member) New Member

582 Visitors; 2 Posts

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I'm a 1st semester nursing student and have been assigned a patient for my first physical assessment. The pt has COPD, Lung Cancer and has MRSA in her lungs. I have to say, I'm a bit freaked out by it. Kardex calls for contact precautions and a mask if coughing. I'm concerned if a simple mask is enough. Should I wear eye protection? I don't want to be wimpy, but I'm nervous about the respiratory MRSA. Any suggestions? My clinical is tomorrow morning. Thanks in advance for your advice.

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PAERRN20 has 3 years experience and specializes in ER.

7,002 Visitors; 660 Posts

Ask your instructor if you have any dobuts, but ALWAYS err on the side of caution (especially in nursing!)

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mariahas4kids has 3 years experience and specializes in hospice, corrections.

3,281 Visitors; 86 Posts

MRSA isn't as scary as a lot of people make it out to be. It is a staph infection that is resistant to 'cillins. A huge population of people have it in their nose. Everyone has staph in their nose (it likes to live in moist, warm places) If the patient is coughing, wear a mask. :nurse: I teach infection control and work in a prison. Most MRSA is a contact precaution because it can cause skin infections, and that is where a lot of it is found. Just like you would be cautious around a person with the flu, be cautious around MRSA.

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classicdame is a MSN, EdD and specializes in Hospital Education Coordinator.

2 Articles; 26,120 Visitors; 7,255 Posts

There should be a sign on the door telling you what to wear. Go for all PPE if you want. If that patient is coughing wear a mask. If not sure, wear a mask. Gloves and gown are required for contact isolation. If you feel goggles would make you more confident then wear them. Be comfortable and safe.

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14,889 Visitors; 937 Posts

I'm half way through my second semester of nursing school, and every one of my patients have had MRSA and many have had VRSA. Just wear PPE (mask, gloves, gown, shoe covers, cap); make sure your face mask has a shield or wear goggles; and practice hand hygiene.

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Sun0408 has 4 years experience as a ASN, RN and specializes in Trauma Surgical ICU.

35,872 Visitors; 1,761 Posts

I have yet to wear shoe covers, mask, or a cap for MRSA.. Just follow the facilities protocol and talk to your instructor if you need more info.. Gown and gloves are just fine for MRSA. If the pt is coughing then yes where the mask.. You will run into a lot of pts with MRSA,VRE,AIDS,TB, hep B and C.. Just follow procedure.

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CCL RN has 10 years experience as a RN and specializes in Cath Lab/ ICU.

11,687 Visitors; 557 Posts

Oh gees. Just gown and glove. If the pt is coughing up phlegm at you, then you can wear a mask. Wash your hands.

Probably 20 people at the grocery store that you went to last had resp mrsa...

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SlightlyMental_RN specializes in chemical dependency detox/psych.

6,173 Visitors; 471 Posts

Ah, yes....I remember being so freaked out at the first times that I encountered MRSA, etc. It's really not that bad, though. I think that the thing to keep in mind, is that you have a healthy immune system, whereas these people got the infections d/t having a compromised immune system. There are many people that are walking around in the community that are MRSA positive. As a previous poster mentioned, you have, no doubt, already been exposed to it. Just wear any PPE that the infection control people put out there for you, and there will usually be a sign telling you what to put on. It will be okay...just wear your PPE and wash your hands well.

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12,738 Visitors; 763 Posts

What a great opportunity to learn about MRSA and precautions. Just tackle it and get it over with and from now on it won't seem so scary.

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studentmom77 has 2 years experience and specializes in LTC.

1,894 Visitors; 52 Posts

Remember the real reason to use precautions is to protect the other pts. many of them are immuno-compromised and much more likely to catch anything than you are (assuming you are healthy) always keep that in mind as you move from room to room. The only reason I could see for real concern is if you have someone at home who is compromised in that case I might speak with the instructor to be certain that you know all you need to but really all you need to know is what we all reviewed the 1st day of nursing school ....hand washing and more hand washing:nurse:

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Noimanurse specializes in Med./Surg. and paramed. exams.

3,285 Visitors; 154 Posts

As others have said, its not as CRAZY as it sounds, but it is a good lesson to learn precautions. Many people you come in contact with anywhere (i.e. work) will have MRSA and all other kinds of bugs and diseases. Many of these will not be diagnosed or known in any form...use precautions as necessary and wash those hands whether they've been diagnosed or not.

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9,661 Visitors; 486 Posts

mrsa isn't as scary as a lot of people make it out to be. it is a staph infection that is resistant to 'cillins. a huge population of people have it in their nose. everyone has staph in their nose (it likes to live in moist, warm places) if the patient is coughing, wear a mask. :nurse: i teach infection control and work in a prison. most mrsa is a contact precaution because it can cause skin infections, and that is where a lot of it is found. just like you would be cautious around a person with the flu, be cautious around mrsa.

i've yet to see evidence-based data saying that all of us or even a majority are staph aureus carriers. here's a study that you might find interesting (32.4 percent studied were colonized with staph while 0.8 percent were colonized with mrsa):

http://www.ncbi.nlm.nih.gov/pubmed/16362880

for 2001-2002, national s. aureus and mrsa colonization prevalence estimates were 32.4% (95% confidence interval [ci], 30.7%-34.1%) and 0.8% (95% ci, 0.4%-1.4%), respectively, and population estimates were 89.4 million persons (95% ci, 84.8-94.1 million persons) and 2.3 million persons (95% ci, 1.2-3.8 million persons), respectively.

to the op: it is a good idea to wear an eye shield and mask if the pt is coughing and you may be close to them. if not, gown and gloves.

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