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Fundamentals > Ch 24: Asepsis And infection > Flashcards

Ch 24: Asepsis And infection Flashcards

1
Q

define asepsis

A

Absence of disease producing organisms

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2
Q 
Regarding infectious agents
 describe
1. bacteria 
2. viruses 
3. fungi

what is a reservoir// what is a resevior aka?

what are means of transportation

how do you describe a portal of entry

A

Bacteria: MOST COMMON
Viruses: SMALLEST Cold, HIV
Fungi: mold, yeast

Reservoir: natural habitat 
-reservoir a.k.a. carriers

Means of transportation:

  • direct contact
  • indirect contact
  • airborne

Port of entry: point at which organisms enter host

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3
Q

what must infectious agents overcome host overcome

who are susceptible hosts

How must we care for a wound

A

Infectious agents must overcome resistance mounted by hosts defense

Hosts at risk:

  • newborns
  • elderly
  • immunocompromised
  • catheter
  • poor hygiene/nutrition (obese)

Care for wound Aseptically 

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4
Q

What is the number one way to break the infectious cycle

What are ways to break the infectious cycle

A

1: hand hygiene

  • proper equipment
  • proper disposal
  • sterilization
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5
Q

Give examples of fungi and where they are present

A

Fungi examples:

  • Tinea pedis
  • ringworm address: parasites living on outer skin
  • helmets: parasitic worms
  • flukes
  • nematodes: round worm
  • malaria

Fungi present in air, soil, water

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6
Q

How is bacteria classified
(3 classifications) 

Give examples of anaerobic bacteria

A
  1. Shape
  2. Reaction to gram stain
  3. Aerobic or anaerobic
Anaerobic: 
-clostridium tetani
-clostridium botulinum: food poisoning
-clostridium perfringens: gangrene
- E. coli

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7
Q

What is the process of colonization give an example

Describe virulence

How do you describe an opportunistic infection

A

Colonization is a process in which microbes become resident flora
-people walking with MRSA ( resident) don’t know and begins spreading it

Virulence: strength of pathogen to invade host

Opportunistic infections are present in normal flora and overgrow causing infection if host’s immune system is not competent
-candida

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8
Q

What can viruses cause That is very common and what do you do

A

Viruses can cause the common cold that does not respond to antibiotics patient must run the course of the cold

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9
Q

Give the five possible reservoirs for micro organisms

Contact
Vectors
Clostridium‘s
Separate into three
A.k.a. (specific to hospital)
A

Other people: through direct contact or proximity
-activities: touching, sex


animals ( A.k.a. vector)
-factors such as rabies, Zika, West nile

soil : clostridium perfringens: gangrene + clostridium tetani

•food: E. coli
•water: (GI)ardia
•milk: listeria

inanimate objects (AKA Fomites )
-artificial nails stethoscopes scrubs

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10
Q

***How do we prevent being reservoirs for micro organisms

A
  1. Change linens daily with gloves
    - do not shake out
    - do not put on floor
    - hold close
    - do not clean linen on scrub
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11
Q

What infection or disease can spread by touching contaminant in adamant (fomite) objects

A

Influenza conspired by touching inanimate (four mites) contaminated objects

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12
Q

What are common portals of exit and their infections

A

Respiratory : airborne and droplet
-I. E: pneumonia and TB

G.I. exposure to E. coli,
Shingella , Salmonella

GU : infection with E. coli and hep A

Breaks in skin: herpes

Blood and tissue: HIV, HEP B&C

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13
Q

In hospitals when we’re looking at IV skin what are we looking for

What procedures require aseptic technique in hospitals

A

We’re looking at IV skin we’re looking for signs of infection such as erythema, warms

Aseptic technique required for:

  • injections
  • catheterization
  • wounds
  • incisions
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14
Q

Give the four stages of infection And describe each

A

1. Incubation: organism growing and multiplying

  1. Prodromal stage: MOST INFECTIOUS!!
    - vague and non-specific of disease
  2. Full stage of illness: Specific signs and symptoms of disease
  3. Convalescent period: recovery from infection
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15
Q

What population may be more ill then they appear

A

Elders and alcoholics may be more ill than they appear due to decreased thermal regulation or absence of fever

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16
Q

CARDINAL Signs of acute “local” infection

A 
Erythema
Edema
Warmth
Pain
Loss of function to affected side
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17
Q

Signs and symptoms of systemic (SPECIFIC) infection

A

-Fever 101+
-WBC plus sign 10K
-MALAISE: feeling of lack of well-being, Uncomfy

  • Tachycardia/ypnea
  • Enlarged lymph nodes
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18
Q

When someone is in the prodomal stage of infection what do they not realize

How long does it take food poisoning to present

How long does it take HIV to present

A

When someone is in the prodromal stage they often do not realize they are contagious

Food poisoning = 8hours to present

HIV = 6 months – 1 year

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19
Q

What type of factors affect host susceptibility

(

A

-intact skin and mucous membranes
-PH/WBC
-age, sex, race, hereditary
-immunization: natural or acquired
• passive: injection of immunoglobulin
• exposure to antigen
-Fatigue, climate, nutritional/general health
-stress = ⬆️ risk of infection
-use of invasive or indwelling devices
• IV/Cath
• external fixator‘s/drains

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20
Q

Who are the most susceptible hosts

What do cortical steroids cause

A

The most susceptible hosts are neonates and the elderly

Cortical steroids cause an increase in infection because they decrease bodies protective inflammation

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21
Q

 What are outcome identification and planning/infection control

A

THINK (+)

  • demonstrate effective hygiene
  • identify signs of infection
  • maintain adequate nutritional intake -dispose of soiled articles
  • properly cleanse and disinfect -immunize
  • decrease stress 
22
Q

What are lab data that indicate infection

A

If elevated= inf

  • neutrophils & lymphocytes: bacteria
  • eosinophils: allergies/parasites
  • monocytes: severe infection
23
Q

Laboratory data indicating infection

WBC 

A

Elevated WBC count

  • norm: 5–10 K
  • Abnorm: +10 K

Elevated erythrocyte sedimentation rate

  •  mild: 30 - 40
  •  moderate: 40–70
  • severe: 70–1 50

Presence of pathogen in body fluids

24
Q

Give the WHO 5 moments for hand hygiene

How long do you wash for

A
  1. Before touching patient
  2. Before a clean or aseptic procedure
  3. After a body fluid exposure risk
  4. After touching a patient
  5. After touching patients surroundings
    •+ restroom/eat

Wash for 20 seconds

25
Q

Describe the difference between transient and resident bacterial flora

A 
Transient 
-attached loosely on skin
-On hands with ADL
-Easily removed with handwashing
Example: dirt, grease

Resident:

  • Found in skin creases
  • stable in number and type
  • tenacious adhesion needs friction brush for removal
26
Q

Give other names for hospital acquired infections (HAI) 

What are the four majority hospital acquired infections

A

HAI= nosocomial, healthcare associated

  • CAUTI
  • SSI: Surgical site infection
  • CLABSI: Central line associated bloodstream infection
  • VAP: Ventilator associated pneumonia
27
Q

Other types of infections: describe

Atrogenic
Exogenous
Endo genious

A

Atrogenic:
-result from treatment and diagnostic procedures

Exogenous
-Acquired from OTHER people

Endogenous
- Microlife IN person

28
Q

What kind of bacteria can invade equipment in cars issues like VAP (ventilator associated pneumonia

A 
C diff
 E. coli 
S aureus
 streptococcus Faecalis
 pseudomonas
 klebsiella 
aeruginosa
29
Q

What are risk factors for VRE

A 
•Compromised the immune systems
   -older, neonate, CA
 •chronic illness
-Kidney disease, diabetes
•Recent surgery 
•invasive devices
 ***prolonged antibiotic use 
-Especially if treated with broad-•spectrum antibiotics and not done correctly
•prolonged hospitalization
 •previous MRSA
30
Q

What infection resistance pose a Risk factor for VRE

What meds are affective VVRE

A

MRSA, VISA, CRE

Effective meds:

  • Linzeloid
  • Doxycycline
  • rifampin
31
Q

What are CDC recommendations to prevent C Diff infection (CDI)

A
  • C Diffis difficult because it is a spore
  • Avoid electronic equipment that’s difficult to clean
  • disinfect all patient care items and equipment between patients
  • use full barrier contact precautions I. E: gowns and gloves

placing patients in private rooms cohort if same strain

perform meticulous hand hygiene

32
Q

Under CDC recommendations to prevent C diff what info Regarding antimicrobials
(KEy STEP)

A

Towelette containers must have dwell time of 5 to 10 minutes to fully kill microorganisms

33
Q

What do we know about older age and infection

A

We know that age related changes ⬆️/Predispose to infection

Pulmon: ⬇️ cough, lung recoil,
• position patient upright, encourage incentive spirometer

UTI:⬇️ incom empty bladder, decrease sphincter control decreased renal blood flow
• drink 1500 ML water, get patient to void regularly

Skin inf: ⬇️ elasticity, thinning, vasc supply
• Drink fluids, lotion, monitor skin

34
Q

 what is a recommendation Used for sterilization and disinfection

What is the disadvantage of boiling water

  • duration
  • where

What is the disadvantage of chemicals

What does household bleach inactivate

A

Treat all supplies, linen, equipment as infectious

Disadvantage of boiling:🚫 kill some spores and viruses

  • boil minimum 10 minutes
  • Home

Disadvantage of chemicals:🚫 kill all spores

Household bleach inactivates human immuno deficiency virus
-1:100

35
Q

Are soaps and detergents (non-antimicrobial agents ) Considered adequate for routine mechanical cleansing of hands and removal of transient organisms

A

Yes because transient = easily removed

36
Q

 give the four PPE

Give the sequence of donning PPE

Give the sequence of doffing PPE

A

4 PPE
-gloves, gowns, mask, protective eyewear

dON:

  1. Gown
  2. mask
  3. face shield
  4. gloves

dOFF

  1. Gloves
  2. goggles
  3. gown
  4. mask
37
Q

When using PPE what is vital to check for the patient

What must sterile gloves Be and how do you measure them

When do you use an N 95 mask


A

When using PPE is vital to check efficient has latex allergy

Sterile gloves must be a good fit measured with measuring tape over knuckles

N 95 used for airborne isolation
-known/suspected TB, measles, varicella

38
Q

What are precautions taken in a patient who has Tb

A 
In patient  with TB
-N95
-PRIV negative pressure room
- Close door

39
Q

Who are standard precautions used in

A

standard precautions used in ALL patients, visitors , staff

Apply to secretions, excretions, non-intact skin, blood and mucous membranes
-now includes respiratory hygiene/cough etiquette safe injection practice and using a mask when performing high risk prolong procedures
• nurse won’t talk during procedure

40
Q

What do you need to keep in mind with patient placed on precautions

What may someone in precautions feel

A

Patient placed in precautions may have psychosocial issues due to separation less healthcare personal contact

Someone in precautions may feel self-esteem disturbances and dirty


41
Q

Give a few isolation precaution guidelines

A
  • Hand hygiene
  • Nonsterile gloves, PPE
  • Respiratory cough etiquette
  • 3 feet separation from visitors
  • Don’t recap: safe injection practices
  • Handle used equipment carefully to prevent transfer organisms
  • Review room assignments carefully
  • have adequate control of environment
42
Q

Who is under airborne precautions give three airborne precautions

A

Who: TB, varicella, measles

Precautions:

  • negative pressure room
  • N 95 respirator mask
  • if transporting patient put surgical mask
43
Q

Who is under droplet precautions give 4 droplet precautions

What does droplet =

A

Droplet =large particles

Who: rubella, months, diphtheria, meningitis, adenovirus

Precautions:

  • 3 feet from visitor
  • private room
  • door closed
  • PPE
44
Q

Who are contact precautions used in give one precaution

A

Contact precautions in those who have MDRO (multi drug)

Precaution:
-don’t share equipment

45
Q

What are the two subcategories under aseptic technique

A

Two sub categories of aseptic technique

Medical asepsis: CLEAN

  • Confined microbes to specific area
  • Contaminated if suspected of pathogens

Surgical a sepsis: STERILE
-no pathogens
-kills ALL microorgs INCLUDING SPORES


46
Q

Give two situations where is the reality is maintained Insta reality is not maintain

How do you know a catheter Package is not sterile

A

Sterile + sterile = sterile

Sterile + not sterile/? = not sterile

If catheter package looks water damaged it is not Sarah

47
Q

When would you use surgical a sepsis

A
  • An operating room
  • certain diagnostic testing areas
  • urinary catheter, sterile dressing changes, injecting medications
48
Q

What does sterilization kill

What do airborne germs have to do with something becoming non-sterile



A

Sterilization kills all micro organisms including spores

Airborne germs if prolonged exposure make something not sterile 

49
Q

Rules for sterality 

A

Outer wrapping and 1 inch edge not Sterile

  • only sterile can touch sterile
  • don’t reach across sterile site
  • add items 6 inches above sterile field
  • Laying sterile drape shiny side down
  • turning back on sterile field = not sterile
  • sterile field to waste
  • germs move by gravity and make unsterile
    
    
50
Q

 Give me a few examples of medical a sepsis at home

A 
Washing hands before prepping food
Cooking food thoroughly
Used two different cutting boards
1 Veggies 
1meat

51
Q

What are patient goals regarding asepsis an infection control

A

Use medical a sepsis
Identify health habits lifestyle patterns promoting health
State signs and symptoms of infection
Identify unsafe home environment situations

Fundamentals (17 decks)

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