Chapter 28 Infection Prevention

Question 1

Infection is

Answer 1

the invasion of a susceptible host by pathogens or microorganisms, resulting in disease.

Question 2

Entry and multiplication of organisms result in

Answer 2

disease

Question 3

Colonization occurs when

Answer 3

a microorganism invades the host but does not cause infection

Question 4

Communicable disease is

Answer 4

the infectious process transmitted from one person to another.

Question 5

symptomatic infection:

Answer 5

pathogens multiply and cause clinical signs and symptoms

Question 6

asymptomatic infection:

Answer 6

clinical signs and symptoms are not present

Question 7

Hand hygiene is

Answer 7

the most important technique to use in preventing and controlling transmission of infection

Question 8

Chain of Infection

Answer 8

Infectious agent or pathogen –> Reservoir or source for pathogen growth –> Portal of exit –> Mode of transmission –> Portal of entry –> Susceptible host

Question 9

Immunocompromised means

Answer 9

having an impaired immune system

Question 10

Virulence is

Answer 10

the ability to produce disease

Question 11

Aerobic bacteria require

Answer 11

oxygen for survival and for multiplication sufficient to cause disease.

Question 12

Anaerobic bacteria thrive

Answer 12

where little or no free oxygen is available.

Question 13

bacteriostasis—

Answer 13

prevention of growth and reproduction of bacteria

Question 14

bactericidal—

Answer 14

destructive to bacteria

Question 15

Infectious Process: 4 Stages

Answer 15

1. Incubation period
2. Prodromal stage
3. Illness stage
4. Convalescence

Question 16

Infectious Process is a localized

Answer 16

versus systematic infection

Question 17

Normal flora

Answer 17

Microorganisms
-helps to resist infection by releasing antibacterial substances and inhibiting multiplication of pathogenic microorganisms

Question 18

Body system defenses

Answer 18

organs

Question 19

Inflammation:

Answer 19

Vascular and cellular responses
Exudates (serous, sanguineous, or purulent)
Tissue repair

Question 20

Signs of local inflammation and infection are

Answer 20

identical

Question 21

Health Care–Associated Infections:

Answer 21

Results from delivery of health services in a health care facility

Question 22

Patients at greater risk for health-care associated infections (HAIs):

Answer 22

Multiple illnesses
Older adults
Poorly nourished
Lowered resistance to infection

Question 23

Types of HAI infection:

Answer 23

latrogenic
exogenous
endogenous

Question 24

Latrogenic:

Answer 24

from a procedure

Question 25

Exogenous:

Answer 25

from microorganisms outside the individual

Question 26

Endogenous:

Answer 26

when the patient's flora becomes altered and an overgrowth results

Question 27

Risk factors:

Answer 27

Number of health care employees with direct contact with the patient Types and numbers of invasive procedures Therapy received Length of hospitalization

Question 28

Major sites for HAI infection:

Answer 28

Surgical or traumatic wounds Urinary and respiratory tracts Bloodstream

Question 29

Factors influencing infection:

Answer 29

``` prevention and control: Age Nutritional status Stress Disease process Treatments or conditions that compromise the immune response ```

Question 30

Assessment includes a thorough investigation:

Answer 30

Review of systems, travel history | Immunizations and vaccinations

Question 31

Nursing Process: Assessment (cont’d)

Answer 31

``` See through the patient’s eyes. Status of defense mechanisms Patient susceptibility Clinical appearance Laboratory data ```

Question 32

Patient susceptibility:

Answer 32

medical therapy

Question 33

Clinical appearance:

Answer 33

signs and symptoms of infection

Question 34

Nursing diagnoses for infection:

Answer 34

Risk for infection Imbalanced nutrition: less than body requirements Impaired oral mucous membrane Risk for impaired skin integrity Social isolation Impaired tissue integrity Readiness for enhanced immunization status

Question 35

Planning: Goals and outcomes:

Answer 35

Preventing exposure to infectious organisms Controlling or reducing the extent of infection Maintaining resistance to infection Verbalizing understanding of infection prevention and control techniques (e.g., hand hygiene)

Question 36

Planning: Setting Priorities

Answer 36

Establish priorities for each diagnosis and for related goals of care.

Question 37

Planning: Teamwork and collaboration

Answer 37

Remember to plan care and include other disciplines as necessary.

Question 38

Implementation:

Answer 38

Health Promotion | Acute Care

Question 39

Health Promotion:

Answer 39

Preventing an infection from developing or spreading

Question 40

Acute care:

Answer 40

Treating an infectious process includes eliminating the infectious organisms and supporting the patient’s defenses

Question 41

When implementing care, consider:

Answer 41

``` Medical and surgical asepsis Control or elimination of infectious agents Control or elimination of reservoirs Control of portals of entry Control of transmission Hand hygiene Isolation precautions ```

Question 42

Asepsis =

Answer 42

Absence of pathogenic (disease-producing) microorganisms.

Question 43

Aseptic technique =

Answer 43

Practices/ procedures that assist in reducing the risk for infection.

Question 44

Medical asepsis, or clean technique, includes

Answer 44

procedures for reducing the number of organisms present and preventing the transfer of organisms.

Question 45

Surgical asepsis or sterile technique prevents

Answer 45

contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery.

Question 46

Standard precautions help infection and can

Answer 46

Apply to contact with blood, body fluid, nonintact skin, and mucous membranes from all patients.

Question 47

Hand hygiene includes

Answer 47

using an instant alcohol hand antiseptic before and after providing patient care, washing hands with soap and water when they are visibly soiled, and performing a surgical scrub.

Question 48

Handwashing is:

Answer 48

the act of washing hands with soap and water, followed by rinsing under a stream of water for 15 seconds.

Question 49

Disinfection:

Answer 49

- a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects - Disinfection of surfaces - High-level disinfection, which is required for some items such as endoscopes

Question 50

Sterilization:

Answer 50

the complete elimination or destruction of all microorganisms, including spores

Question 51

Patient safety:

Answer 51

Separate personal care items Handling solid and fluid waste Wound cleaning

Question 52

Other infection preventions include:

Answer 52

Patient education Cough etiquette Isolation and isolation precautions Surgical asepsis

Question 53

Cough Etiquette:

Answer 53

- Cover your nose/mouth with a tissue when you cough, and promptly dispose of the contaminated tissue. - Place a surgical mask on a patient if it does not compromise respiratory function or is applicable; this may not be feasible in pediatric populations. - Perform hand hygiene after contact with contaminated respiratory secretions - Maintain spatial separation greater than 3 feet from persons with respiratory infection

Question 54

Isolation:

Answer 54

the separation and restriction of movement of ill persons with contagious diseases. -Standard precautions and isolation precations

Question 55

Isolation precautions:

Answer 55

airborne, droplet, contact, and protective environment

Question 56

Isolation includes:

Answer 56

- Psychological implications - Isolation environment - Personal protective equipment - Specimen collection - Bagging of trash or linen - Patient transport

Question 57

Surgical Asepsis includes:

Answer 57

- Patient preparation - Sterile field: an area free of microorganisms and prepared to receive sterile items - Principles - Performing sterile procedures

Question 58

Principles of Surgical Asepsis: Steps 1-4

Answer 58

1. a sterile object remains sterile only when touched by another sterile object 2. only sterile objects may be placed on a sterile field 3. a sterile object or field out of the range of vision or an object held below a person's waist is contaminated 4. a sterile object or field becomes contaminated by prolonged exposure air

Question 59

Principles of Surgical Asepsis: Steps 5-7

Answer 59

5. when a sterile surface comes in contact, the sterile object or field becomes contaminated by capillary action 6. fluid flows in the direction of gravity 7. The edges of a sterile field or container are considered to be contaminated

Question 60

Performing Sterile Procedures:

Answer 60

- Donning and removing caps, masks, and eyewear - Opening sterile packages - Opening a sterile item on a flat surface - Opening a sterile item while holding it - Preparing a sterile field - Pouring sterile solutions - Surgical scrub - Applying sterile gloves - Donning a sterile gown

Question 61

Evaluation:

Answer 61

See through the patient's eyes | Patient Outcomes

Question 62

See through the patient's eyes:

Answer 62

Have the patient’s expectations been met?

Question 63

Patient outcomes:

Answer 63

- Measure the success of the infection control techniques. - Compare the patient’s actual response with expected outcomes. - If goals are not achieved, determine what steps must be taken.

Question 64

Exposure issues:

Answer 64

- infection from accidental needlesticks - report immediately - begins with source patient testing - stated in the testing law for each state

Question 65

MDRO:

Answer 65

``` -Multi-Drug Resistant Organism MRSA - Staph aureus 1 organism VRE - found in family CRE C. difficile (lives in GI) ```

Question 66

How do infections spread?

Answer 66

Contact Airborne Person to person Vectors

Question 67

Antimicrobial Stewardship 5 D's:

Answer 67

``` Diagnosis Drug Dose Duration De-escalation ```