401 Exam #2 Flashcards
Otitis media and UTIs = ________ type of infection?
Local
Bacteremia and septicemia are systemic infections (T or F?)
T
what is an etiologic agent?
microorganism capable of causing infection
what is reservoir?
source of infection
- parts of body, humans, plants, animals, general environment
what is the portal of exit?
How the pathogen leaves the reservoir
- saliva, coughing, vaginal discharge, open wound, need puncture site
what are the three modes of transmission?
direct, indirect, airborne
What determines a patient’s susceptibility to infection?
age and genetics
4 stages of infection
- incubation period
- prodromal stage
- illness stage
- convalescent stage
___________ defenses for infection include mucous membranes, intact skin, GI tract, GU tract, phagocytosis, inflammation, antibody and cell-mediated immune system
Physiological
Describe the chain of infection (E.R.P.M.P.S.)
E - etiologic agent. pathogen with virulence and ability to infiltrate the host and live in the host body
R - reservoir. where the organism usually resides. Includes patient’s own microorganisms from other parts of their body, other humans, plants, animals, and the environment
P - portal of exit. nose, mouth, vagina, anus, and open wounds (people are the most common source of infection for themselves and for others)
M - mode of transmission. direct, indirect, or airborne transmission
P - portal of entry. mouth, cuts in the skin, eyes, nose
S - susceptible host. ANYONE! mostly elderly, infants, and immunocompromised at risk
PPE for contact precautions includes _________ and ___________.
gown and gloves
PPE for DROPLET precautions includes _________, ________, ____________ and ___________.
gown, gloves, surgical mask, EYE PROTECTION
PPE for AIRBORNE precautions includes _________, ________, ____________ and ___________.
gown, gloves, N95 MASK, EYE PROTECTION
Infections that require CONTACT precautions (MRS. WEE).
M – multi-drug resistant organisms
R – respiratory infection
S – skin infections (varicella zoster, cutaneous diphtheria, herpes simplex, impetigo, pediculosis, scabies)
W – wound infection
E – enteric infection (clostridium difficile)
E – eye infection (conjunctivitis)
Infections that require DROPLET precautions (SPIDERMAN)
S – sepsis, scarlet fever, streptococcal pharyngitis
P – parvovirus B19, pneumonia, pertussis
I – influenza
D – diphtheria (pharyngeal)
E – epiglottitis
R – rubella
M – mumps, meningitis, mycoplasma or meningeal pneumonia
AN – adenovirus
Infections that require AIRBORNE precautions (MTV).
M – measles
T – tuberculosis
V – varicella
Clinical manifestations of sepsis
- Fever OR hypothermia (older adults/infants)
- hypotension
- no or low urine output
- Tachycardia
- Increased respirations
- Skin = rash or sweaty
- mental status changes
- musculoskeletal pain
Expected lab results of sepsis
- Abnormal CBC (leukocytosis or leukopenia)
- Alteration in clotting factors (thrombocytosis or thrombocytopenia)
- Elevated liver, C-reactive protein, and creatinine levels
- Positive blood culture
Are the following EARLY or LATE signs of septic shock?
Normal to hypotensive
Pulse >90 bpm
Respirations >20
Skin: warm, flushed
Mental status: alert, oriented, anxious
Urine output: normal
Other: increase or decrease in temperature, chills, weakness, nausea, vomiting, diarrhea, decreased CVP ( a normal central venous pressure is 2-8)
Early
Are the following EARLY or LATE signs of septic shock?
Hypotension
Tachycardia, arrhythmia
Rapid, shallow respirations, dyspneic
Skin: decreased cap refill, mottled, cool
Mental status: irritable, lethargic, comatose
Urine output: oliguria to anuria
Other: decreased or absent bowel sounds, decreased CVP
Late
What things need to be monitored when a patient has sepsis?
- vital signs (<100, MAP <65, CVP <2 = concerning)
- Hemodynamic monitoring
- I & O
- skin
- JVD
- mental status
- level of consciousness
What nursing actions need to be done when a patient has sepsis?
- obtain blood cultures
- IV fluids administered via Large-bore needle or central line
- Administer NS, LR, or crystalloids/colloids fluids
- maintain O2 above 90%
- Administer vasopressors
- Whole blood or blood products may be used after crystalloid bolus to increase oxygen-carrying capacity
What disease is a highly infectious airborne disease, and begins when a susceptible person inhales mycobacterium?
Tuberculosis
T or F: everyone who is infected with TB will develop the disease
False
(If the pt has an adequate immune response to tb bacilli, then scar tissue develops around the tubercle and the bacilli remain enclosed, these lesions will then calcify (they might be visible on an x-ray), but the pt will not develop the Tb disease)
T or F: TB pneumonia is the result of infected tubercles that rupture and spread the bacilli.
True
What diagnostics are used for T?
- tuberculin skin test (TST) or interferon-gamma
- acid-fast stain and culture
- chest x-ray
- NAAT
Risk factors for cellulitis
- Trauma to skin, breakdown of skin
- Impetigo, folliculitis, burns, stasis ulcers, abrasions
- Untreated tooth decay
- Otitis media
- Reduced physical activity
- diabetes mellitus
- obesity
- peripheral vascular disease
- tinea pedis
- Weakened immune system
- Malnutrition
What are the 3 most common causative agents of cellulitis? (3 bacterial strains)
Staph aureus, MRSA, Group A streptococcus
Nursing interventions for cellulitis.
Draining purulent drainage
Keep the area clean and dry
Maintain adequate hydration (fever)
Adequate nutrition to promote wound healing
Manage pain
Sepsis interventions for a concern of sepsis
Adequate rest
Elevating affected area above heart to reduce swelling
Infection control measure
Which type of conjunctivitis has watery rather than thick discharge? (viral, bacterial or allergic?)
viral
What are clinical manifestations of conjunctivitis?
Pink or red color in white of the eye(s)
Swelling of conjunctiva and/or eyelids
Increased tear production (inflammatory response)
Feeling like foreign body is in eye(s)
Urge to rub eye
Itching, irritation, and/or burning
Discharge (wateery, pus, mucus)
Crusting of eyelids or lashes, especially in morning
Don’t usually have pain but might have Photophobia
Pharyngitis
Fever
Malaise
Swollen lymph nodes
What chronic conjunctivitis is the leading cause of blindness in the world, caused by infected genital secretions, and resembles bacterial conjunctivitis?
Trachoma (caused by chlamydia)
type of precautions for TB?
airborne
T or F, negative pressure room is needed for airborne diseases?
True
hallmark symptom of TB
purulent, frothy sputum after dry cough
UTI risk factors
diabetes
dehydration
female anatomy
incontinence
menopause
signs infection has triggered inflammatory response?
vasodilation
fever
tachycardia/tachypnea
erythema
pain
swelling
client has O2 of 89%, what are some actions to take as nurse?
administer oxygen
raise head of bed
contact provider
encourage patient to take deep breaths
interventions for conjunctivitis
vision assessment
warm compress/cool compress
eye irrigation
photophobia management
infection control
antibiotics or antivirals
manifestations of otitis media
loss of balance
fever
difficulty hearing
fluid draining
pain
When to give an NSAID vs when to hold an NSAID
NOT:
- Ulcerative Colitis
A ________ is ONLY required when coming into contact with secretions for a DROPLET precautions
gown
manifestions of influenza
chills
fever
muscle aches
headache
sore throat
cough
malaise
education for flu vaccine
changes yearly
vulnerable populations are infants, young children and older adults
everyone over 6 months of age
who should get a colonoscopy?
45-75 years old
bowel disease
every 10 years
vague symptoms of cancer?
fatigue
loss of appetite / weight loss
fever
pain
skin changes
lab values to expect with leukemia?
low red blood cells / platelets (thrombocytopenia)
low leukocytes (leukopenia)
low erythrocytes (anemia)
symptoms of low H&H?
fatigue
SOB
arrythmias
dizziness
chest pain
cold feet, hands
manifestations sickle cell disease?
fatigue
SOB
pain due to vaso-occlusive crisis
infections
vision changes
nursing interventions for patients who have sickle cell?
administer O2
bed rest
blood transfusions
nutrition management
pain management
hydration
nursing interventions for appendicitis?
don’t apply heat
general concerns for patient with ulcerative colitis?
blood
electrolytes
nutrition
anemia
impaired function
skin integrity
emotional concerns
Where is McBurney’s Point?
Lower Right Quadrant (appendicitis)
nursing interventions for cholecystitis (gallbladder inflammation)?
education about nutrition (avoid high fat)
pain management
fever management
monitor I/O
NG tube to low suction
place in Fowler’s position
lab values to expect with glomerulonephritis (inflammed kidneys)?
proteinuria
increased creatinine and BUN
Decreased GFR
electrolyte imbalance
Risk factors for Peptic Ulcer Disease (PUD)?
stress
spicy foods
alcohol
H pylori infection
NSAID misuse/abuse
c
