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asepsis and infection control Flashcards

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1
Q

what are the components or “chains” included in the infection cycle

A
  • infectious agent
  • reservoir
  • portal of exit from reservoir
  • means of transmission
  • portals of entry
  • susceptible host
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2
Q

what can break the chain between the susceptible host and infectious agent

A
  • immunizations
  • screenings of healthcare staff
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3
Q

what can break the chain between infectious agent and reservoir

A
  • hand hygiene
  • sterilization
  • antibiotics/antimicrobials
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4
Q

what can break the chain between reservoir and portal of exit from reservoir

A
  • transmission based precautions
  • sterilization or use of disposable supplies
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5
Q

what can break the chain between portal of exit from reservoir and means of transmission

A
  • dry contact dressing
  • hand hygiene
  • wearing gloves if contact with body fluids
  • cover nose and mouth when sneezing
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6
Q

what can break the chain between means of transmission and portals of entry

A
  • hand hygiene
  • use pesticides to eliminate vectors
  • adequate refrigeration
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7
Q

what can break the chain between portals of entry and susceptible host

A
  • hand hygiens
  • wear gloves
  • use masks and ppe
  • proper disposal of sharps
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8
Q

what are infectious agents

A
  • bacteria
  • viruses
  • fungi
  • parasites
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9
Q

describe bacteria

A
  • most significant in healthcare setting
  • ex. staph/strep
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10
Q

describe viruses

A
  • smallest of all microorganisms
  • ex. ecoli and influenza
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11
Q

describe fungi examples

A
  • athletes foot
  • ringworm
  • yeast infection
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12
Q

describe parasites

A
  • live in or on a host and require the host to survive
  • malaria
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13
Q

are healthcare acquired infections never events?

A

yes

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14
Q

name three types of HAIS

A
  • iatrogenic
  • exogenous
  • endogenous
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15
Q

describe iatrogenic

A
  • results from a therapeutic or diagnostic procedure
  • ex. UTI from foley
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16
Q

describe exogenous infection

A
  • organisms external to patient/ not normally present
  • ex. salmonella
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17
Q

describe endogenous infection

A
  • microorganisms that exist as part of the normal flora become pathogenic
  • ex. streptococci, ecoli, and yeasts
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18
Q

name some HAIs commonly seen in healthcare settings

A
  • c diff (#1, generally happens to ppl on antibiotics and immunocompromised)
  • VAE (ventilator associated events)
  • CAUTI (catheter associated urinary tract infections)
  • CLABSI (central line associated bloodstream infections)
  • hepatitis A
  • influenza
  • TB
  • MDRO
  • blood borne pathogens
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19
Q

name some MDRO (multi-drug resistant organisms)

A
  • MRSA (methicillin resistant staphaureus)
  • VRE (vancomycin resistant enterococci)
  • c diff (clostridium difficile)
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20
Q

name some different bloodborne pathogens

A
  • hep B and C
  • HIV
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21
Q

describe direct contact

A

must touch

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22
Q

describe indirect vector contact

A

insect os carrier of disease (ex. tics mosquitos)

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23
Q

describe indirect fomite transmission

A

inanimate object is used where pathogen can exist

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24
Q

describe the difference between droplet and airborne transmission

A
  • difference is in the size of the particle and the distance it travels
  • droplets are larger and transmission occurs within 5-6 feet range
  • airborne particles are smaller (less than 5 mcm) and can travel over 5 feet
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25
Q

which of the following is the most significant and commonly found infection causing agent in healthcare settings?

A. bacteria

B. fungi

C. viruses

D. mold

A

bacteria

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26
Q

what is the first line of defense against infection

A
  • healthy, well maintained, and intact skin
  • normal flora (skin and GI tract)
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27
Q

what are the two protective responses in defending against infection

A
  • inflammatory
  • immune
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28
Q

describe inflammatory response

A
  • can be acute or chronic
  • occurs after trauma and infection
  • purpose is to eliminate invader
  • sets the stage for tissue repair
  • signs are due to both the vascular and cellular response
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29
Q

describe the vascular response during inflammatory response

A
  • vasoconstriction (decrease blood flow) followed by vasodilation (increase blood flow)
  • histamine release
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30
Q

describe cellular response during inflammatory response

A

WBCs move into the area (bc of increased blood flow)

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31
Q

what are the hallmark signs of inflammation (usually localized response)

A
  • redness
  • swelling
  • pain
  • heat
32
Q

describe immune response

A
  • complex mechanisms to protect and defend
  • humoral immunity (antigen-antibody response)
  • cellular immunity (increase in lymphocytes)
33
Q

what is an anitgen

A

an invader

34
Q

what is an antibody and what produces them

A
  • a blood protein produced in response to and counteracting a specific antigen
  • chemically combine with substances which the body recognizes as foreign substances in the blood
  • B lymphocytes produce antibodies
35
Q

describe cellular immunity

A

increase in lymphocytes (type of white blood cell) that destroy harmful cells and also the infected cells

36
Q

what do t lymphocytes do

A

attack cells of body that have been infected (have memories)

37
Q

how can a person achieve acquired immunity

A
  • vaccines
  • exposure to disease
  • another person antibodies (ex. breastfeeding newborn)
38
Q

describe vaccines

A
  • help develop immunity by imitating an infection. this type of infection almost never causes illness, but does cause the immune system to produce T-lymphocytes
  • sometimes after getting a vaccine, imitation infection can cause minor symptoms, such as fever. these are normal and should be expected as the body builds immunity
  • once imitation infection goes away, the body is left with a supply of “memory” T lymphocytes, as well as B lymphocytes that will remember how to fight the disease in the future.
  • usually takes a few weeks to produce T and B lymphocytes after vaccination
39
Q

describe a compromised host

A
  • breaks in skin and mucous membranes
  • invasive devices
  • stasis of body fluids
  • inadequate nutrition
  • stress/hyperglycemia
  • immune system dysfunction
  • co-existing medical problems
  • drug therapy
40
Q

describe some lifespan considerations to take with newborns/infants

A
  • only immune system they have is what they got from their mother
  • immune system is not fully functional until 6 months
41
Q

describe some lifespan considerations to take with toddlers/preschoolers

A
  • finish up vaccinations
  • require help with hygiene
  • stick everything in their mouths- gross
42
Q

describe some lifespan considerations to take with children/adolescents

A
  • go to school → immune system is exposed to more/new infections
  • more susceptible to skin diseases
43
Q

describe some lifespan considerations to take with adults/older adults

A
  • immunity is well established
  • nutritional status/hospitalization/chronic disease
  • as we age immune system may diminishes (booster may be required)
44
Q

describe the CDC

A
  • center for disease control
  • federal agency (department of health and human services)
  • tracks data
  • makes recommendations
45
Q

describe TJC

A
  • the joint commission
  • not a federal agency
  • accreditation is required to bill for medicare and medicaid services
  • inspections are unannounced
  • has chapters and standards for infection control
46
Q

describe OSHA

A
  • occupational safety and health administration
  • federal agency (department of labor)
  • has a right to conduct work inspections without notice
  • requires employers use:
  • universal precautions
  • -PPE*
  • -hep B vaccine*
  • -exposure follow up*
  • -employee training*
  • -monitoring compliance*
47
Q

true or false

standard precautions should be used when caring for a noninfectious postoperative patient who is vomiting blood

A

true

48
Q

standard precautions is also referred to as…

A

universal precautions

49
Q

describe standard precautions

A
  • decrease transmission from blood borne pathogens regardless of diagnosis
  • treat all bodily fluids as if they are contaminated with infectious substance
  • wear gloves when handling: blood, nonintact skin, mucous membranes and all body fluids, secretions, and excretions except sweat
  • new additions are respiratory hygiene/cough etiquette, safe injections practices, and directions to use a mask when performing high risk prolonged procedures involving spinal canal punctures
50
Q

name some of the many interventions to prevent or minimize the risk of transmission of infections within the healthcare setting

A
  • bundles (VAP, CAUTI, Time-outs)
  • needle-less devices
  • hand hygiene
  • PPE
  • isolation of infectious or at risk patients
  • immunizations of HCWs
  • protocols for disinfecting medical equipment
  • proper waste disposal
51
Q

describe isolation

A

isolating infectious people to prevent or reduce the spread of illness

52
Q

describe nursing responsibilities with isolation

A
  • educate pt and family and other HCWs
  • limit pt movement outside of room
  • ensure appropriate signage
  • private room or cohorting
  • ensure proper PPE is available
  • help police and enforce this with other providers
53
Q

describe reverse isolation

A
  • used with neutropenia (not enough WBC to fight infection)
  • no infection but pt is highly susceptible
54
Q

describe contact precautions

A
  • PPE - usually gloves, impervious gown
  • ex. cdiff (must use soap and water)
55
Q

describe droplet precautions

A
  • wear PPE - gloves, mask, face shield
  • keep visitors 3 ft from pt
  • ex. influenza, rubella, mumps, diptheria
56
Q

describe airborne precautions

A
  • most restrictive
  • wear PPE - N95 particulate respirator mask, gloves, impervious gown
  • negative pressure room
  • ex. TB, varicella, rubeola (measles)
57
Q

describe medical asepesis (clean)

A
  • includes all measures aimed at reducing the number or spread of microorganisms
  • examples: hand washing, gloving, gowning, disinfecting
58
Q

describe surgical asepsis (sterile)

A
  • prevent the introduction of microorganisms from the environment into the patient
  • examples:
  • surgical procedures
  • procedures involving: the bloodstream, broken skin or mucous membranes (certain dressings), insertion of medical equipment into body cavities
59
Q

describe different types of sterile technique

A
  • strict sterile → everything is sterile
  • sterile no touch → dont touch, injections are no touch sterile
60
Q

describe subjective data in assessment r/t asepsis and infection control

A
  • risk identification (exposure, comorbidities, medications)
  • nutrition (use of vitamins/herbs/supplements)
  • sleep
  • knowledge (prevention and isolation)
61
Q

describe objective data in assessment r/t asepsis and infection control

A
  • general survey
  • VS
  • auscultation
  • diagnostic tests and procedures
62
Q

what diagnostic tests and procedures are part of objective data in assessment

A
  • WBCs (4500-11000)
  • ESR (erythrocyte sedimentation rate) → increased with inflammation
  • lactate → increased with infection
  • cultures
  • radiologic tests
63
Q

what are the 4 stages of infection

A
  • incubation
  • prodromal
  • acute phase/illness
  • convalescence
64
Q

describe incubation

A
  • time between pathogens entrance and appearance of symptoms
  • can vary based on pathogen
65
Q

describe the prodromal stage

A
  • nonspecific symptoms (fever malaise, pain, nausea begin)
  • inflammatory response
66
Q

describe the acute phase/illness

A

specific symptoms caused by pathogen occur

67
Q

describe convalescence

A

antibodies are present in the blood and body systems begin to return to normal

68
Q

what are the manifestations of infection

A
  • fever (38C or 100.4F) - 104-107f is dangerous, fevers can get higher in the evening
  • increased pulse and respiratory rate
  • inflammation
  • pain
  • purulent drainage
  • enlarged lymph nodes
  • rash
  • GI symptoms - anorexia, nausea, vomiting, diarrhea
69
Q

describe sepsis

A
  • systemic inflammatory response to an infection → leads to multiple body systems failing
  • SIRS = systemic inflammatory response syndrome
  • remember: inflammation → vasodilation → first sign is hypotension (systolic less than 90)
70
Q

describe symptoms of septic shock

A
  • hypotension (SBP < 90mmhg)
  • T > 100.4 or < 96.8
  • WBC >12 or <4
  • HR > 90bpm
  • RR >20/min
  • altered mental status

infection + 2 other symptoms = sepsis

71
Q

name some different nursing diagnoses r/t asepsis and infection control

A
  • risk for infection
  • knowledge deficit
  • imbalanced nutrition
  • impaired physical mobility
  • impaired skin integrity
72
Q

describe planning r/t asepsis and infection control

A
  • establish outcomes and pts goals
  • set priorities
  • communicate for continuity
  • ex. pt will exhibit no signs or symptoms of infection by discharge AEB: temp WNL and WBCs WNL
73
Q

describe implementing and prevention r/t asepsis and infection control

A
  • standard precautions
  • medical and surgical asepsis
  • education
  • promote activities (hygiene, ambulation/positioning, pulmonary toileting)
  • EBP bundles
74
Q

describe pulmonary toileting

A
  • getting rid of stuff in the lungs
  • coughing and deep breathing and incentive spirometry are important
75
Q

describe implementation and treatment r/t asepsis and infection control

A
  • administer medications (antibiotics, analgesics, antipyretics)
  • education
  • isolation
  • monitor labs, radiologic test results
  • comfort measures (treat pain and fever, increase oral fluid intake, tepid baths, and rest)
76
Q

describe evaluating r/t asepsis and infection control

A
  • evaluate outcomes and interventions
  • coordinate with other members of the HC team and with the pt and support person

nursing 20030 (31 decks)

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