Asepsis Flashcards
What is a host?
Living being where an infectious, parasitic, or pathogenic agent resides and receives sustenance
Are all microorganisms harmful?
No, it depends on the type organism, its location, the host, and the circumstances.
Define antimicrobials
Drugs that treat infections by killing or slowing the growth of microbes causing infection…. bacterial infections are treated with drugs called antibiotics
Differences between antibiotics and anti microbial
Anti-microbials include antifungals and drugs that treat parasites and viruses
Common examples of bacteria that cause diseases
E. coli
Enterococcus
Pseudomonas
Staph
Common virus that cause infection
Hep B
HIV
Common cold
West Nile
Zika
Common fungi that caused infections
Yeast and molds
Types of parasites that causes infections
Tick and malaria
Define infection
A disease state that results from the presence of pathogens (which are disease producing microorganisms) in or on the body
What are the components of the infection cycle?
Infectious agent: bacteria, viruses, fungi
Reservoir: natural habitat of the organism
Portal of exit: point of escape for the organism
Means of transmission: direct contact, indirect contact, airborne route
Portal of entry: point at which organisms enter a new host
Susceptible host: must overcome resistance
What are the different shapes of bacteria?
Spherical (cocci)
Rod shaped (bacilli)
Corkscrew (spirochetes)
Define gram positive?
Gram-positive bacteria have a thick cell wall that resist decolorization and are stained purple
Define gram-negative
Gram-negative bacteria have chemically more complex cell walls, and can be decolorized by alcohol. Thus gram-negative bacteria do not stain.
What are aerobic and anaerobic bacteria?
Aerobic bacteria require oxygen to live and grow
Anaerobic bacteria can live without oxygen
What is the smallest of all microorganisms?
A virus. They are only visible with an electron microscope.
What are some infections caused by fungi?
Athletes foot, ringworms, and yeast infections
An organisms potential to produce disease in a person depends on a variety of factors including:
Number of organisms
Virulence of the organism or it’s ability to cause disease
Competence of the persons immune system
Length and extent of the contact between the person and the microorganism
What are possible reservoirs that support organisms pathogenic to humans?
People, animals, soil, food, water, milk, inanimate objects
What are carriers?
Some people who act as reservoirs for an infectious agent, demonstrate signs and symptoms of a disease. Other people act as reservoirs for the infectious agent, but do not exhibit any manifestations of the disease. These people are considered carriers. Carriers, although asymptomatic, can transmit the disease.
What is the portal of exit?
The portal of exit is the portal of escape for the organism from the reservoir. The organism cannot exert its influence, unless it moves away from its original reservoir.
What is direct contact?
Requires close proximity between the susceptible host and an infected person or carrier
What is an indirect contact?
Involved personal contact with either
1) a vector, which is a living creature that transmits an infectious agent to a human, usually an insect
2) and inanimate objects, called a fomite, such as equipment or countertops
Difference between airborne and droplet transmission
Droplet transmission is similar to airborne transmission. However, airborne particles are smaller than 5 µm, and droplets are greater than 5 µm.
What are the stages and infection progresses through?
Incubation
Prodromal stage
Full (active) stage of illness
Convalescent period
Who are the most immuno compromised?
Very young infants
Elderly
HIV patients
Those receiving chemo
Transplant patients
Diabetics
What is the incubation period?
The incubation period is the interval between the pathogens invasion of the body and the appearance of symptoms and infection. During this stage, the organisms are growing and multiplying.
What is the prodromal stage?
A person is most infectious during the prodromal stage. Early signs and symptoms of disease are present, but these are often vague, and non-specific. During this phase, the patient often is unaware of being contagious.
What is the full stage of illness
The presence of infection.
What are systemic symptoms?
Symptoms manifested throughout the entire body
What are localized symptoms?
Symptoms that are limited or occur in only one body area
What is the convalescent period?
Involves the recovery from the infection. The signs and symptoms disappear.
What is the inflammatory response?
The inflammatory response is a protective mechanism. Inflammation helps the body neutralize, control, or eliminate the offending agent, and prepare the site for repair.
When does the inflammatory response occur?
Infection and in response to injury. And it is either acute or chronic.
What are the Hallmark signs of acute infection?
Redness, heat, swelling, pain, and loss of function.
What are the two phases of the inflammatory response?
The vascular and cellular phases
What is the vascular phase?
In the vascular phase, small blood vessels, constrict in the area, followed by vasodilation of arterioles and venules that supply that area. This increase in blood flow results in redness and heat in the area. Histamine is released, leading to an increased permeability of vessels, which allows protein rich fluid into the area. At this point, swelling, pain, and loss of function can occur.
What is the cellular stage?
White blood cells (leukocytes) move quickly into the area. Neutrophils, the primary phagocytes engulfs the organism and consume cell debris and foreign material.
What is the immune response?
Another protective mechanism. The complex mechanisms that constitute the immune response occur as the body attempts to protect and defend itself.
The foreign material is called an antigen, and the body commonly responds to the antigen by producing an antibody.
What is another type of immune response?
Cell mediated immunity. This type of immunity involves an increase in the number of lymphocytes that destroy or react with cells the body recognizes as harmful.
What are factors affecting risk for infection?
Intact skin
Normal pH levels
Bodies white blood cells
Age, sex, and hereditary factors
Immunization, natural or acquired
Fatigue, climate, nutritional and general health status
Stress
Use of invasive, or indwelling medical devices
What are age related changes for pulmonary infections?
Decreased cough reflex
Decreased elastic recoil of lungs
Decreased activity of cilia
Abnormal swallowing reflexes
What are nursing strategies for pulmonary infections?
Place patient in sitting position to eat or drink
Encourage patient to drink plenty of fluids, unless contraindicated
Encourage patient to cough and deep breaths, or use spirometer
What are age related changes to urinary tract infections?
Incomplete emptying of bladder
Decreased sphincter control
Bladder outlet obstruction due to enlarge prostate gland
Pelvic floor relaxation due to estrogen depletion
Reduced renal blood flow
What are nursing strategies for UTI?
Discuss with patient need to void at regular intervals
Encourage patient to drink plenty of fluids, unless contraindicated
Administer meds for enlarged prostate (BPH) and estrogen depletion as prescribed
If patient wears absorbent product such as incontinence pad, instruct patient to change pad frequently and perform good perineal care
What are age related changes for skin infections?
Loss of elasticity
Increased dryness
Thinning of epidermidis
Slowing of cell replacement
Decreased vascular supply
Nursing strategies for skin infections
Encourage patient to drink plenty of fluids, unless contraindicated
Help patient to perform good hygiene practices daily
Apply lotion to skin as needed
Assess frequently for any breaks in skin integrity, rashes, or changes in skin
What is asepsis
Includes all activities to prevent infections or break the chain of infection. There are two asepsis categories: medical asepsis, and surgical asepsis
What is medical asepsis
Also known as clean technique, involves procedures, and practices that reduce the number and transfer of pathogens. Medical procedures include performing hand hygiene, and wearing gloves.
What is surgical asepsis?
Also known as sterile technique includes practices, used to render and keep objects and areas from microorganisms. Surgical asepsis procedures include inserting an urinary catheter or inserting an IV catheter
What are some clinical situations where an alcohol based hand rub is used to clean hands
Before direct contact with patients
After direct contact with patient skin
After contact with bodily fluids, mucus membranes, non-intact skin, and wound dressings, if hands are not visibly soiled
After removing gloves
After contact with objects (including equipment) located in patients environment
Before donning sterile gloves
What is an exogenous infection?
When the causative organism is acquired from other people
What is an endogenous infection?
Occurs when the causative organism comes from microbial life in the same person.
What is an iatrogenic infection
When it results from a treatment or diagnostic procedure
What are standard precautions?
Precautions used in the care of all hospitalized patients, regardless of their diagnosis or possible infection status
What is transmission based precautions?
Precautions used in addition to standard precautions for patients in hospitals with suspected infection with pathogens that can be transmitted by airborne, droplet, or contact routes.
Why do HAIs happen?
Poor infection control
During surgery
Use of invasive medical devices
Poor medical asepsis
What does a SERIOUS infection look like?
Sepsis/shock - organ failure, low temp and BP, elevated RR, decrease urine output
What are the 5 moments of hand hygiene?
Before touching a patient
Before clean/aseptic procedure
After body fluid exposure risk
After touching a patient
After touching patient surroundings
Some examples of contact precautions (diseases)
MRSA
VRE
VRSA
Hep A
C Diff (hand wash with soap!)
PPE for contact isolation
Gloves, gown
Place before entering and remove before leaving
Examples of droplet disease
Mumps, flu, adenovirus
PPE for droplet isolation
Mask, eye protection, gloves, transport client with mask
Hand sanitizer in and out
Some examples of airborne disease
TB
Measles
Chickenpox
PPE used for airborne transmission
N95, gloves, gown, googles/face shield
Transport patient with mask
Hand sanitizer in and out
Patient will be in negative pressure room
What does donning PPE mean?
Putting it on
What is the order to put on PPE
Hand hygiene
Gown
Mask
Goggles/face shield
Gloves
What is doffing PPE mean?
Taking it off
Correct order to take off PPE?
Gloves
Face shield
Gown
Mask
Hand hygiene
When is hand washing preferred over alcohol rubs?
When hands are visibly soiled
Hands are contaminated with blood or body fluids
Before eating and after using the wash room
If exposed to certain organisms like c diff, anthrax or Nora virus
