Chapter 14 Flashcards
1
Q
(Infect)
Administer analgesics no more than ….. prior to a sterile procedure
A
Thirty minutes
2
Q
(Infect)
A. Exogenous infection
B. Endogenous infection
A
A. Comes from microorganisms that are found outside the individual
B. Occur when the normal flora becomes altered and overgrown (broad spectrum antibiotics, inappropriate movement of bacteria)
3
Q
(Infect)
Airborne precautions mean the door has to stay
A
Closed
4
Q
(infect)
A. Localized inflammation
B. Systemic inflammation
A
A. Swelling, redness, heat, pain, tenderness, loss of function in body part
B. Fever, leukocytosis, malaise, anorexia, nausea, vomiting, lymph node enlargement, loss of appetite
5
Q
(Infect)
A. Medical asepsis
B. Surgical asepsis
A
A. Clean techniques (hand hygiene, barrier techniques, routine environmental cleaning)
B. Sterile techniques (procedures to eliminate all microorganisms)
6
Q
(Infect) Are patients in A. Health care settings or B. Home care setting more at risk for infection?
A
A!
7
Q
(Infect) A. WBC count B. Iron M/F C. Neutrophils D. Lymphocytes E. Monocytes F. Eosinophils G. Basophils
A
A. 5,000-10,000 (I in acute, D in viral)
B. 15 mm/h, 20 mm/h (D in chronic)
C. 55-70% (I in acute, D in overwhelming bacterial)
D. 20-40% (I in bacterial and viral, D in sepsis)
E. 2-8% (I in infections)
F. 1-4% (I in parasitic)
G. 0.5-1% (Normal)
8
Q
(Infect)
A. When the pathogens multiply and cause signs and symptoms
B. When the pathogens are present but do not cause signs or symptoms
A
A. Symptomatic
B. A symptomatic
9
Q
(Infect)
Because older adults have less stomach acid …..
A
Smaller meals should be eaten
10
Q
(Infect)
The bodys normal defenses against infection,
A
- Normal flora,
- physiological body system defenses,
- inflammation,
- and the immune response
11
Q
(Infect)
Body system defenses
A
- The reapiratory tract,
- skin,
- and GI tract,
have physiological characteristics that make it harder for pathogens to infect the body (mucous)
12
Q
(Infect)
Can taking care of isolated patients be delegated to a NAP and if so what are you as a RN required to do?
A
Yes! You are required to assess the patients status and isolation indications.
13
Q
(Infect)
Carrier
A
Showing no signs or symptoms, but having the disease
14
Q
(Infect)
The chain of infection includes;
A
- Infectious agent
- Reservoir
- Mode of transmission
- Portal of entry
- And a susceptible host
15
Q
(Infect)
Cleaning
A
Removing organic material from an object. Occurs before disinfection or sterilization. Use PPE when cleaning objects soiled with bodily fluids. (Soap)
16
Q
(Infect)
Colonization
A
The presence or growth of microorganisms without cause tissue damage or invasion
17
Q
(Infect)
Critical item
A
Something that will come in contact with a steril tissue/vascular system (sterilized)
18
Q
(Infect)
Diaphoresis
A
Excessive sweating
19
Q
(infect)
Direct transmission
A
Touching or breathing in the microorganism
20
Q
(Infect)
Discard masks or gowns asap if;
A
The become damaged, soiled, or moist (masks)
21
Q
(Infect)
Disease from pathogens results when
A
Pathogens multiply and alter normal tissue function
22
Q
(Infect)
Disenfection
A
Eliminates almost all pathogenic organisms. With the exception of bacterial spores
23
Q
(Infect)
Exogenous Infection
A
Infection from organisms from outside the body
24
Q
(Infect)
Factors that influence susceptibility
A
- Age,
- nutritional status,
- chronic disease,
- trauma,
- smoking
25
(Infect)
Having a serious infection can lead to feels of ..... in patients and families, can also increase risk of ..... as a nurse you should combat this by .....
1. Anxiety, frustration, and loneliness
2. Falling
3. Discuss the disease process and the reason for maintaining isolation procedures
26
(Infect)
| Immune response
When a foreign material (antigen) enters the body the body the body learns about it so the next time it enters the body the immune system will attack
27
(Infect)
| Indirect transmission
Infected hands touching surface, another person touching surface and getting pathogens on hand
28
(Infect)
| Infection
Invasions of a host by HARMFUL microorganisms resulting in disease (Protozoa, bacteria, viruses, fungi)
29
(Infect)
Infection prevention precautions are not needed with PTs who are in the hospital for other reasons besides infection
T of F
False
| Health care workers should use Standard Precautions and assume that all patients may be infectious.
30
(Infect)
| Infectious agent depends on;
1. Number or microorganisms
2. Microorganisms virulence
3. And susceptibility of host
31
(Infect)
| Inflammation
Vascular reaction that delivers blood/nutrients to the interstitial space of the infected tissue.
32
(Infect)
| In step 1. of the nursing process you should be sure to,
Assess risk factors for a patients susceptibility to an infection
33
(Infect)
| In step four of the nursing process special attention to ..... is very important when a patient has a systemic infection
Managing and preventing fever
34
(Infect)
In steps three and four of the nursing process what should you consider in regard to patient teaching on infection control?
1. Cultural ideas and practices regarding
2. hygiene/knowledge of microorganisms,
3. knowledge of nutrition,
4. adherence to immunization schedules,
5. and daily rest and exercise
35
(Infect)
| MDROs
Multidrug-resistant organisms. MRSA (19% of healthcare associated bloodstream infections), VRE, CDIFF
36
(Infect)
| Modes of transmission;
Washing your hands will interrupt the transmission,
| Can be spread through airborne droplets or direct contact with infected fluid
37
(Infect)
| The most frequent cause of transfer from LTCFs to acute care hospitals is.....
HAIs
38
(Infect)
| Noncritical item
Something that comes in contact with intact skin, not mucous membranes. (Disinfected)
39
(Infect)
| Normal flora,
Usually does not cause disease (as long as it stays where it's supposed to) and health to prevent growth of pathogens
40
(Infect)
A nurse discovers that there is a large amount of drainage on a surgical dressing and the bed linens when attempting to insert a new IV catheter. The nurse performs hand hygiene, puts on clean gloves, and assesses the wound beneath the dressing to be sure that the situation is not emergent. Which action should the nurse take next?
1 Remove gloves and perform hand hygiene before changing the bed linen
2 remove gloves and perform had hygiene before regloving and applying a clean dressing
3 call someone else to insert the IV line
4 immediately apply new dressing and notify the health care worker
2
Gloves are contaminated from contact with the wound. Without removing the gloves and performing hand hygiene, microorganisms will be transferred from one site to another.
41
(Infect)
| Nurses should participate in;
Cost effective and quality health care by using strategies that prevent or reduce infections
42
```
(Infect)
An older patient is obese and is being treated with chemotherapy for colon cancer. Which of the following nursing diagnoses is the highest priority based on these data?
1 acute pain
2 anticipatory grieving
3 risk for infection
4 impaired tissue integrity
```
3
This patient is obese and is being treated with chemotherapy. Both of these factors place this patient at a greater risk for infection.
43
(Infect)
| Outside of the OR and labor/delivery area, where/when would you practice surgical asepsis?
When performing surgical aseptic techniques at the bedside (IVs, urethral catheters, in cases of trauma and burns, anytime a piece of equipment is inserted into a sterile body cavity)
44
```
(Infect)
Portal of
A. Exit
B. Entry
C. Both
```
A. Must find way out of growth site in order to find more hosts to cause more disease
B. Must enter body to grow and cause disease
C. Broken skin. Mycous membranes, GU tract, GI tract, respiratory tract, urinary tract, reproductive tract, blood
45
(Infect)
| PPE should be put in in this order,
Gown, mask, eyewear, gloves
46
(Infect)
| PPE should be taken off in this order,
Gloves, eyewear, gown, bottom string of mask, top string of mask
47
(Infect)
| The process resulting in infection is called;
The chain of infection
48
(Infect)
A PT diagnosed with a multi drug resistant organism in the surgical wound asks the nurse what this means. What is the nurses best response?
1 there is more than one organism in the wound that is causing the infection
2 the antibiotics the PT has received are not strong enough to kill the organism
3 the PT needs more than one type of antibiotic to kill the organism
4 the organism has developed a resistance to one or more broad spectrum antibiotics, indicating that the organism is hard to treat effectively
4
The statement "The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism is hard to treat effectively" defines multidrug resistant organism correctly.
49
(Infect)
A PT is placed on airborne precautions for a confirmed TB infection. The nurse noticed that the PT seems to be depressed and withdrawn. Which are the best interventions that the nurse takes to help the PT?
1 encourage the PT to voice his or her feelings and concerns regarding the diagnosis and isolation precautions
2 consider making a social services consult if the PT continues to display symptoms of depression
3 explain the reason for airborne precautions and answer the PTs questions, giving them reassurance that you will respond promptly when needed
4 remove you respirator mask intermittently so the PT can see your face
1, 2, 3
Patients on isolation precautions may interpret the needed restrictions as a sign of rejection by the health care worker. Offer appropriate explanations and reassurance that the patient will not be ignored. Never remove a mask while caring for a patient with a confirmed tuberculosis infection.
50
(Infect)
| Reservoirs are;
1. Animals,
2. food,
3. water,
4. organic matter on inanimate surfaces(fomites)
5. Often healthcare workers (Wash ya damn hands!!),
6. bodily excretions and secretions,
7. equipment and health care environment can lead to HAIs
51
(Infect)
| Rhinorrhea
AKA runny or stuffed nose
52
(Infect)
| Semi critical item
Something that will come in contact with a mucous membrane or nonintact skin (sterilized of high level disinfected)
53
(Infect)
| Severity of an infection depends on,
1. The pathogenicity and virulence of the microorganism, 2. the extent of the infection,
3. and the susceptibility of the host
54
(Infect)
| Signs/symptoms of a localized infection
1. Pain,
2. tenderness,
3. and swelling at the infection site.
55
(Infect)
| Signs/symptoms of a systemic infection
1. Fever,
2. increase in WBCs.
Often fatal!
56
(Infect)
| Standard Precaution includes;
Hand hygiene and gloves/masks, used for everyone
57
(Infect)
| Sterilization
Eliminates/destroys all forms of bacterial life, including spores. (Steam, dry heat. Hydrogen peroxide plasma, ETO)
58
(Infect)
| Suprainfection
Use of broad spectrum antibiotics can lead to this kind of infection because they also kill resident flora
59
(Infect)
| Susceptible host;
Depends on individuals degree of resistance to pathogen. The more virulent and the greater the dose the more likely one will succumb to the pathogen and get ill
60
(Infect)
| Transmission based precautions include;
Gowns, eye protection, anything extra to prevent getting an infection from an ill patient
61
(Infect)
| Vectors inclue
1. Flies,
2. ticks,
3. fleas,
4. mosquitoes.
62
(Infect)
| Vehicles include
1. Contaminated items,
2. water,
3. drugs,
4. blood,
5. food
63
(Infect)
| What are some risks for having a latex allergy?
1. Spina bifida,
2. defects,
3. indwelling or condom catherization,
4. childhood surgeries, 5. food allergies,
6. occupational expose to latex
64
(Infect)
| What form of hand cleaning should you use after being exposed to clostridium difficile or bacillus anthracis?
Normal hand washing with soap and warm water
65
(Infect)
| What is most effective against common pathogens found on hands?
Ethanol based hand antiseptics with 60-90% alchohol
66
(Infect)
What is the most effective action the nurse takes to break the chain of infection
1 Perform hand hygiene
2 wear gloves
provide education on infection prevention
4 provide private rooms for all patients
1
| Hands contaminated with transient bacteria are a primary source for transmission of infection.
67
(Infect)
| What kind of thermometer should you not use if the patient has CDIFF?
An electric thermometer
68
(Infect)
| What physiological changes occur in older adults that contribute to infection?
1. Decreased immunity,
2. dry mucous membranes,
3. decreased secretions,
4. decreased skin elasticity,
5. decrease in T and B lymphocytes
69
(Infect)
| What reduces HAIs?
Practice aseptic technique and wash ya damn hands!
70
(Infect)
| What should you do after contacting infectious material regardless of whether or not you are done with patient care?
Perform hand hygiene and change gloves!
71
(Infect)
| What should you do in an isolation room with anything you plan on taking out the the room?
Place items on a clean paper towel
72
(Infect)
| What should you do with equipment that comes in contact with patients with VRE or MRSA?
Leave contaminated equipment in the room
73
(Infect)
| What should you not do over a surgical wound/sterle dressing field?
Talking, sneezing, coughing.
74
(Infect)
| What's is susceptibility affected by?
1. Age,
2. heredity,
3. cultural practices,
4. nutritional status,
5. stress,
6. rest and exercise,
7. inadequate defenses,
8. personal habits,
9. neuron mental factors,
10. immunization/disease history,
11. medical therapies
75
(infect)
| When an infectious disease spreads to another being it is;
Communicable
76
(Infect)
| When a patient has an infection, and in the fifth step of the nursing process, you will.....
1. Evaluate the patients response,
2. noting fever,
3. wound pain or drainage,
4. swelling,
5. decreased energy,
6. increased fatigue
77
(Infect)
| When applying sterile gloves, glove your ..... Hand first
Dominant
78
(Infect)
| When can you use an alcohol based hand rub or antimicrobial soap and water? (Hands are not visibly dirty)
Direct patient contact. Sterile gloves, inserting invasive devices, after contact with bodily fluids, when moving from contaminated to clean site, after contact wit surfaces in patients room, after removing gloves.
79
(Infect)
When is it recommended by the CDC that you use soap and water instead of an alcohol based hand cleaner?
1 when ungloved hands are visibly soiled
2 when caring for a PT with a diagnosis of CDIFF
3 before eating and after toileting
4 all of the above
4
All recommendations are supported by research as interventions in preventing transmission of potentially harmful organisms.
80
(Infect)
Which are effective ways to prevent transmission of microorganisms between PTs? Select all that apply
1 following isolation precautions correctly when caring for a PT in transmission based precautions
2 cleaning hands before and after each PT encounter with soap and water or hand gel contain alcohol
3 cleaning hands before and after wearing personal protective equipment such as gloves, gowns, masks, and goggles
4 providing all PTs with private rooms
1, 2, 3
Hands become contaminated through contact with the patient and the environment and serve as an effective vector of transmission.
81
(Infect)
Which nursing intervention decreases the risk for urinary tract infection when placing an indwelling urinary catheter into a patient?
1 encourage the PT to drink additional fluids immediately before insertion
2 wear a mask, gown, and sterile gloves during the procedure
3 maintain strict surgical asepsis during the entire procedure
4 have the PT void before the insertion
3
Use surgical asepsis during procedures that involve insertion of a catheter or surgical instruments into sterile body cavities. The presence of a catheter in the urethra breaches the natural defenses of the body.
82
(Infect)
Why is it important for the nurse to use appropriate skin antisepsis before insertion of any invasive device?
1 inserting a device such as an intravenous line or drainage tube bypasses the skin as a natural barrier to infection
2 in enhances the effect of antibiotics administered at the same time
3 the sterility of the inserted device is not always certain
4 the PT may have poor personal hygiene or sometime of infectious skin condition
1
Antisepsis of the skin before insertion of an invasive device removes and, in some cases, kills microorganisms, preventing them from migrating into the patient during insertion of the device.
83
```
(Infect)
You can acquire immunity though
A. Natural active
B. Active
C. Natural passive
```
A. From previously having a disease
B. Vaccines
C. The acquisition of antibodies through another person (baby + momma). Short duration.
