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NCLEX PART 1

CH 02. Safety & Infection Control

"Safety First!" is the golden rule of NCLEX.

You must know exactly which PPE to wear for which disease.
Also, remember: Restraints are a LAST resort.
Use them incorrectly, and it's considered battery or false imprisonment.

1. Transmission-Based Precautions

You will definitely get a question about "Who can room with whom?". Memorize these three categories.

Type Key Diseases (Mnemonics) PPE & Requirements
Airborne "MTV"
- Measles (Rubeola)
- Tuberculosis (TB)
- Varicella (Chickenpox) / Herpes Zoster (Shingles)
- N95 Respirator (Fit-tested)
- Negative Pressure Room
- Keep door closed
- Client wears surgical mask during transport
Droplet "PIMP"
- Pertussis (Whooping cough)
- Influenza
- Meningitis
- Pneumonia
- Surgical Mask
- Private room preferred
- Wear mask within 3 feet of client
Contact "MRS. WEE"
- MRSA / VRE
- RSV / Rotavirus
- Skin infections (Scabies, Impetigo)
- Wound infections
- Enteric (C.difficile)
- Eye infections (Conjunctivitis)
- Gown + Gloves
- Dedicated equipment (BP cuff, stethoscope)
- Hand Hygiene: Soap & Water for C.diff! (No Alcohol gel)

2. PPE: Donning & Doffing

The order matters! Putting it on protects you; taking it off protects you from contamination.

  • Donning (Putting ON):
    "Big to Small, Bottom to Top"
    1. Gown
    2. Mask / Respirator
    3. Goggles / Face Shield
    4. Gloves (Last!)
  • Doffing (Taking OFF):
    "Alphabetical Order" (mostly)
    1. Gloves (Dirtiest first!)
    2. Goggles
    3. Gown
    4. Mask (Protect your airway until the end)

3. Restraints & Fire Safety

① Restraints (Physical & Chemical)

  • Last Resort:
    Always try alternatives first (e.g., sitter, distraction, bed alarm).
  • Requirements:
    - MD order required within 1 hour (Renew every 24 hrs).
    - Check circulation/skin every 30 mins.
    - Release and offer ROM/toileting every 2 hours.
    - Tie to the bed frame (not side rails) using a quick-release knot.

② Fire Safety (R.A.C.E.)

  • R.A.C.E Rule:
    1. Rescue (Remove clients from danger)
    2. Alarm (Activate fire alarm)
    3. Confine (Close doors/windows)
    4. Extinguish (Use fire extinguisher)
  • P.A.S.S Rule (Extinguisher):
    Pull pin → Aim at base → Squeeze handle → Sweep side to side.

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