A nurse is preparing to administer subcutaneous enoxaparin.
In which order should the nurse perform the following steps?

(Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

The RACE protocol dictates the sequence of events:

1. R – Rescue/Remove: The nurse’s first action is to remove any clients, visitors, or staff from the immediate area of danger (the smoke or fire). Assisting the client to a common area or behind fire-rated doors fulfills this step.

2. A – Alarm/Activate: After the client is safe, the nurse should pull the fire alarm and notify the facility operator of the exact location.

3. C – Confine/Contain: Once the alarm is set, the nurse should close doors and windows to prevent the spread of smoke and oxygen from feeding the fire.

4. E – Extinguish/Evacuate: If the fire is small and manageable, a fire extinguisher can be used. If not, the focus shifts to a full evacuation of the unit.

Choice A rationale: Closing doors is the "Confine" step of the RACE protocol. While this prevents oxygen from fueling the fire and contains smoke, it must only occur after the client is rescued.

Choice B rationale: Activating the alarm is the "Alarm" step. Notifying the facility is the second priority, but the nurse must first ensure the client is no longer in immediate physical danger.

Choice C rationale: This represents the "Rescue" step, which is always the first priority. The nurse must immediately move the client away from the smoke to ensure their safety and prevent inhalation.

Choice D rationale: Using an extinguisher is the "Extinguish" step, which is the final part of the protocol. It is only attempted after rescue, alarm, and containment are successfully completed.

Choice A rationale

Adverse effects of antituberculosis medications do occur, but taking a single medication doesn't necessarily reduce their frequency or severity. Combination therapy aims to prevent resistance, not specifically to avoid side effects.

Choice B rationale

Multiple medications in TB treatment don't directly protect the liver from toxic effects. In fact, they may increase the risk of hepatotoxicity, but the benefit outweighs the risk due to reduced resistance.

Choice C rationale

The primary reason for using multiple antituberculosis medications is to prevent the development of drug resistance. TB bacteria can quickly become resistant when only one medication is used, leading to treatment failure.

Choice D rationale

TB treatment typically involves multiple drugs regardless of the severity of the disease to ensure effective eradication of the bacteria and prevent resistance.