Bacterial, Viral, Fungal, and Parasitic Infections - ATI Chapter 56 Flashcards
______ are the micro-organisms or microbes that cause infections.
Pathogens
_____ is the ability of a pathogen to invade the host and cause disease.
Virulence
_____ is a common viral infection that erupts years after exposure to chickenpox and invades a specific nerve tract.
Herpes zoster i
_______ is the most common type of pathogen (Staphylococcus aureus, Escherichia coli, Mycobacterium tuberculosis)
bacteria
______ are organisms that use the host’s genetic machinery to reproduce (rhinovirus, HIV, hepatitis, herpes zoster, herpes simplex)
viruses
____ are molds and yeasts (Candida albicans, Aspergillus)
fungi
_____ are protein particles that have the ability to cause infections (Creutzfeldt-Jakob disease).
prions
____ are organisms that live on and often cause harm to a host organism.
parasites
Malaria and toxoplasmosis are examples of
protozoa
Worms: flatworms, roundworms are examples of
Helminths
Schistosomes are examples of
Flukes
Lice, mites, ticks are examples of
Arthropods
The infection process (________) includes the following.
chain of infection
______ of infections include bacteria, viruses, fungus, prion and parasites.
causative agent
Examples of ______ of infection include humans, animals, food, water, soil, insects, and fomites.
reservoir
Portals of exit from (means leaving) the host
respiratory tract gastrointestinal tract genitourinary tract skin/mucous membranes blood/body fluids
HIV and hepatitis B and C exit the body (portal of exit) via ______.
blood/body fluids
Herpes simplex virus and varicella exit the body (portal of exit) via ______.
skin/mucous membranes
Escherichia coli, herpes simplex virus (type 1), HIV exit the body (portal of exit) via _______.
genitourinary tract
Shigella, Salmonella enteritidis, Salmonella typhi, hepatitis A, C. diff exit the body (portal of exit) via ______.
gastrointestinal tract
Mycobacterium tuberculosis and Parainfluenza virus exit the body (portal of exit) via ______.
respiratory tract
Modes of transmissions
contact
droplet
airborne
vector-borne
Contact modes of transmission
direct physical contact
indirect contact with a vehicle of transmission
fecal-oral transmission
Person to person transmission is known as _____ contact.
direct physical
Inanimate objects, water, food, and blood are modes of transmission known as _______.
indirect contact with a vehicle of transmission
Handling food after using a restroom and failing to wash hands result in the _______.
fecal-oral transmission
_____ transmission is when large droplets travel through the air up to 3 to 6 feet (sneezing, coughing, and talking).
droplet
_____ transmission is when small droplets remain int he air and can travel extended distances depending on airflow (sneezing and coughing)
airborne
_____ transmission occurs when animals or insects as intermediaries (ticks transmit Lyme disease; mosquitoes transmit West Nile virus and malaria).
vector-borne
The portal of ______ to the host is often the same as the portal of exit.
entry
A _______ has compromised defense mechanisms (immunosuppression, breaks in skin) leave the host more susceptible to infections.
susceptible host
______ allows the body to restrict entry or immediately respond to a foreign organisms (antigen) through the activation of phagocytic cells, complement and inflammation.
nonspecific innate - native immunity
______ immunity provides temporary immunity but does not have memory of past exposures.
nonspecific innate-native
Intact skin is the body’s _____ of defense against microbial invasion.
first line
The skin, mucous membranes, secretions, enzymes, phagocytic cells, and _______ work in concert to prevent infections.
protective proteins
Phagocyic cells (neutrophils, eosinophils, macrophages), the complement system, and ______ are involved in the inflammatory response.
interferons
An ________ localizes the area of microbial invasion and prevents its spread.
inflammatory response
_______ allows the body to make antibodies in response to a foreign organism (antigen).
specific adaptive immunity
Specific adaptive immunity requires time to react to _____.
antigens
_____ immunity provides permanent immunity due to memory of past exposures.
specific adaptive
______ immunity involves B and T lymphocytes.
specific adaptive
Specific adaptive immunity produces specific ______ against specific antigens (immunoglobulins: IgA, IgD, IgE, IgG, IgM)
antibodies
The 5 immunoglobulins produced via specific adaptive immunity
IgA IgD IgE IgG IgM
Environmental Risk Factors
excessive alcohol consumption
nicotine use: smoking, smokeless tobacco
malnutrition
Medication therapy (immunosuppressive agents) Risk Factors
glucocorticosteroids
antineoplastics
Chronic disease Risk factors
Diabetes mellitus Cancer HIV, AIDS Peripheral vascular disease Chronic pulmonary disease Heart failure
Older adults are at increased risk for _______.
infection
Older adults are at increased risk for infection because of the slowed response to ______.
antibiotic therapy
Older adults are at increased risk for infection because of the slowed ______: indicators of infection are more difficult to identify, resulting in possible delays in diagnosis and treatment.
immune response
Older adults are at increased risk for infection because of the loss of _______ and thinning of the skin.
subcutaneous tissue
Older adults are at increased risk for infection because of the decreased vascularity and slowed ______.
wound healing
Older adults are at increased risk for infection because of the decreased cough and ____ reflexes.
gag
Older adults are at increased risk for infection because of the ________ such as diabetes mellitus, COPD, neurological or musculoskeletal impairments)
chronic illnesses
Older adults are at increased risk for infection because of the decreased _____ acid production.
gastric
Older adults are at increased risk for infection because of the _____ mobility.
decreased
Older adults are at increased risk for infection because of the bowel/bladder ______.
incontinence
Older adults are at increased risk for infection because of _______.
dementia
Older adults are at increased risk for infection because of the greater incidence of _____ devices (urinary catheters, feeding tubes, tracheostomies, intravenous lines)
invasive
Common indications of _____ are not always present in the older adult client. Altered mental status, agitation, or incontinence can be present instead.
infection
Expected findings with infections
chills
sore throat
fatigue and malaise
change in level of consciousness, nuchal rigidity, photophobia, headache
nausea, vomiting, anorexia, abdominal cramping and diarrhea
localized pain or discomfort
Physical assessment findings with an infection
Fever
Increased pulse and respiratory rate, decreased blood pressure
localized redness and edema
enlarged lymph nodes
dyspnea, cough, purulent sputum, and crackles in lung fields.
dysuria, urinary frequency, hematuria, and pyuria
rash, skin lesions, purulent wound drainage, and erythema
dysphagia, hyperemia, and enlarged tonsils
Lab tests for infection
white blood cell (WBC) count with differential
Erythrocyte sedimentation rate (ESR)
Immunoglobulin electrophoresis
Antibody screening tests
Antibody screening tests
Auto-antibody screening tests
Antigen tests
Stool for ova and parasites
Culture and Sensitivity
An elevated _____ is an indicator of infection (expected reference range is 5k to 10k /mm^3).
white blood cell (WBC) count
The differential with a WBC identifies specific types of WBC’s that can assist in diagnosis of the ______ of infection or the specific type of pathogen.
severity
The rate at which ______ settle out of plasma is determined by the Erythocyte sedimentation rate (ESR).
red blood cells
An elevated ______ is an indicator of an active inflammatory process or infection (expected reference range is 15 to 20 mm/hr)
ESR
An increase indicates in ESR indicates an ______ inflammatory process or infection.
active
The immunoglobulin electrophoresis determines the presence and quantity of specific ________.
immunoglobulins (IgG, IgA, IgM)
_______ is used to detect hypersensitivity disorders, autoimmune disorders, chronic viral infections, immunodeficiency, multiple myeloma, and intrauterine infections.
immunoglobulin electrophoresis
______ tests detect the presence of antibodies against specific causative agents (bacteria, fungi, viruses, parasites).
antibody screening tests
A _______ antibody screening test indicates that the client has been exposed to and developed antibodies to a specific pathogen, but it does not provide information about whether or not the client is currently infected (HIV antibodies)
positive
_____ detect the presence of antibodies against a person’s own DNA (self-cells).
auto-antibody screening tests
Auto-antibody screening tests detect the presence of antibodies against ______ is associated with autoimmune conditions (systemic lupus erythematosus, rheumatoid arthritis).
self cells
______ detect the presence of a specific pathogen (HIV).
antigen tests
Antigen tests are used to identify certain infections or _____.
disorders.
_______ detects presence of ova and parasites, such as hookworm ova in stool.
stool for ova and parasites test
_____ separate stool specimens usually are collected for stool for ova and parasites test.
three
Each specimen must be transported to the lab while it is still _____ for the stool for ova and parasites test.
warm
A _____ is a microscopic exam to identify an infecting organism.
culture
Cultures can be obtained from blood, sputum, urine, wound and _____.
soft tissue
Cultures should be obtained before any _____ is initiated.
antibiotic
The sensitivity report indicates which antibiotics are _____ against the identified organism.
effective
X-rays, computed tomography (CT) scan, ______ , and biopsies are used to determine the presence of infection, abscesses, and lesions.
magnetic resonance imagining (MRI)
A _____ is a nuclear scan that uses a radioactive substance to identify hot spots of WBC’s within the client’s body.
Gallium scan
Radioactive gallium citrate is injected intravenously and accumulates in areas where _____ is present.
inflammation
Patient centered care involves assessing the presence of risk factors for ____.
infection
Patient centered care involves assessing recent _____ or exposure to an infectious disease.
travel
Patient centered care involves assessing _____ that can put the client at increased risk.
behaviors
Patient centered care involves assessing increased temp, heart and respiratory rate, thirst, and _____.
anorexia
Patient centered care involves assessing the presence of _____, which occur when temperature is rising, and diaphoresis, which occurs when temperature is decreasing.
chills
Patient centered care involves assessing the presence of _______ (greater than 105.8F) which can cause brain and organ damage.
hyperpyrexia
Patient centered care involves implementing infection control measures which include performing frequent ______ to prevent transmission of infection to other clients.
hand hygiene
Patient centered care involves implementing infection control measures which include maintaining a clean _____.
environment
Patient centered care involves implementing infection control measures which include performing wound care measures, such as ______.
sterile dressing changes
Patient centered care involves implementing infection control measures which include the use of _______ (gloves, masks, gowns, goggles)
personall protective equipment/barriers
Patient centered care involves implementing infection control measures which include encouraging recommended ______.
immunizations
Patient centered care involves implementing infection control measures which include the implementation of _______ as needed.
protective precautions
Patient centered care involves implementing infection control measures which include encouraging adequate rest and _____.
nutrition
Patient centered care involves implementing infection control measures which include providing _____ activities if needed.
diversional
Patient centered care involves implementing infection control measures which encourageme of ____ intake or maintaining intravenous fluid replacement to prevent dehydration.
increased fluid
Patient centered care involves implementing infection control measures which protect and maintain the client’s _____ (skin, mucous membranes)
protective barriers
____ protective precautions that are implemented for all clients.
standard
You need to use ____ precautions for C diff, herpes simplex virus, impetigo, MRSA, and VRSA.
contact
You need ____ precautions for Haemophilus influenzae type B (Hib), pertussis, mumps, rubella, plague, streptococcal pneumonia, and meningoccoccal pneumonia.
droplet
You need _____ precautions for measles, varicella, and tuberculosis.
airborne
Acetaminophen and aspirin are used for fever and discomfort as prescribed and known as _____.
antipyretics
When using antipyretics monitor fever to determine effectiveness of _____.
medications
When using antipyretics document temperature ______ on the medical record for trending.
fluctuations
______ meds kill pathogens or prevent their growth.
antimicrobial therapy
____ are given for worm infestations.
anthelmintics
There are currently no treatments for _____.
prions
Administer anitmicrobial therapy as ____.
prescribed
When using antimicrobial meds monitor for medication ______ (reduced fever, increased level of comfort, decreasing WBC count)
effectiveness
Maintain a medication ______ with antimicrobial therapy to assure consistent therapeutic blood levels of the antibiotic.
schedule
Patient education in regards to infection should include (3)
any infection control measures needed at home
self-administration of medication therapy
complications that need to be reported immediately
______ should receive the H. influenzae type b (Hib) vaccine.
infants
Adults and _______ at risk should receive the pneumococcal polysaccharide vaccine (PPSV).
older adults
____ should receive the meningococcal vaccine on schedule and prior to living in a residential or communal setting.
adolescents
_____ are becoming less effective for some strains of pathogens, due to the pathogen’s ability to adapt and become resistant to previously sensitive antibiotics. This significantly _____ the number of antibiotics that are effective against the pathogen.
antimicrobials
limit
Use of antibiotics, especially _______ antibiotics, has significantly decreased to prevent new strains from evolving.
broad-spectrum
____ is a strain of S. aureus that is resistant to all antibiotics, except vancomycin.
MRSA
____ is a strain of S. aureus that is resistant to vancomycin but so far is sensitive to other antibiotics specific to the strain.
VRSA
Monitor antimicrobial levels and ensure that therapeutic levels are ____.
maintained.
Implement precautions to prevent the spread of _____, in particular with medication-resistant infections.
infection
Patient education about medication-resistant infections should include making sure they know to _____ the full course of antimicrobial therapy.
complete
Patient education about medication-resistant infections should include making sure they know to avoid the _____ of antimicrobials.
overuse
______ is a systemic inflammatory response syndrome resulting from the body’s response to a serious infection, usually bacterial (peritonitis, meningitis, pneumonia, wound infections and UTIs)
sepsi
Sepsis is a potentially _____ complication that can lead to widespread inflammation, blood clotting, organ failure, and shock.
life-threatening
Blood cultures definitively diagnose _____.
sepsis
Systemic _____ are prescribed accordingly for sepsis.
antimicrobials
Vasopressors and ______ may be prescribed for shock and blood clotting manifestations with sepsis.
anticoagulants
Mechanical ventilation, dialysis, and other interventions can be needed for treatment of ________ with sepsis.
specific organ failure
Risk Factors for Sepsis
Very young age
Very old age
Weakened Immune system
sever injuries (trauma)
Herpes zoster is a ____ infection.
viral
Herpes zoster initially produces chickenpox, after which the virus lies dormant int he ______ of the sensory cranial and spinal nerves. It is reactivated as shingles later in life.
dorsal root ganglia
____ is usually preceded by a prodromal period of several days, during which pain, itching, tingling, or burning can occur along the involved dermatome.
shingles
Shingles can be very painful and _____.
debilitating
Risk factors for Herpes zoster (Shingles)
concurrent illness stress compromise to the immune system fatigue poor nutritional status
Possible _________ makes older adult clients more susceptible to herpes zoster infection. Assess the client carefully for typical and atypical indications of infections.
immunocompromise
Expected finding with Herpes zoster (Shingles)
paresthesia (tingling, prickling)
pain that is unilateral and extends horizontally along a dematome
With ______ during a physical assessment you might find vesicular, unilateral rash (the rash and lesions occur on the skin area innervated by the infected nerve)
Herpes zoster (Shingles)
With ______ during a physical assessment you might find if the eye is infected there are changes or a loss of vision.
Herpes zoster (Shingles)
With ______ during a physical assessment you might find rash that is erythematous, vesicular, pustular, or _____ (depending on the stage).
Herpes zoster (shingles) crusting
Herpes zoster (shingles) presents in a physical exam as a rash that usually lasts _____.
several weeks
With Herpes zoster (shingles) there is usually a ____ fever.
low-grade
_____ provide a definitive diagnosis of Herpes zoster (Shingles) (but the virus grows so slowly that cultures are often of minimal diagnostic use)
cultures
Occasionally, and _______ assay can be done for Herpes zoster (Shingles)
immunofluorescence
For a patient with Herpes zoster (Shingles) you want to assess/monitor (5)
pain condition of lesion presence of fever neurologic complications indications of infections
Use an air mattress or _____ for pain prevention/control of affected areas for patients with Herpes zoster (Shingles)
bed cradle
With ______ you need to isolate the client until the vesicles have crusted over.
Herpes zoster (Shingles)
With ______ you need to maintain strict wound care precautions.
Herpes zoster (Shingles)
With Herpes zoster (Shingles) the virus can be transmitted through _____ causing chickenpox. Avoid exposing the client to infants, pregnant women who have not had chickenpox, and clients who are immunocompromised.
direct contact
Moisten dressings with cool tap water or 5% aluminum acetate (Burow’s solution) and apply to the affected skin for ___ to ___ , four to six times per day as prescribed for patient’s with Herpes zoster (Shingles).
30 to 60 minutes
With Herpes zoster (Shingles) use _____, such as calamine lotion, or recommend oatmeal baths to help relieve itching and discomfort.
lotions
For patients with Herpes zoster (Shingles) administer _____ as prescribed.
medications
_____ (NSAIDs, narcotics) enhance client comfort.
Analgesics
If medications are started soon after the rash appears with Herpes zoster, ______, such as acyclovir, can decrease the severity of the infection and shorten and clinical course.
antiviral agents
Recommend zoster vaccine live for clients _______ to prevent shingles. This vaccine does not treat active shingles infections.
60 and older
Postherpetic neuralgia is a complication of Herpes zoster that is characterized by pain that persists for longer than ____ following the resolution of the vesicular rash.
1 month
Postherpetic neuralgia is a complication of Herpes zoster which a physician may prescribe _______.
tricyclic antidepressants
Postherpetic neuralgia is a complication of Herpes zoster that is common in adults older than _____.
60
