Which of the following actions is necessary before terminal sterilization in high-risk compounding?

The necessary action before terminal sterilization in high-risk compounding is to ensure that any manipulations of the compounded products are conducted in controlled conditions to prevent contamination. Terminal sterilization itself is a critical process used to eliminate viable microorganisms and requires certain precautions to guarantee the sterility of the product afterward.

Open air procedures are not compatible with sterile compounding as they significantly increase the risk of contamination from environmental sources. In contrast, controlled environments like laminar flow hoods or clean rooms, especially ones maintained at specific ISO class standards, are essential for high-risk compounding to minimize any possible contamination before sterilization occurs.

While refrigerated items may be necessary for the storage of certain materials, and isolation from other compounds can be important for reducing cross-contamination, both of these actions are secondary to the actual process of preparing the compounded product under proper conditions. Ensuring that compounding is performed in a way that minimizes exposure to open air is crucial to maintaining sterility until terminal sterilization can be applied. Thus, the emphasis on controlling environmental factors to reduce contamination risk aligns with good compounding practices before terminal sterilization.