An older client with a history of heart failure is admitted with influenza and requests assistance to sit up in bed to eat lunch. The nurse observes the unlicensed assistive personnel (UAP) wearing a gown and gloves to assist the client.
Which action should the nurse take?
A Review the need for the UAP to wear a face mask while in close contact with the client.
B Remind the UAP to apply a fitted respirator mask before entering the client’s room.
C Assign the UAP to provide care for another client and assume full care of the client.
D Instruct the UAP to notify the nurse of any changes in the client’s respiratory status.
The Correct Answer and Explanation is:
The correct answer is A. Review the need for the UAP to wear a face mask while in close contact with the client.
In this scenario, the client has been admitted with influenza, a contagious respiratory illness caused by the influenza virus, which primarily spreads through respiratory droplets when an infected person coughs, sneezes, or talks. Since influenza is transmitted through close contact, the use of appropriate personal protective equipment (PPE) is essential for preventing the spread of the virus.
The UAP is already wearing a gown and gloves, which are part of standard precautions. However, the UAP should also be wearing a face mask to protect against respiratory droplet transmission, especially when within 6 feet of the client. The nurse should intervene and review the need for the UAP to wear a mask, as this is a key aspect of infection control when caring for a patient with a contagious respiratory illness like influenza.
Option B, which suggests wearing a fitted respirator mask, would be necessary for airborne precautions, which are used for diseases like tuberculosis or measles. Influenza requires droplet precautions, not airborne precautions, so a standard face mask is sufficient, not a fitted respirator mask.
Option C, reassigning the UAP, is unnecessary as long as the UAP follows appropriate infection control measures, including wearing a face mask.
Option D involves instructing the UAP to monitor the client’s respiratory status, but UAPs are typically not responsible for making clinical assessments such as changes in respiratory status. This responsibility falls to the nurse, who must evaluate the client’s condition regularly. While it is important for UAPs to report concerns, this does not address the immediate need for proper PPE.
By choosing A, the nurse ensures that infection control protocols are followed, reducing the risk of influenza transmission to the UAP and others in the healthcare setting.