hey everyone it's Sarah with register nurirstrn.com and in this video I'm going to be doing an inlex review over precautions specifically standard precautions and transmissionbased precautions And as always in the YouTube description below or at the end of this video you can access the quiz that will test your knowledge on precautions So let's get started Okay Okay on the ENLEX exam you may be asked some questions about precautions and some things you want to pay attention to during this lecture is especially about these transmissionbased precautions like how are they transmitted specifically the airborne the droplet or the contact Um what PPE is required for each that you have to wear at all times and the diseases included in each category So what I'm going to do is I'm going to walk you through this and I'm going to give you three pneumonics on how to remember contact droplet and airborne What diseases are included in each of those precautions and what type of PPE you wear and that pneumonic will include all of that so you can move on and study other things and have this behind you Okay so first let's start out talking about standard precautions Okay standard precautions are precautions that we take with every single patient at all times because we don't know what they have and they could potentially have something that we're not aware of yet So um we do this to protect ourselves and to protect other patients Now if we suspect or know that a patient has a infectious disease we will add on the transmissionbased precautions like we'll put them e either an airborne if they have chickenpox or droplet if they had whooping cough which is ptasus So we would do that and follow keep following our standard precautions because there's some special steps that we want to take when we put them in either airborne contact or droplet Now some standard precautions include performing hand hygiene wearing appropriate PPE as needed how to handle patient equipment injection safety practices environmental cleaning respiratory hygiene/coughing etiquette handling of laundry and patient room placement Now let's look at some highlights specifically the hand hygiene and the PPE Okay first hand hygiene Hand hygiene will be performed by you before and after patient contact And you'll perform it after you wear gloves and if you touch any surfaces in a patient's room because they could be contaminated And whenever you perform hand hygiene you will either use soap and water or hand sanitizing gel Now there are some instances where you will only use soap and water and this includes when your hands are visibly soiled before eating or touching food after using the bathroom or if the patient has a diarrhea illness like Cadiff the Nora virus or the roto virus Now let's look at PPE PPE is personal protective equipment that you will use as needed to protect your skin clothing or mucous membranes from like potential splashes because again we don't know what this patient has So at all times for standard precautions we're going to take the necessary precautions to use the right type of personal protective equipment to protect ourselves from potential um maybe um splashes from blood or getting mucus on us from suctioning or something like that And some types of PPE are gloves which um are needed if you're coming into contact with any types of fluids like vomit stool urine mucus and blood Gowns which are needed if there is a potential contact with fluids or blood that could get onto your scrubs or clothing Goggles face mask or shield And this is needed if there will be any potential contact with fluids or blood like the patient starts coughing or vomiting while you're suctioning them or providing mouth care Okay Now let's look at transmissionbased precautions We just covered standard precautions but now our patient is placed into one of these precautions and based on whatever it is there's going to be some special things that we're going to do So let's look at airborne first Okay How are airborne diseases transmitted okay they're transmitted when a patient coughs or sneezes whatever gets a respiratory droplet to come out And in that respiratory droplet are germs And these germs are special types of germs with airborne And we'll take chickenpox for instance So this person has chickenpox They're coughing they're sneezing getting all these respiratory droplets out everywhere Well what happens is normally like in droplet precaution diseases the droplets will dry and the germ will die Say like it was a ptasus germ It'll dry after that droplet dries over time But with airborne um whenever the person sneezes that droplet comes out that germ survives that drying out process and actually turns into a droplet nuclei which is a very very small residue particle that is going to stay and float in the air and it's just waiting to be inhaled and that's what makes it so dangerous and why you have to wear a special mask with this an N95 5 mask because the particle is so small you can't see it And this person has to have special ventilation in the room to um clean the air out because these particles stay in there And the transmission is through inhalation You inhale it it goes down into your respiratory tract It um starts to live in there and grow So it's different than droplet because droplet these diseases will enter in through your eyes your nose your mouth your mucous membranes for you to in get infected with it So that's why we have to take some extra precautions with airborne and why it's different Now some diseases that are included in airborne are chickenpox which is also called vicella um disseminated herpes zoster which is also known as shingles and this disseminated is a widpread infection of this all over the body um also measles and tuberculosis And it's important to note that chickenpox and the disseminated herpes zoster the patient will also be in contact precautions along with airborne precautions as well So with those two remember that Now let's look at a pneumonic to help you remember what diseases are in airborne and um what special PPE you have to wear at all times with airborne precautions Okay this pneumonic says airborne chicken number 95 dissected her tubby meal worm and airborne is just telling you it's the airborne precaution The C and chicken represents chickenpox N in number and 95 represents the N95 mask you have to wear Dissected her represents disseminated herpes zoster Tubby rep represents tuberculosis and then mealworm represents measles Now with airborne you want to always wear the N95 mask at all times and follow the standard precautions So you will select your other types of PPE as needed based on what you're doing in that patient's room Also this patient will be in a special room with special ventilation an air room which is an airborne infection isolation room also called a negative pressure room And what happens is that it keeps the pressure lower in the patient's room than the outside room And you will and it will perform 6 to 12 air changes per hour to keep those residue particles droplet nuclei as low as it can And the door needs to be closed at all times because those particles can get out and float around and someone else can get it And uh transport this patient has to go to another testing part of the hospital Um see if you can get it by bedside so someone can come do it because it needs to be limited Um and limit that And if the patient has to leave the room uh they need to wear a mask a surgical mask Now let's look at droplet precautions How are these diseases transmitted they are transmitted when the person coughs sneezes talks etc produces that respiratory droplet Now these droplets are a lot larger than the droplets with the airborne and they travel less distance and um they fall usually about three feet Remember 3 feet is the magic number with this They travel that far And how they infect people is that these droplets go into the eyes the nose or the mouth And diseases included with droplet are diptheria the fngilkine epiglotitis flu meninja coakal disease like sepsis pneumonia or menitis mumps pneumonia myopplasm pneumonia parvo virus B19 also known as fifth disease pneumonic plague adenino virus streptocoal ferngitis whooping cough also called protessus rhino virus scarlet fever and German measles also called rebella and it's also important to know on this list that influenza the flu and the adenino virus the patients are also in contact precautions along with being in droplet precautions so let's look at pneumonic to help you remember all those diseases because that's a lot of diseases to remember for droplet okay so this pneumonic says "Whose adjustable droplet mask stops scary pneumatic fluid parasites pling plaguing distinguished German men?" My epic mom's Rhonda So let's analyze this Okay who's that represents whooping cough Adjustable that represents adinino virus Droplet is the type of precaution we're dealing with Mask is what you have to wear at all times when providing care for this patient Stops represents streptocoal ferngitis Scary represents scarlet fever Pneumatic represents pneumonia Fluid represents flu Parasites represents parvo virus B19 Plaging represents the pneumonic plague Distinguish represents diptheria German represents German measles also called rebella Men represents the meninja coakal diseases and remember that was sepsis you let the e in sepsis help you with this part of this pneumonic of men um m for menitis this m and then n for in the part of pneumonia so you remember that there's three and the word men will help you remember what three my is my plasm pneumonia epic for epiglotitis mums for mumps and in Rhonda for the rhino virus And you'll want to remember that while providing care to this patient you will always wear a surgical mask at all times and of course follow the standard precautions with this patient So for instance say that you um this patient is in droplet precautions and you need to provide mouth care to them and you know that droplet precautions with this this patient the respiratory droplets have a germ If they get in your eyes or your nose or your mouth you can get this So since you're going to be really up close in that patient's face providing mouth care and they're going to be coughing and gagging you'll want to wear your mask because that's what you're going to wear all the time but you'll want to throw on some goggles or a face shield Of course wear gloves and a gown because um you don't want to get any of those droplets on your body Okay Um with this there is no special air ventilation required because it doesn't produce that droplet nuclei those residue particles like how that happened in airborne The door can stay open with droplet precautions because remember um the droplets go for 3 feet and fall Um keep visitors and patient and other patients away from the patient about 3 feet or more And if they're to be transported somewhere for testing they you'll need to warn the area that they're getting a patient droplet precautions And the patient will need to wear a surgical mask during transport and while they're in the other area Okay Now let's look at contact precautions Our last one Okay These diseases or organisms are transmitted from direct or indirect contact from the patient or something the patient has touched So their environment is a big indirect place that you can pick up whatever germ they have So not only touching the patient but everything that the patient has come in contact with And these diseases include medication resistant diseases such as MRSA vre extended spectrum beta lactamase producers or klepsial pneumonia also diarrhea infections or of an unknown origin And those diarrhea infections can include cadiff noravirus or the roto virus Also want you want to keep in mind is hepatitis A And if the patient is diapered or incontinent of stool they'll need to be in contact precautions because hepatitis A is transmitted through the stool Okay also skin infections like impantigo lice scabies herpes simplex chickenpox skin dtheria or shingles And remember that patients with chickenpox and disseminated herpes zosture are in airborne precautions along with contact precautions and wound infections with excessive drainage or the stafacy Also pulmonary infections like RSV paralin influenza and eye infections like conjunctivitis And a pneumonic to help you remember that is dawn medical glove/gown with every contact precaution session And dawn will represent the diarrhea infections Medical will represent the medication resistant drugs Gloves gown is what you will always wear when in contact with these patients With represents wound drainage excessive wound drainage or safy Every represents eye infections like conjunctivitis Contact is the pneumonic It goes along for contact Precautions represents pulmonary infections like the RSV or parinfluenza And S represents the skin infections like impentigo lice herpes simplex and things like that And remember you will always wear gloves and a gown at all times when providing care to this patient and follow standard protocols based on what you'll be doing with that patient And um the patient it's best for them to be in a single room or if you can't get them in a single room group the patient with another patient who has the same disease And again with CIFF or Noravirus or the roto virus you have to perform hand hygiene with soap and water Hand sanitizer does not work So if you see a test question and it says patient has C diff um you're done providing care you remove your PPE what will you do next and you know it's hand hygiene but you will wash with soap and water not hand sanitizer Okay so that wraps up the Inlex review lecture over precautions Thank you so much for watching Don't forget to take the free quiz and to subscribe to our channel for more videos