A nurse is caring for a client on a medical-surgical unit. Exhibits Which of the following actions are part of the isolation precautions for this client? Select all that apply.

Rationale A. Perform hand hygiene with at least 4 to 5 mL of hand sanitizer when leaving the client's room: Alcohol-based hand sanitizer is ineffective against C. difficile spores, which require mechanical friction with soap and water for removal. Handwashing is the required method when caring for clients with confirmed C. difficile. B. Provide a mask for the client when they are outside their room: The client has influenza, which requires droplet precautions to prevent respiratory particle spread during coughing or talking. Wearing a mask when outside the room reduces the risk of transmitting the virus to others in the hallway or waiting areas. C. Place the client in a room with positive air flow: Positive airflow rooms push air out into the hallway and are not appropriate for infections spread by respiratory droplets or for infections requiring contact precautions. The client with influenza and C. difficile should be placed in a standard private room using droplet plus contact precautions. D. Don a gown when entering the client's room: C. difficile is spread through contact with spores shed in stool, and gowns protect clothing from contamination. The presence of ongoing diarrhea increases the risk of spore dispersal in the environment. Wearing a gown helps prevent the spread of infection during direct and indirect contact. E. When removing personal protective equipment, remove gloves first: Gloves have the highest level of contamination because they come into direct contact with infectious materials such as stool and respiratory secretions. Removing gloves first prevents the transfer of pathogens to clean PPE surfaces or the nurse’s skin during removal.