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Nursing Fundamentals > Chapter 28: Infection Prevention (Intro Wk) > Flashcards

Chapter 28: Infection Prevention (Intro Wk) Flashcards

1
Q

How does disease or infection result?

A

Disease or infection results only if the pathogens multiply and alter normal tissue function. You start looking for colonization, communicable diseases, look for vectors, look for symptomatic people

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2
Q

Define infection

A

Results when a pathogen invades tissues and begins growing within a host. It is the invasion of a susceptible host by pathogens or microorganisms — it results in disease

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3
Q

Define colonization

A

Presence and growth of microorganisms within a host but without tissue invasion or damage

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4
Q

Define communicable disease

A

infectious process transmitted from one person to another

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5
Q

What is the chain of infection include

A
  1. Infectious agent or pathogen
  2. Reservoir or source for pathogen growth
  3. Port of exit from the reservoir
  4. Mode of transmission
  5. Port of entry to a host
  6. Susceptible host
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6
Q

What is the most effective way to break the chain of infection

A

Hand Hygiene

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7
Q

What is the reservoir in the chain of infection

A

A place where microorganisms survive, multiply and await transfer to a susceptible host

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8
Q

Does the presence of a pathogen mean infection will occur?

A

No, the presence of a pathogen DOES NOT mean an infection will occur. Infection occurs in a cycle that depends on the presence of all of the elements in the chain of infection. If the chain is broken, you will hopefully not become symptomatic

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9
Q

What can be done to prevent infection

A
  1. Wash hands for 20 seconds or more
  2. Nutritious diet - lets of Vitamin C, Zinc, Calcium and protein
  3. PPE
  4. Prevent reservoirs for pathogens, time, date and initial all equipment and saline, sterile water
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10
Q

What 2 types are human reservoirs divided into

A

1 Those with acute or symptomatic disease
2. Those who show no signs of disease but are carriers of it

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11
Q

What kind of environment do organisms need to thrive

A
  1. Aerobic - bacteria that requires oxygen for survival and for multiplication sufficient to cause disease
  2. Anaerobic - bacteria thrive where little or no free oxygen is available
  3. Water or moisture for survival
  4. Ideal temperature between 68 - 109 F (20-43 C)
  5. pH between 5-7
  6. Dark environments such as those under dressings and within body cavities
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12
Q

Systemic

A

An infection that affects the entire body instead of just a single organ

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13
Q

What are modes of transmissions

A
  1. Direct
  2. Indirect
  3. Droplet
  4. Airborne
  5. Vehicles - contaminated items
  6. Vector - External mechanical transfer/internal transmission such as parasitic conditions
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14
Q

What are the 4 stages of the infectious process

A
  1. Incubation period - time interval between entrance of the pathogen and appearance of first symptoms
  2. Prodromal stage - may or may not see any symptoms. Most infectious. Interval from onset of nonspecific signs and symptoms to more specific symptom
  3. Illness stage - interval when the patient manifests signs and symptoms specific to the type of infection
  4. Convalescence - interval when acute symptoms of infection disappear
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15
Q

How do our bodies protect us against infection

A

Normal flora, body system defenses – our organs and by inflammation (inflammation is the cellular response of the body to injury, infection or irritation - it is also the reaction that delivers fluid, blood products and nutrients to injured area)

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16
Q

What is Normal flora

A

They are microorganisms that reside in the body and maintain a sensitive balance with other microorganisms to prevent infection

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17
Q

What are the inflammatory response events that take place

A
  1. Vascular and cellular responses - this process neutralizes and eliminates pathogens or dead (necrotic) tissues and establishes a means of repairing body cells and tissues
  2. Formation of inflammatory exudates
  3. Tissue repair
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18
Q

Explain the cellular response that occurs during inflammation

A

WBC arrive at the site – the WBC pass through blood vessels and into the tissues — then phagocytosis and leukocytosis

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19
Q

Phagocytosis

A

Specialized white blood cells called neutrophils and monocytes that ingest and destroy microorganisms or other small particles during the cellular response of inflammation

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20
Q

Leukocytosis

A

It is the increase in the number of circulating WBCs – response of the body to WBCs leaving blood vessels

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21
Q

What is the normal range of WBC in an adult

A

5,000 to 10,000/mm3

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22
Q

What does the WBC rise to during inflammation

A

15,000 to 20,000 or higher

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23
Q

What are inflammatory exudates

A

accumulation of fluid, dead tissue cells and WBCs forms an exudate. It can be serous (clear like plasma), sanguineous (containing RBCs) or purulent (containing WBC and bacteria)

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24
Q

What are signs of local vs. systemic inflammation

A

Local - swelling, redness, heat, pain, tenderness, loss of function in affected body part

Systemic - fever, increased WBC, nausea, vomiting, lymph node enlargement

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25
Q

What PPE would you wear if you were changing a wound dressing?

A

Wounds are purulents (contains WBCs and bacteria). First wash hands, if it smells waft it, wear goggles, mask and gloves

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26
Q

Where is normal flora located in the body?

A

Surface and deep layers of skin, in the saliva and oral mucosa, in the GI and GU tracts

27
Q

What are Healthcare associated infections (HAI)

A

HAI results from delivery of health services in a health care facility. They occur as the result of invasive procedures, antibiotic administration, presence of multidrug resistant organisms and breaks in infection prevention

28
Q

What are major sites for HAIs

A

surgical or traumatic wounds, urinary tract, respiratory tract and the bloodstream

29
Q

What type of patients are at greater risk for HAI

A
  1. Multiple illnesses
  2. Older adults
  3. Poorly nourished
  4. Compromised immune system
30
Q

What are the 3 types of HAIs

A
  1. Iatrogenic infection - from a procedure
  2. Endogenous - when the patient’s flora becomes altered and an overgrowth results (example Streptococci)
  3. Exogenous - from microorganisms outside the individual (example: Salmonella)
31
Q

During a endogenous HAI what is often the reason this occurs

A

This often happens when a patient receives broad spectrum antibiotics that alter the normal floras

32
Q

What are the factors that influence a patient’s susceptibility to infection

A
  1. Age
  2. Nutritional status
  3. Stress - elevated cortisone levels result in decreased resistance to infection
  4. Disease process - Example: leukemia, AIDS, lymphoma, and aplastic anemia
  5. Treatments or conditions that compromise immune response (example: burns)
33
Q

What is the first step in the nursing process?

A

Assessment - Gathering objective and subjective data

34
Q

Name some ways that makes for a thorough assessment

A

Review the following:
- Medications
- Travel history
- Stressors
- Risk factors
- Defense mechanisms, susceptibility and knowledge of how infections are transmitted
- Review of systems
- Immunizations/vaccines
- possible existing infections

And analyze lab data

35
Q

What is the second step in the nursing process

A

Diagnosis - analyzing the assessment data

36
Q

What are examples of diagnoses commonly associated with infection prevention and control

A
  1. Risk for infection
  2. Imbalanced nutrition: less than body requirements
  3. Impaired oral mucous membrane
  4. Risk for impaired skin integrity
  5. Social isolation
  6. Impaired tissue integrity
  7. Readiness for enhanced immunization status
37
Q

What is the third and 4th step in the nursing process?

A

Third - outcome identification
Fourth - Planning

38
Q

During the planning and outcome identification stage what kind of goals and outcomes should the nurse set

A
  • Realistic outcomes so interventions are purposeful, direct and measurable
  • S.M.A.R.T Goals
    Specific (simple, sensible, significant)
    Measurable (meaningful, motivating)
    Achievable (agreed, attainable)
    Relevant (reasonable, realistic and resourced, results-based)
    Time Bound (time based, time limited, time/cost limited, timely and time sensitive)
39
Q

What are some common goals of care applicable to patients with infection

A
  1. Preventing exposure to infectious organisms
  2. Controlling or reducing the extent of infection
  3. Maintaining resistance to infection
40
Q

Describe what happens during the planning and outcome identification stage of the nursing process

A
  1. Set Goals and outcomes
  2. Set priorities - establish priorities for each dx and for related goals of care
  3. Teamwork and collaboration
41
Q

What is the Fifth step in the nursing process?

A

Implementation

42
Q

What does the nurse do during the implementation stage

A

Health promotion – > preventing an infection from developing or spreading by promoting
- Nutrition support
- Rest/exercise
- Maintenance of physiological protective mechanisms (hand hygeine)
- Immunizations

43
Q

What is Asepsis

A

This is the absence of pathogenic (disease producing) microorganisms

44
Q

What are the 2 types of aseptic techniques

A
  1. Medical - use for all patients even when no infection is diagnosed
  2. Surgical
45
Q

What are examples of medical asepsis

A

Hand hygiene, use of PPE and routine environmental cleaning
standard precautions - designed to be used for all patients
alcohol based hand rub

46
Q

What is surgical asepsis

A

Includes procedures used to eliminate all microorganisms including pathogens and spores from an object or area
- An area or object. is considered contaminated if touched by any object that is not sterile
- Demands the highest level of aseptic technique and requires that all areas be kept free of infectious microorganisms

47
Q

What is sterile field

A

An area free of microorganisms and prepared to receive sterile items
It requires a work area in which objects can be handled with minimal risk of contamination

48
Q

Can a nurse turn their back on a sterile field?

A

NO. Never leave sterile field (i.e. sterile tray) unattended. DO NOT TURN YOUR BACK. Anything out of range of vision is no longer sterile

49
Q

Is sterile field below or above your waist?

A

Above your waist to be considered sterile.

50
Q

What is anything within a 1 inch border considered? STERILE or CLEAN

A

It is considered clean. IT IS NOT STERILE. The edges of a sterile field or container are not sterile

51
Q

Can a sterile object or field become contaminated by prolonged exposure to air?

A

YES

52
Q

What happens when a sterile surface comes in contact with a wet surface?

A

Becomes contaminated by capillary action

53
Q

What is disinfection

A

a process that eliminates many or all microorganisms with the exception of bacterial spores from inanimate objects

54
Q

What are the 2 types of disinfection

A
  1. Disinfection of surfaces
  2. High level disinfection which is required for some patient care items such as endoscopes
55
Q

What is sterilization

A

the complete elimination or destruction of all microorganisms including spores

56
Q

What are some sterilization methods

A

Using steam, dry heat, hydrogen peroxide plasma, or ehtylene oxide

57
Q

What order do you remove your PPE

A

Gloves, Faceshield or goggles, gown and mask

58
Q

What is isolation

A

Isolation is the separation and restriction of movement of ill persons with contagious disease

59
Q

What are the 4 types of transmission based precautions which are based on the mode of transmission

A
  1. Airborne
  2. Droplet
  3. Contact - Direct and indirect contact with patients
  4. Protective environment

These precautions are for patients with highly transmissible pathogens

60
Q

What do contact precautions require

A

Requires gown and gloves

61
Q

What are the droplet precautions

A

Requires wearing surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated care equipment
Example: Sepsis, Pneumonia, influenza, adenovirus

62
Q

What are the airborne precautions

A

Requires a specifically equipped room with negative air flow referred to as an airborne infection isolation room. All health care personnel wear a N95 respirator every time they enter. If mask is moist, not being protected anymore. Other PPE needed is gown, N95 and gloves. No faceshield is needed
Example: TB patients

63
Q

What type of isolation precaution is appropriate for meningitis

A

Droplet precaution

Nursing Fundamentals (15 decks)

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