Ch28 Infection Prevention and Control Flashcards
Standard precautions apply to:
all patients
disease associated with standard precautions
CMV, HIV, Hep B and C, Aspergillosis
Standard precautions include doing what (4)
- hand hygiene
- no artificial nails
- gloves when coming into contact with bodily fluids
- no private room
hand hygiene should be performed:
before and after contact with patient
before and after gloving
visibly soiled
When should you only use soap and water and not hand sanitizer
visibly soiled
dealing with diarrheal conditions (C. Diff)
What precaution: direct and indirect contact with patients and their environment
contact
Conditions associated with contact precautions
Mrs. Wee multidrug resistant organism (MRSA) respiratory infection (RSV) skin infection (shingles) wound infection (Hep A) enteric (C. Diff) eye infection (conjunctivitis)
Precautions for contact (4)
hand hygiene
gown
gloves
private room/cohort
What precaution: transmitted by large droplets expelled into the air
Droplet precaution
Conditions associated with droplet precautions
SPIDERMAN sepsis/scarlet fever pneumonia/pertussis influenza diphtheria epiglottitis rubella mumps/meningitis adenovirus
droplet precautions: (4)
hand hygiene
surgical mask
private room
distancing ~6ft
what precaution: transmitted by smaller droplets remain in the air for long periods of time
airborne
conditions associated with airborne
MTVS measles TB Varicella (chicken pocks) SARS
precautions for airborne (3)
hand hygiene
negative pressure room (6-12 air changes/hour)
N-95 mask
caring for a client with a fever (1-4)
- Obtain cultures of body fluids (urine, sputum, or blood)
- Obtain blood culture specimens to coincide with temperature spikes when the antigen-producing organism is most prevalent
- Minimize heat production - reduce frequency of activities that increase oxygen demand (excessive turning and ambulating), allow rest, limit physical activity
- Maximize heat loss - reduce external covering (without causing shivering), keep patient, clothing, and bed linen dry
caring for a client with a fever (5-9)
- Satisfy requirements for increased metabolic rate - provide supplemental oxygen as ordered, provide measures to stimulate appetite, provide fluids
- Promote patient comfort - encourage oral hygiene, control the temperature of the environment (ex. Apply damp cloth to pts forehead)
- Identify onset and duration of fever (examine previous temperature measurements for trends)
- Initiate health teaching as indicated
- Control environmental temperature (70-80 degrees F)
Five moments of hand hygiene
- before toughing patient
- before clean/aseptic procedure
- after body fluid exposure risk
- after touching patient
- after touching patient surrounding
Chain of infection (6)
- infectious agent/pathogen
- reservoir
- portal of exit
- mode of transmission
- portal of entry
- host
most effective way to break chain of infection
hand hygiene
“clean technique” = aimed at controlling the number of microorganisms and is used for ALL clinical patient care activities
medical asepsis
“sterile technique” = aimed at removing all microorganisms and is used for all surgical/sterile procedures
surgical asepsis
Maintaining sterile field (9)
- open sterile packacge on flat, dry surface that is above the waist
- keep sterile field in site
- unsterile items cannot be in the field
- unsterile if exposed to air for a long time
- unsterile if fluid flows into field
- have all equipment ready
- skin must be gloved
- 1 inch margin of packaging is not sterile
maintaining sterile field when pouring liquids (3)
- cap placed up
- hold label in palm so that your chances of getting level wet lessens
- pour in small amounts
steps of surgical hand asepsis (8)
- remove all jewelry
- fingernails no longer than 1/4 inch
- No artificial nails/ polish <4 days old
- inspect nails
- Apply surgical cap, shoe cover, mask, and eyewear before gloving
- keep hands above elbows
- scrub with sponge and clean nails with nail pick
- Put on gloves using sterile glove technique
Normal WBC count
5000-10,000
leukopenia:
decreased WBC
leukocytosis:
increased WBC
Normal neutrophils:
55-70% with 0-3% bands
how do you know a lab study is normal?
varies based on the presentation of the patient
age, weight, height
What do you do if patient has a latex allergy
use latex free gloves, supplies, and equipment
microorganisms that are external to the host
exogenous
examples of exogenous microorganisms
SCAB-C Salmonella cholera anthrax botulism C. Tetani
microorganisms naturally in a closed system
endogenous
examples of endogenous micros
SESY Strep E. coli Staph Yeast
When do endogenous micros become a problem?
flora is altered and overgrows
or
flora enters a sterile body area
what is a common cause of endogenous micro problems
broad spectrum antibiotics
