Chapter 23: Care of Patients with Infection Flashcards
The nursing instructor explaining infection tells students that which factor is the best and most important barrier to infection?
Skin and mucous membranes
The skin and mucous membranes are the most important barrier against infection.
A nursing manager is concerned about the number of infections on the hospital unit. What action by the
manager would best help prevent these infections?
Auditing staff members hand hygiene practices
Health care workers lack of hand hygiene is the biggest
cause of healthcare-associated infections.
A student nurse/assistive personnel asks why brushing clients teeth with a toothbrush in the intensive care unit is important to
infection control. What response by the registered nurse is best?
It mechanically removes biofilm on teeth.
Biofilms are a complex group of bacteria that function within a slimy gel on surfaces such as teeth. Mechanical disruption (i.e., toothbrushing with friction) is the best way to control them
A client is admitted with possible sepsis. Which action should the nurse perform first?
Obtain specified cultures
Prior to administering antibiotics, the nurse obtains the ordered cultures. Broad-spectrum antibiotics will be
administered until the culture and sensitivity results are known
A client is hospitalized and on multiple antibiotics. The client develops frequent diarrhea. What action by the nurse is most important?
Consult with the provider about obtaining stool cultures.
Hospitalized clients who have three or more stools a day for 2 or more days are suspected of having infection
with Clostridium difficile. The nurse should inform the practitioner and request stool cultures
A nurse is observing as an unlicensed assistive personnel (UAP) performs hygiene and changes a clients bed
linens. What action by the UAP requires intervention by the nurse?
Shaking dirty linens and placing them on the floor
Shaking dirty linens (or even clean linens) can spread microbes through the air. Placing linens on the floor
contaminates the floor surface and can lead to infection spread via shoes.
A hospital unit is participating in a bioterrorism drill. A client is admitted with inhalation anthrax. Under
what type of precautions does the charge nurse admit the client?
Standard Precautions
Only Standard Precautions are needed
Which action by the nurse is most helpful to prevent clients from acquiring infections while hospitalized?
Consistently using appropriate hand hygiene.
Consistent practice of proper hand hygiene is the best method to prevent infection, as most healthcare-associated
infections are due to staff members contaminated hands.
A client is admitted with fever, myalgia, and a papular rash on the face, palms, and soles of the feet. What action should the nurse take first?
Place the client on Airborne Precautions
This client has manifestations of smallpox, a public health emergency, and should be placed on Airborne Precautions first before other care measures are implemented.
A client has been placed on Contact Precautions. The clients family is very afraid to visit for fear of being contaminated by the client. What action by the nurse is best?
Inform them that the infection is the issue, not the client
Show the family how to avoid spreading the disease
Families and clients often have negative reactions to isolation precautions. The nurse can explain that the infection is the problem, not the client, and encourage
Visitors may be apprehensive about visiting a client in Transmission-Based Precautions. The
nurse would reassure the visitors that taking appropriate precautions will minimize their risks
A nurse is caring for a client who has methicillin-resistant Staphylococcus aureus (MRSA) infection cultured from the urine. What action by the nurse is most appropriate?
Prepare to administer vancomycin (Vancocin).
Vancomycin is one of a few drugs approved to treat MRSA. The others include linezolid (Zyvox) and ceftaroline fosamil (Teflaro).
A hospitalized client is placed on Contact Precautions. The client needs to have a computed tomography (CT) scan. What action by the nurse is most appropriate?
Ensure that the radiology department is aware of the isolation precautions
Clients in isolation should leave their rooms only when necessary, such as for a CT scan that cannot be done
portably in the room
A client has a wound infection to the right arm. What comfort measure can the nurse delegate to the unlicensed assistive personnel (UAP)?
Elevate the arm above the level of the heart.
Elevating the extremity above the level of the heart will help with swelling and pain.
A nurse receives report from the laboratory on a client who was admitted for fever. The laboratory
technician states that the client has a shift to the left on the white blood cell count. What action by the nurse is most important?
Notify the provider and request antibiotics
A shift to the left indicates an increase in immature neutrophils and is often seen in infections, especially those caused by bacteria
A client has been admitted to the hospital for a virulent infection and is started on antibiotics. The client has laboratory work pending to determine if the diagnosis is meningitis. After starting the antibiotics, what action by the nurse is best?
Assess the client frequently for worsening of his or her condition.
Meningitis is a disease caused by endotoxins, which are released with cell lysis. Antibiotics often work by
lysing cell membranes, which would increase the amount of endotoxin present in the clients body. The nurse should carefully monitor this client for a worsening of his or her condition.
The student nurse caring for clients understands that which factors must be present to transmit infection?
(Select all that apply.)
Host
Mode of transmission
Portal of entry
Reservoir
Factors that must be present in order to transmit an infection include a host with a portal of entry, a mode of
transmission, and a reservoir
Which statements are true regarding Standard Precautions? (Select all that apply.)
Use personal protective equipment as needed for client care.
Wear gloves when touching client excretions or secretions
Standard Precautions implies that contact with bodily secretions, excretions, and moist mucous membranes and tissues (excluding perspiration) is potentially infectious. Always wear gloves when coming into contact with such material. Other personal protective equipment is used based on the care being given. For example, if face splashing is expected, you should also wear a mask
The student nurse learns that effective antimicrobial therapy requires which factors to be present? (Select all
that apply.)
Appropriate drug
Proper route of administration
Sufficient dose
Sufficient length of treatment
In order to be effective, antimicrobial therapy must use the appropriate drug in a sufficient dose, for a sufficient
length of time, and given via the appropriate route
A client is being admitted with suspected tuberculosis (TB). What actions by the nurse are best? (Select all
that apply.)
Admit the client to a negative-airflow room.
Order specialized masks/respirators for caregiving.
A client with suspected TB is admitted to Airborne Precautions, which includes a negative-airflow room and
special N95 or PAPR masks to be worn when providing care
A student nurse asks the nursing instructor why older adults are more prone to infection than other adults.
What reasons does the nursing instructor give? (Select all that apply.)
Age-related decrease in immune function Decreased cough and gag reflexes Diminished acidity of gastric secretions Thinning skin that is less protective Higher rates of chronic illness
Older adults have several age-related changes making them more susceptible to infection, including decreasedn immune function, decreased cough and gag reflex, decreased acidity of gastric secretions, thinning skin, and
fewer lymphocytes and antibodies.
A client with an infection has a fever. What actions by the nurse help increase the clients comfort? (Select
all that apply.)
Change the clients gown and linens when damp.
Offer cool fluids to the client frequently
Sponging the client with tepid water.
Comfort measures appropriate for this client include offering frequent cool drinks, and changing linens or the gown when damp.
A nurse plans care for a client who is at risk for infection. Which interventions will the nurse implement to prevent infection? (Select all that apply)
Monitor white blood cell count and differential.
Screen all visitors for infections.
Promote sufficient nutritional intake.
Nursing interventions for clients at risk for infection include monitoring white blood cell
count and differential, screening visitors for infections and infectious disease, and promoting
sufficient nutritional intake
A nurse cares for several clients on an inpatient unit. Which infection control measures will
the nurse implement? (Select all that apply.)
Wear a gown when contact of clothing with body fluids is anticipated.
Teach clients and visitors respiratory hygiene techniques.
Disinfect frequently touched surfaces in client-care areas.
Infection control measures appropriate to all clients include hand hygiene with alcohol-based
hand rub or soap between client contact, procedures for routine care, cleaning and disinfection
of frequently contaminated surfaces, and wearing personal protective equipment when
contamination is anticipated
The nurse caring for clients admitted for infectious diseases understands what information about emerging global diseases and bioterrorism?
Many infections are or could be spread by international travel.
A nurse manager is preparing an educational session for floor nurses on drug-resistant
organisms. Which statement below indicates the need to review this information?
“If you leave work wearing your scrubs, go directly home and wash them right
away.”
To help prevent the transmission of an MDRO, wear scrubs and change clothes before leaving
work. Keep work clothes separate from personal clothes
A client is to receive a fecal microbiota transplantation tomorrow (FMT). What action by the
nurse is best?
Administer bowel cleansing as prescribed.
The usual route of delivering an FMT is via colonoscopy, so the client would have a bowel
cleansing as prescribed for that procedure.
A nurse is observing as an assistive personnel (AP) performs hygiene and provides comfort
measures to a client with an infection. What action by the AP requires intervention by the
nurse?
Ordering an oscillating fan for the client
Fans in client care areas are discouraged because they can disperse airborne or droplet-borne
pathogens.
The nurse learning about infection discovers that which factor is the best and most important
barrier to infection?
Skin and mucous membranes
The skin and mucous membranes are two of the most important barriers against infection
