A nurse is caring for a female client who sustained second- to third-degree burns. Reverse-protective isolation techniques are implemented. The nurse maintains reverse isolation by which of the following interventions?

  1. Perform surgical handwashing before entering the client's room
  2. Place the client in a single room maintained under positive pressure
  3. Using sterile sheets
  4. Using a sterile-type mask on entering the room
Explanation

Answer: B - The client should be placed in a single room maintained under positive pressure. A positive pressure room keeps the flow of air out of the room to protect the client from contaminants. The nurse must wash her hands before entering the room; surgical hand washing is not necessary. Sterile sheets are more appropriate for clients with immunosuppression. A non-sterile type mask must be worn on entering the room.

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