Apex- Misc: Infection Flashcards
What is hte most common source of bloodstream infection in hospitalized patients?
central venous catheters
According to the CDC, what is the preferred method of skin prep before central line placement?
Chlorohexidine
The Surgical Care Improvement Project (SCIP) provides 7 measures designated to do what?
how many of them are we responsible for?
reduce the incidence of perioperatie surgical site infection
3
- prophylactic abx within 60 mins of incision (vanco 120)
- cardiac pateints must achieve glycemic contro (<200mg/dL)
- colororectal patients are normothermic upon arrival to PACU (>36 C)
Prophylactic antibiotics should be administered within how many minutes of surgical incision
whats the exception
60 mins
vanco = 120 mins
cardiac patients must achieve glycemiccontrol of less than what
200mg/dL
infection prevention (sCIP) protocol
According to SCIP, which kind of surgical patients need to be normothermic upon arrival to PACU
colorectal (>36 degrees)
Alochol based prep solutions must be allowed to dry for how long?
why?
2 mins
flammable
SCIP Protocol:
The choice of antibotic is determined by what
the site of surgery
SCIP protocol
Phophlyactic abx are discontinued within how many hours after surgery?
what about cardiac surgery patients?
24 hours
48 hrs
What is the most common cause of occupational exposure to HIV?
a needle-stick injury with a hollow-bore needle
Seroconversion rates after exposure to HIV-infected blood:
-Percutaneous injury (needle stick) =
-Mucous membrane exposure =
needle stick = 0.3%
mucous membrane = 0.09%
Which procedure places health care workers at the HIGHEST risk of developing a positive TB skin test?
a. bronchosocopy
b. video-assisted thoracoscopic surgery
c. cataract removal
d. ORIF of a femur
A. bronchoscopy
endotracheal intubation is the second-highest risk procedure
What happens if you have a positive TB skin test?
you get a CXR
3 drugs to treat TB
2 risks with these drugs
- Isoniazid (P450 inhibitor)
- Rifampin (P450 inducer)
- Pyridoxine
thrombocytopenia and renal failure
elective surgery should be delayed for TB pts until what 3 things have occured?
- they are on anti-TB chemo
- have had 3 negative acid-fast bacillus tests
- demonstrates improvement in symptoms
Myobacterium tuberucolosis is a bacillus that thrives in what kind of enviornment
what does it mainly target?
what can it also infect? (5)
Aerobic enviornment
anterior apical lung segments
brain
spine
joints
gi tract
kidneys
5 key symptoms of TB
*productive cough
*hemoptysis
*weight loss
*fever
*night sweats
anorexia and general malaize
What does the Mantoux test tet for?
AKA?
TB
tuberculin skin test
TB test should be read within what time frame
Positive TB test = site of induration > how many mm in a healthy pt vs immonocompromised pt (HIB)
48-72 hrs
> 10mm healthy
5mm immonocompromised
CXR with apical infiltrates and nodules
TB
T/F: a negative CXR rules out TB
True
what does acid-fast bicillus test?
sputum for TB
First line agent for TB
2 main side effecits
what can be done to reduce ffects
Isoniazid
peripheral neuropathy and hepatotoxicity
Pyridoxine can be added to reduce incidence of liver damage
5 side effects of Rifampin
- causes bodily secretions to turn orange/red
- renal failure
- thrombocytopenia
- anemia
- leukopenia
TB patients- what is placed between the y-piece and pt’s airway
-what is placed in the expiratory limb of the circuit?
high efficiency particulate air filter (HEPA)- between y-piece and pt aiwrway
Bacterial filter in the expiratory limb
