RN Nursing · Medical and Surgical Asepsis · Practice question
When entering a client's room to change a surgical dressing, a nurse notes that the client is coughing and sneezing. Which of the following actions should the nurse take when preparing the sterile field?
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Keep the sterile field at least 6 feet away from the client's bedside.
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✓
Place a mask on the client to limit the spread of microorganisms into the surgical wound.
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Instruct the client to refrain from coughing and sneezing during the dressing change.
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Keep a box of facial tissues nearby for the client to use during the dressing change.
Answer & explanation
Correct: Place a mask on the client to limit the spread of microorganisms into the surgical wound.
When a client is coughing and sneezing, airborne droplets containing microorganisms are dispersed into the environment and can contaminate a sterile field, introducing pathogens directly into an open surgical wound. Placing a mask on the client limits the spread of droplets at their source, protecting the sterile field and reducing the risk of surgical site infection. This is the most effective and practical intervention because it directly controls the source of contamination while still allowing the dressing change to proceed in a safe manner. Keeping the sterile field six feet away from the bedside is not feasible because the dressing must be applied to the wound, which is on the client. Instructing the client to refrain from coughing and sneezing is unrealistic because these are involuntary reflexes that cannot simply be stopped on command, and compliance cannot be guaranteed. Keeping facial tissues nearby addresses covering the mouth after the fact but does not prevent the initial aerosol dispersion that contaminates the field before the client can react. Source control through masking the client is the recognized standard practice for protecting a sterile field from a coughing or sneezing patient.
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