Ch. 10 Asepsis

Question 1

Describe microorganisms.

Answer 1

living animals or plants visible only through a microscope, are commonly called “microbes” or “germs.”

Question 2

Name and describe specific types of microorganisms.

Answer 2

Pathogens, Non-Pathogens

Question 3

What are Non Pathogens?

Answer 3

Nonpathogens

• They are found in areas of the body exposed to the external environment, as well as internal areas such as the skin, nose, mouth, throat, lower urethra, and intestines.
• Assume one of two relationships with the human host—mutually beneficial or neither harming nor helping the host.
• They inhibit pathogenic growth and reproduction by competing for nutrients, vying for space, or producing substances that interfere with pathogens. They thus ensure a hospitable habitat for themselves.

Question 4

What are Pathogens?

Answer 4

• Pathogens have a high potential for causing infectious communicable diseases (diseases that can be transmitted to other people), also called contagious diseases and community-acquired infections
• They may become established, grow, and proliferate when numbers of non pathogens are reduced such as when broad-spectrum antibiotics (those prescribed to eliminate a wide range of bacteria) are prescribed.
• Pathogens may also cause infections when the host is immunosuppressed from acquired immunodeficiency syndrome (AIDS), cancer chemotherapy, or steroid drug therapy.

Question 5

What does Aerobic mean?

Answer 5

Requires Oxygen to grow.

Question 6

What does Anaerobic Mean?

Answer 6

Does not require Oxygen to grow.

Question 7

Give examples of the ways some microorganisms have adapted for their survival.

Answer 7

Non-Pathogens develop one of two relationship with its host:

1. Mutually benefits the host
2. Does not harm or help the host.
3. Pathogens have some have fimbriae , tiny hairs used to attach themselves to the host’s tissue to avoid expulsion.
4. Some pathogens use flagella , long tails that promote motility to reach a site less hostile to survival.
5. Others release toxins (harmful chemicals). Many enter the host’s cells and use their content to support their life cycles.

Question 8

Name the Components of the infection Process.

Answer 8

1. Infectious Agent
2. A reservoir for growth and reproduction.
3. An exit route
4. A means of transmission
5. A portal of entry
6. A susceptible host

Question 9

Cite examples of biologic defense mechanisms.

Answer 9

Biologic defense mechanisms are anatomic or physiologic methods that stop microorganisms from causing an infectious disorder. The two types of biologic defense mechanisms are:

• Mechanical defense mechanisms are physical barriers that prevent microorganisms from entering the body or expel them before they multiply.
  
  • Examples include intact skin and mucous membranes, reflexes such as sneezing and coughing, and infection-fighting blood cells called phagocytes or macrophages.
• Chemical defense mechanisms destroy or incapacitate microorganisms through natural biological substances.
  
  • Examples include lysozymes, gastric acid, and antibodies.

Question 10

Define health care–associated infection.

Answer 10

Infections acquired while a person is receiving care in a health care agency.

Question 11

Discuss the concept of asepsis.

Answer 11

Those practices that decrease or eliminate infectious agents, their reservoirs, and vehicles for transmission.

It is the major method for preventing and controlling infection.

Health care providers use medical and surgical asepsis to accomplish this goal.

Question 12

Differentiate between medical and surgical asepsis.

Answer 12

Those practices that confine or reduce the numbers of microorganisms.

Also called clean technique , it involves measures that interfere with the chain of infection in various ways.

Question 13

Identify principles of medical asepsis.

Answer 13

Microorganisms exist everywhere except on sterilized equipment.

Frequent hand hygiene and maintaining intact skin are the best methods for reducing the transmission of microorganisms.

Blood, body fluids, cells, and tissues are considered major reservoirs of microorganisms.

Personal protective equipment such as gloves, gowns, masks, goggles, and hair and shoe covers serve as barriers to microbial transmission.

A clean environment reduces microorganisms.

Certain areas like the floor, toilets, and the insides of sinks are more contaminated than others.

Cleaning should be done in order from cleaner to dirtier areas rather than vice versa.

Question 14

List examples of medical aseptic practices.

Answer 14

Examples of medical aseptic practices include using

• antimicrobial agents
• performing hand hygiene
• wearing protective garments
• confining and containing soiled materials appropriately
• keeping the environment as clean as possible.

Question 15

Name techniques for sterilizing equipment.

Answer 15

Physical Sterilization:

Microorganisms and spores are destroyed physically through radiation or heat, boiling water, free-flowing steam, dry heat, and steam under pressure.

Steam under pressure is the most dependable method for destroying all forms of organisms and spores.

Chemical Sterilization:

• Both gas and liquid chemicals are used to sterilize invasive equipment.
• Until chemicals were perfected as a sterilizing agent, sterilization using liquid chemicals was difficult and some questioned its reliability.
• Gas sterilization, using ethylene oxide gas, is a traditional method for destroying microorganisms if heat or moisture is likely to damage items or if no better method is available.

Question 16

Identify principles of surgical asepsis.

Answer 16

• They preserve sterility by touching one sterile item with another that is sterile.
• Once a sterile item touches something that is not sterile, it is considered contaminated.
• Any partially unwrapped sterile package is considered contaminated.
• If there is a question about the sterility of an item, it is considered unsterile.
• The longer the time since sterilization, the more likely it is that the item is no longer sterile.
• A commercially packaged sterile item is not considered sterile past its recommended expiration date.
• Once a sterile item is opened or uncovered, it is only a matter of time before it becomes contaminated.
• The outer 1-in margin of a sterile area is considered a zone of contamination.
• A sterile wrapper, if it becomes wet, wicks microorganisms from its supporting surface, causing contamination.
• Any opened sterile item or sterile area is considered contaminated if it is left unattended.
• Coughing, sneezing, or excessive talking over a sterile field causes contamination.
• Reaching across an area that contains sterile equipment has a high potential for causing contamination and is therefore avoided.
• Sterile items that are located or lowered below waist level are considered contaminated because they are not within critical view.

Question 17

List nursing activities that require application of the principles of surgical asepsis.

Answer 17

• Health care professionals observe the principles of surgical asepsis during surgery, when performing invasive procedures such as inserting urinary catheters, and when caring for open wounds.
• Practices that involve surgical asepsis include creating a sterile field, adding sterile items to the sterile field, and donning sterile gloves.

Question 18

The most effective method for preventing infections is ____________, an essential nursing activity that must be performed repeatedly when caring for clients.

Answer 18

Hand washing or hand antisepsis

Question 19

____________, commonly called germs, are living animals or plants that are visible only with a microscope.

Answer 19

Microorganisms

Question 20

____________, or normal flora, live abundantly and perpetually on and in the human body, which is their host.

Answer 20

Fimbriae

Question 21

Pathogens have ____________, which are tiny hairs that prevent pathogens from being eliminated during urination.

Answer 21

Fimbriae

Question 22

Pathogens may cause ____________ when the host is immunosuppressed from acquired immune deficiency syndrome (AIDS), chemotherapy, or steroid drug therapy.

Answer 22

Infections

Question 23

The three types of fungal (mycotic) infections are superficial, intermediate, and ____________.

Answer 23

Systemic

Question 24

Helminths are classified into three major groups: nematodes, trematodes, and ____________.

Answer 24

Cestodes

Question 25

A __________________, the last link in the chain of infection, is one whose biologic defense mechanisms are weakened in some way.

Answer 25

Susceptible host

Question 26

Before each use of a sterile solution, a nurse pours and discards a small amount from the mouth of the container to wash away airborne contaminants in a process called _____________ the container.

Answer 26

Lipping

Question 27

Identify and label the figure. Give the scientific names for each.

Answer 27

A. Cocci

B. Bacilli

C. Spirochetes

Question 28

What are the two types of bacteria?

Answer 28

There are two types of bacteria.

• Aerobic bacteria require oxygen to live
• Anaerobic bacteria exist without oxygen

Question 29

Which type of drug is used most often to combat bacterial infections?

Answer 29

The chemical actions of antibacterials, which consist of antibiotics and sulfonamides, alter the metabolic processes of bacteria but not viruses.

They damage or destroy bacterial cell walls or the mechanisms that bacteria need to grow.

They also, however, destroy normal bacterial flora.

Question 30

Helps when there is a potential transfer of microorganisms from one client or object to another client during subsequent nursing care.

Answer 30

Gloves

Question 31

Helps reduce transmission of pathogens present on the hair or shoes; usually worn during surgical or obstetric procedures

Answer 31

Hair and shoe covers

Question 32

Helps when there is a possibility that body fluids will splash into the eyes

Answer 32

Protective eyewear

Question 33

Helps reduce the spread of microorganisms onto or from the surface of clothing worn from home

Answer 33

Clean laboratory coat

Question 34

Helps when working in the nursery, operating room, and delivery room; worn during other sterile procedures as well.

Answer 34

Scrub suits or gowns

Question 35

Presented here, in random order, are the six essential components of the chain of infection.

In the boxes provided below, write the correct sequence that enables the spread of disease-producing microorganisms from one location or person to another.

1. A port of entry
2. An infectious agent
3. A mode of transmission
4. A reservoir for growth and reproduction
5. An exit route from the reservoir
6. A susceptible host

Answer 35

2. An infectious agent
3. Reservoir for growth and reproduction
4. An exit route from the reservoir
5. A mode of transmission
6. A port of entry
7. A susceptible host

Question 36

What are the factors that influence the development of an infection or an infectious disease in the human body?

Answer 36

Factors that cause infection or an infectious disease in the human body include the following:

• The type and number of microorganisms present in the body
• The characteristics of the microorganism (such as its virulence)
• The ability to overcome the immune system
• The person’s state of health.

Question 37

What are the various types of viruses?

Answer 37

Three types of viruses can exist in the human body.

Some can remain dormant in a human and reactivate sporadically, causing recurrence of an infectious disorder, such as herpes simplex virus.

Some are minor and self-limiting and terminate with or without medical treatment, such as the common cold.

Some others are more serious or fatal, such as rabies, poliomyelitis, hepatitis, and AIDS.

Question 38

What are rickettsiae?

Answer 38

Rickettsiae resemble bacteria.

Like viruses, however, they cannot survive outside another living species.

Consequently, an intermediate life form, such as fleas, ticks, lice, or mites, transmits rickettsial diseases to humans.

Question 39

What are the classification of protozoans?

Answer 39

Protozoans are classified according to their ability to move.

Some use amoeboid motion, by which they extend their cell walls and their intracellular contents flow forward.

Others move by cilia (hair-like projections) or flagella (whip-like appendages).

Some cannot move independently at all.

Question 40

Why are mycoplasmas termed “Pleomorphic”?

Answer 40

Mycoplasmas lack a cell wall. They are referred to as pleomorphic because they assume various shapes.

Question 41

Define and list examples of the types of biologic defense mechanisms that exist.

Answer 41

Biologic defense mechanisms are anatomic or physiologic methods that stop microorganisms from causing an infectious

Question 42

A nurse practices medical and surgical asepsis to accomplish care for a client suffering from an infection. There are other clients around who should be protected from the spread of infection.

What are the principles or measures the nurse should follow to break the chain of infection?

Answer 42

To break the chain of infection, a nurse should acknowledge and follow the measures or principles of medical asepsis presented here:

• Microorganisms exist everywhere except on sterilized equipment.
• Frequent hand washing and maintaining intact skin are the best methods for reducing the transmission of microorganisms.
• Blood, body fluids, cells, and tissues are considered major reservoirs of microorganisms.
• Personal protective equipment, such as gloves, gowns, masks, goggles, and hair and shoe covers, serves as a barrier to microbial transmission.
• A clean environment reduces microorganisms.
• Certain areas—the floor, toilets, and insides of sinks—are more contaminated than others; therefore, cleaning should be done from cleaner to dirtier areas.

Question 43

What are antimicrobial agents?

Answer 43

Antimicrobial agents are chemicals that destroy or suppress the growth of infectious microorganisms.

Question 44

Which antimicrobial agents should the nurse use and why? Define the role of each type of agent.

Answer 44

The nurse should use antimicrobial agents such as antiseptics, disinfectants, and antiinfective drugs.

• Antiseptics, also known as bacteriostatic agents, inhibit the growth of but do not kill microorganisms.
  
  • Some are also used as cleaning agents.
• Disinfectants, also called germicides and bactericides, destroy active microorganisms but not spores.
  
  • They are used to kill and remove microorganisms from equipment, walls, and floors.
• Anti Infective drugs are used to combat infections.
• The two groups of drugs used most often to combat infections are antibacterials and antivirals.