Chapter 31: Infection Prevention/Management Flashcards
Disease
the decline in wellness of a host due to infection.
Infection
Infection is a condition in which the host interacts physiologically and immunologically with a microorganism.
Colonization
State in which a microorganism is present but no immune reaction or tissue destruction occurs
Aka the presence of micros w/o host interference or interaction
the introduction of microorganisms onto a body surface, where they grow and multiply but do not invade the body or cause an immune response or symptoms
subclinical infection
When the body successfully resists being overwhelmed by infection
Infection that shows little/few signs or symptoms and host may be unaware of its exposure
Antigens form that can be recovered from the person’s blood
secondary infection
A secondary infection is an infection that occurs during or after treatment for another infection. It may be caused by the first treatment or by changes in the immune system.
Infection that occurs in a weakened client
Clinical Disease
A disease that has obvious/recognizable clinical signs and symptoms
Sepsis
poisoning of body tissues, usually referring to blood borne organisms and their toxic products
Symptoms: increased heart rate greater than 90 respiration greater than 20 a minute
lactate levels increase secondary to anaerobic metabolism due to hypoperfusion
incubation period
refers to the time between the pathogen’s entrance into the host and the appearance of symptoms
incubation period
refers to the time between the pathogen’s entrance into the body and the appearance of symptoms of infection
During this stage, the organisms are growing and multiplying.
prodromal period
characterized by nonspecific symptoms
prodromal period
When a person is most infectious
Early signs and symptoms of disease are present, but are often vague and nonspecific (ranging from fatigue and malaise to a low-grade fever)
passive period
immunity that is transferred to the recipient
Lactic Acid
Present in blood as lactate
Normal levels: 0.3 to 2.6 mol/L
lactate levels increase secondary to anaerobic metabolism due to hypo perfusion
Wound Infection Symptoms
Clinical evidence of redness, heat, and pain, and laboratory evidence of white blood cells on the wound specimen smear, suggest infection
acute phase
occurs when specific symptoms and often laboratory analysis can identify the disease
Neutropenia
present when the absolute neutrophil count (ANC) falls to fewer than 1,000 cells/mm3
Infections that are cause for concern to society
Increasing numbers of multidrug-resistant organisms (MDROs), including TB, methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamases (ESBLs), resistant Clostridium difficile (C. difficile), and vancomycin-resistant enterococci (VRE)
Mechanical Defense Mechanisms
Mechanical defense mechanisms are physical barriers that prevent microorganisms from gaining entry or expel microorganisms before they multiply. Examples are the skin and mucous membranes, physiologic reflexes (e.g., sneezing, coughing, vomiting), and macrophages. Casts, clothing, and sunscreen do not keep microorganisms from gaining entry to the body
Systemic Affect
means affecting the whole body, or at least multiple organ systems
Fever Phase
skin is warm and flushed, and the client has general malaise
Signs of infection
the lymph nodes that drain an infected area may become enlarged and easily palpable (“swollen glands”). As the swelling increases, the nodes may also become tender
Signs of inflammation
the lymphatic capillaries dilate as excess interstitial fluid, proteins, and invading microorganisms enter the lymphatic system
Hyperlactemia
Often present in clients with severe sepsis. All clients with elevated lactate levels greater than 4 mmol/L need early, goal-directed therapy for severe sepsis resuscitation bundle, regardless of blood pressure.
Swelling Indications
The swelling indicates that lymphocytes and macrophages in the lymph node are fighting the infection and trying to limit its spread
Characteristics of Full Stage of Illness
The presence of specific signs and symptoms and this type of infection determines the length of the illness and the severity of the manifestations
Covalence period
recovery from infection
the signs and symptoms disappear, and the person returns to a healthy state.
Septicemia
A temperature greater than 100.4°F (38°C) and a WBC count greater than 12,000 or less than 4,000 are signs of this.
Other signs include a heart rate greater than 90 bpm and a RR greater than 20 bpm, chills, confusion, lethargy, mottling, and decreased urine output.
Acquired Specific Defenses
Include cellular and humoral immunity
Non Specific Natural Defenses
Gastric acid secretion, phagocytosis, and intact skin are nonspecific
From the time of admission, broad-spectrum antibiotics should be administered within 3 hours for emergency department admissions, and within 1 hour for non-emergency department ICU admissions.
Evidence suggests that early administration of appropriate antibiotics reduces mortality in clients with gram-positive and gram-negative bacteremia.
SBAR
Situations: What is happening at the present time? Background: What are the circumstances leading up to this situation? Assessment: What do I think the problem is? Recommendations: What should we do to correct the problem?
Anaerobic Culture
obtained from deep in the cavity to identify organisms that may grow where oxygen is not present.
Aerobic Culture
the nurse would obtain the specimen from deep in an area of active drainage
Additional notes on cultures
cultures are NEVER taken from the edge of a wound or from soiled dressing
Febrile Episode
Has 3 Phases:
- Chill
- Fever
- Flushing (Crisis)
Cellular Immunity Function
reactivate if the same antigen (toxin or foreign substance) reappears.
Complement System
enhances phagocytosis of microbes, helps lysis of bacterial cell walls, and encourages inflammatory response
