Ch 24: Asepsis And infection Flashcards
define asepsis
Absence of disease producing organisms
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
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
what must infectious agents overcome host overcome
who are susceptible hosts
How must we care for a wound
Infectious agents must overcome resistance mounted by hosts defense
Hosts at risk:
- newborns
- elderly
- immunocompromised
- catheter
- poor hygiene/nutrition (obese)
Care for wound Aseptically 
What is the number one way to break the infectious cycle
What are ways to break the infectious cycle
1: hand hygiene
- proper equipment
- proper disposal
- sterilization
Give examples of fungi and where they are present
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
How is bacteria classified
(3 classifications) 
Give examples of anaerobic bacteria
- Shape
- Reaction to gram stain
- Aerobic or anaerobic
Anaerobic: -clostridium tetani -clostridium botulinum: food poisoning -clostridium perfringens: gangrene - E. coli 
What is the process of colonization give an example
Describe virulence
How do you describe an opportunistic infection
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
What can viruses cause That is very common and what do you do
Viruses can cause the common cold that does not respond to antibiotics patient must run the course of the cold
Give the five possible reservoirs for micro organisms
Contact Vectors Clostridium‘s Separate into three A.k.a. (specific to hospital)
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
***How do we prevent being reservoirs for micro organisms
- Change linens daily with gloves
- do not shake out
- do not put on floor
- hold close
- do not clean linen on scrub
What infection or disease can spread by touching contaminant in adamant (fomite) objects
Influenza conspired by touching inanimate (four mites) contaminated objects
What are common portals of exit and their infections
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
In hospitals when we’re looking at IV skin what are we looking for
What procedures require aseptic technique in hospitals
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
Give the four stages of infection And describe each
1. Incubation: organism growing and multiplying
- Prodromal stage: MOST INFECTIOUS!!
- vague and non-specific of disease - Full stage of illness: Specific signs and symptoms of disease
- Convalescent period: recovery from infection
What population may be more ill then they appear
Elders and alcoholics may be more ill than they appear due to decreased thermal regulation or absence of fever
CARDINAL Signs of acute “local” infection
Erythema Edema Warmth Pain Loss of function to affected side
Signs and symptoms of systemic (SPECIFIC) infection
-Fever 101+
-WBC plus sign 10K
-MALAISE: feeling of lack of well-being, Uncomfy
- Tachycardia/ypnea
- Enlarged lymph nodes
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
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
What type of factors affect host susceptibility
(
-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
Who are the most susceptible hosts
What do cortical steroids cause
The most susceptible hosts are neonates and the elderly
Cortical steroids cause an increase in infection because they decrease bodies protective inflammation
 What are outcome identification and planning/infection control
THINK (+)
- demonstrate effective hygiene
- identify signs of infection
- maintain adequate nutritional intake -dispose of soiled articles
- properly cleanse and disinfect -immunize
- decrease stress 
What are lab data that indicate infection
If elevated= inf
- neutrophils & lymphocytes: bacteria
- eosinophils: allergies/parasites
- monocytes: severe infection
Laboratory data indicating infection
WBC 
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
Give the WHO 5 moments for hand hygiene
How long do you wash for
- Before touching patient
- Before a clean or aseptic procedure
- After a body fluid exposure risk
- After touching a patient
- After touching patients surroundings
•+ restroom/eat
Wash for 20 seconds
Describe the difference between transient and resident bacterial flora
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
Give other names for hospital acquired infections (HAI) 
What are the four majority hospital acquired infections
HAI= nosocomial, healthcare associated
- CAUTI
- SSI: Surgical site infection
- CLABSI: Central line associated bloodstream infection
- VAP: Ventilator associated pneumonia
Other types of infections: describe
Atrogenic
Exogenous
Endo genious
Atrogenic:
-result from treatment and diagnostic procedures
Exogenous
-Acquired from OTHER people
Endogenous
- Microlife IN person
What kind of bacteria can invade equipment in cars issues like VAP (ventilator associated pneumonia
C diff E. coli S aureus streptococcus Faecalis  pseudomonas klebsiella aeruginosa
What are risk factors for VRE
•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
What infection resistance pose a Risk factor for VRE
What meds are affective VVRE
MRSA, VISA, CRE
Effective meds:
- Linzeloid
- Doxycycline
- rifampin
What are CDC recommendations to prevent C Diff infection (CDI)
- 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
Under CDC recommendations to prevent C diff what info Regarding antimicrobials
(KEy STEP)
Towelette containers must have dwell time of 5 to 10 minutes to fully kill microorganisms
What do we know about older age and infection
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
 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
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
Are soaps and detergents (non-antimicrobial agents ) Considered adequate for routine mechanical cleansing of hands and removal of transient organisms
Yes because transient = easily removed
 give the four PPE
Give the sequence of donning PPE
Give the sequence of doffing PPE
4 PPE
-gloves, gowns, mask, protective eyewear
dON:
- Gown
- mask
- face shield
- gloves
dOFF
- Gloves
- goggles
- gown
- mask
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

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
What are precautions taken in a patient who has Tb
In patient with TB -N95 -PRIV negative pressure room - Close door 
Who are standard precautions used in
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
What do you need to keep in mind with patient placed on precautions
What may someone in precautions feel
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

Give a few isolation precaution guidelines
- 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
Who is under airborne precautions give three airborne precautions
Who: TB, varicella, measles
Precautions:
- negative pressure room
- N 95 respirator mask
- if transporting patient put surgical mask
Who is under droplet precautions give 4 droplet precautions
What does droplet =
Droplet =large particles
Who: rubella, months, diphtheria, meningitis, adenovirus
Precautions:
- 3 feet from visitor
- private room
- door closed
- PPE
Who are contact precautions used in give one precaution
Contact precautions in those who have MDRO (multi drug)
Precaution:
-don’t share equipment
What are the two subcategories under aseptic technique
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

Give two situations where is the reality is maintained Insta reality is not maintain
How do you know a catheter Package is not sterile
Sterile + sterile = sterile
Sterile + not sterile/? = not sterile
If catheter package looks water damaged it is not Sarah
When would you use surgical a sepsis
- An operating room
- certain diagnostic testing areas
- urinary catheter, sterile dressing changes, injecting medications
What does sterilization kill
What do airborne germs have to do with something becoming non-sterile

Sterilization kills all micro organisms including spores
Airborne germs if prolonged exposure make something not sterile 
Rules for sterality 
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


 Give me a few examples of medical a sepsis at home
Washing hands before prepping food Cooking food thoroughly Used two different cutting boards 1 Veggies 1meat 
What are patient goals regarding asepsis an infection control
Use medical a sepsis
Identify health habits lifestyle patterns promoting health
State signs and symptoms of infection
Identify unsafe home environment situations
