Care of Patients with Infection

Question 1

Communicable infections

Answer 1

transmitted from person to person

Question 2

Transmission of Infection requires three factors:

Answer 2

Reservoir of infectious agents
Susceptible host with portal of entry
Mode of transmission

Question 3

A person with an active infection or asymptomatic carrier is a

Answer 3

reservoir

Question 4

Toxins:

Answer 4

protein molecule released by bacteria to affect host cells at a distant site

Question 5

Passive immunity:

Answer 5

short duration (days or months) and either natural by transplacental transfer from the mother or artificial by injection of antibodies

Question 6

Active immunity:

Answer 6

lasts for years and is natural by infection or artificial by stimulation of the body’s immune defenses

Question 7

What is the body’s best barrier of defenses against infection:

Answer 7

Skin

Question 8

Routes of transmission:

Answer 8

Respiratory: influenza virus, myobacterium tuberculosis, and streptococcus pneumonia

GI tract: Shigella, Salmonella enteritidis, Salmonella typhi, hepatitis A virus

Genitourinary tract: UTIs

Intact skin or mucous membranes: Treponema pallidum

Bloodstream

Question 9

Sometimes medical procedures create a break in cutaneous or mucocutaneous barriers as in

Answer 9

catheter acquired bacteremia (blood in the bloodstream) and surgical site infections (SSIs)

Question 10

Microorganisms can gain direct access to the bloodstream when

Answer 10

invasive devices or tubes are used

Question 11

Methods of transmission:

Answer 11

Contact: direct or indirect
Droplet
Airborne
Vector-borne (for example, insects/animals)
Environment (for example, contaminated food, water)
Portal of exit

Question 12

Common defense mechanisms:

Answer 12

Body tissues
Phagocytosis
Inflammation
Immune systems

Question 13

AMI:

Answer 13

produces antibodies directed against certain pathogens

Question 14

CMI:

Answer 14

Resistance to other microorganisms is mediated by the action of specifically sensitized T-lymphocytes

Question 15

Infection control includes:

Answer 15

Facility policies and procedures
Surveillance and analysis
Patient and staff education
Community collaboration
Product evaluation
Bioengineering

Question 16

Methods of infection control:

Answer 16

Hand hygiene
Disinfection/sterilization
Standard Precautions
Transmission-Based Precautions
Staff and patient placement and cohorting

Question 17

RH/CE elements:

Answer 17

Respiratory hygiene/cough etiquette:
Patient, staff, and visitor education
Posted signs
Hand hygiene
Covering the nose and mouth with a tissue and prompt tissue disposal
Separation from the person with respiratory infection by more than 3 feet

Question 18

Transmission based precautions:

Answer 18

Airborne: use negative airflow rooms
Droplet: may travel 3 ft Ex. influenza, mumps, meningitis, pertussis
Contact: patients with significant multidrug resistant organisms (MDRO) Ex. MRSA, VRE, RSV, lice

Question 19

What has been a way to reduce spread of infection?

Answer 19

Patient placement

Question 20

Cohorting:

Answer 20

the practice of grouping patients who are colonized or infected with the same pathogen

Question 21

Biofilm:

Answer 21

glycocalyx
complex group of microorganism that functions within “slimy” gel coating on medical devices such as urinary catheters, orthopedic implants, and enternal feeding tubes
-extremely difficult to treat

Question 22

MRSA:

Answer 22

Staphlococcus aureus is common bacteria found on the skin and perineum and in the nose of many people

does not respond to methicillin or other penicillin-based drug
Susceptible to vancomycin, linezolid, ceftaroline fosamil

Question 23

How to avoid MRSA:

Answer 23

Frequent hand hygiene
Avoiding close contact w/ people who have infectious wounds
Avoiding large crowds
Avoiding contaminated objects
Using good oral hygiene

Question 24

VRE:

Answer 24

Enterococci are bacteria live in the intestinal tract and are important for digestion
-move to another area and cause an infection
Ex. Surgery

Question 25

CRE:

Answer 25

Carbapenem antibiotics given for abdominal interactions such as peritonitis, have been used extensively for the past 15 years -Recommends chlorhexidine (2% dilution) bathing

Question 26

Problems from inadequate antimicrobial therapy:

Answer 26

- Drug regimen noncompliance or non-adherence also contributes to resistant organism development - Septic shock: insufficient cardiac output is compounded by hypovolemia = inadequate blood supply to organs - Legal sanctions compelling a patient to complete treatment (for example, TB) - Septicemia or bloodstream infection (BSI)

Question 27

Clinical manifestations:

Answer 27

``` pain swelling heat redness pus Lymphadenopathy: enlarged lymph nodes Pharyngitis GI disturbance ```

Question 28

Assessment patient history:

Answer 28

age, history of tobacco or alcohol use, current illness or disease, past and current drug use, and poor nutritional status

Question 29

Psychosocial assessment:

Answer 29

Assess patient's and family's level of understanding about various diagnostic procedures and the time required to obtain test results

Question 30

Lab assessment:

Answer 30

- Best procedure: obtaining a culture - Sensitivity testing: occurs to determine effects of various drugs on that particular microorganism - WBC count - ESR - Serologic testing: performed to identify pathogens by detecting antibodies to the organisms

Question 31

Imaging assessment:

Answer 31

X-ray films | CT and MRI

Question 32

Analysis: Priority NANDA-I nursing diagnosis and collaborative problems include:

Answer 32

1. Hyperthermia related to immune response | 2. Social isolation related to being placed on Transmission Based Precautions

Question 33

Hyperthermia: Expected outcome

Answer 33

Patients with an infection are Expected to have a body temp w/in normal limits

Question 34

Interventions of Hyperthermia:

Answer 34

Drug therapy: antibiotics, antiviral agents, antifungals, antipyretics External cooling: blankets or ice bags or packs Teach UAP to observe and report shivering during any form of external cooling

Question 35

Antimicrobials act on susceptible pathogens by:

Answer 35

Inhibiting wall synthesis Injuring the cytoplasmic membrane Inhibiting biosynthesis Inhibiting nucleic acid synthesis

Question 36

Interventions of Social isolation:

Answer 36

education is priority

Question 37

Home care management:

Answer 37

- Clean home environment is important especially to patients with superinfection - Explain disease and making certain the patient understands what is causing their illness

Question 38

Health Care resources: hand off information to the next facility such as

Answer 38

SBAR

Question 39

Expected outcomes in general:

Answer 39

Has body temp and vital signs w/in normal range Adheres to drug therapy regimen Copes w/ feeling of social isolation

Question 40

C-diff:

Answer 40

due to the use of fluoroquinolone antibiotics, such as ciprofloxacin (Cipro)

Question 41

Pathogen (agent) –

Answer 41

 Microorganism capable of producing disease

Question 42

Pathogenicity –

Answer 42

 Ability to cause disease

Question 43

Virulence –

Answer 43

 Degree of communicability

Question 44

Normal flora –

Answer 44

 Characteristic bacteria of a body location; often compete with other microorganisms to prevent infections

Question 45

Surveillance –

Answer 45

Tracking and reporting of infections

Question 46

Types of HAIs

Answer 46

1. Endogenous infection – From patient flora | 2. Exogenous infection – From outside the patient, often from tubes, implants, or health care workers’ hands

Question 47

MRSA Spread by:

Answer 47

Indwelling urinary catheters Vascular access devices Endotracheal tubes

Question 48

Emerging Infections and Global Bioterrorism:

Answer 48

``` Emerging infectious diseases Multidrug-resistant organisms (MDROs) Pandemic infections Contaminated food Clostridium difficile (C. difficile) ```