Chapter 2 of 713% of exam

Safety and Infection Control

Safety and Infection Control focuses on protecting clients, staff, and visitors from injury and the spread of infection. The nurse applies standard and transmission-based precautions, prevents falls and errors, and responds correctly to emergencies such as fire and hazardous exposures.

Standard and Transmission-Based Precautions

Standard precautions apply to all clients, while transmission-based precautions add contact, droplet, or airborne measures based on the organism. Correct precaution selection prevents the spread of infection.

Use standard precautions always

Perform hand hygiene and use PPE whenever contact with blood or body fluids is possible.

Airborne precautions

Tuberculosis, measles, and varicella require a negative-pressure room and an N95 respirator.

Droplet precautions

Influenza and meningococcal meningitis require a mask and a private room when possible.

Contact precautions

MRSA, C. difficile, and scabies require gowns and gloves; use soap and water for C. difficile.

Personal Protective Equipment

PPE is donned and doffed in a specific order to protect the wearer from contamination. Hand hygiene frames every PPE sequence.

Donning order

Apply gown, then mask or respirator, then goggles, then gloves.

Doffing order

Remove gloves, then goggles, then gown, then mask, performing hand hygiene between and after.

Hand hygiene bookends PPE

Wash or sanitize hands before donning and after doffing every time.

Right PPE for the task

Select PPE based on anticipated exposure to blood, secretions, or airborne particles.

Fall Prevention and Restraints

Falls are a leading cause of client injury, especially in older, confused, or sedated clients. Restraints are a last resort, require an order, and demand frequent monitoring.

Screen for fall risk

Assess age, mobility, cognition, and medications; use bed alarms and frequent rounding for high-risk clients.

Modify the environment

Remove clutter, improve lighting, and keep the call light and needed items within reach.

Restraints need an order

Obtain a current provider order and use the least restrictive device for the shortest time.

Monitor restrained clients

Check circulation, skin, and needs every 15 to 30 minutes and use a quick-release knot on the bed frame.

Emergency and Environmental Safety

The nurse must respond quickly and correctly to fires, oxygen hazards, seizures, and hazardous exposures. Structured protocols guide safe action.

Follow RACE for fire

Rescue, Alarm, Confine, then Extinguish, in that order.

Prevent oxygen fires

Prohibit smoking and open flames near oxygen and use only water-based lubricants.

Prepare for seizures

Keep suction and oxygen at the bedside, pad rails, and never place objects in the mouth.

Decontaminate before care

Remove hazardous chemicals from the client before other treatment to protect the client and staff.

Error Prevention and Handling Hazards

Preventing medication and treatment errors relies on identity verification and safe handling of high-alert substances and allergens. Systems thinking reduces harm.

Verify two identifiers

Confirm client identity with two identifiers before medications, procedures, and transfusions.

Double-check high-alert items

Two qualified staff verify blood products, insulin, and other high-risk agents.

Honor allergy alerts

Provide latex-free or allergen-free supplies and hold any drug the client is allergic to.

Store medications safely

Keep drugs in original labeled containers, locked away from children, and discard expired medications.

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Management of Care

Health Promotion and Maintenance

Last updated: November 2026

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