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PNC 102 lecture > Chapter 8: nursing care of patients w/ infections > Flashcards

Chapter 8: nursing care of patients w/ infections Flashcards

1
Q

Infection process

A
  • chain of infection required
  • six links in the chain
  • treatment breaks the chain
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2
Q

infective (causative) agents

A
  • bacteria
  • virus
  • fungi
  • protozoa
  • Helminth
  • Prion
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3
Q
A
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4
Q

microbiota

A

microbes occurring naturally in a body part

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5
Q

pathogen

A

disease causing microbe

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6
Q

reservoir

A

environmental ome for infectious agents
- animate: people, insects, animals, plants
- inanimate: water, soil, medical devices

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7
Q

portal of exit

A

path by which infectious agent leaves its reservoir

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8
Q

mode of transmission

A

direct
indirect

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9
Q

direct mode of transmission: direct contact

A

touching
kissing
sexal contact

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10
Q

direct mode of transmission: droplet spread

A

sneezing
coughing
talking

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11
Q

disease examples for direct transmission

A

scabies
infectious mononucleosis
STIs
pertussis
influenza

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12
Q

prevention of direct contact

A

hand hygiene
aseptic technique
PPE: gloves, surgical masks, goggles, gowns, shoe covers

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13
Q

indirect transmission

A

vehicle born transmission by contact w/ contaminated object

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14
Q

indirect vehicle examples

A

toys, bedding, dressings, surgical instruments
biological: blood, organs
water/food

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15
Q

disease examples of indirect transmission

A
  • influenza, norovirus, hepatitis
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16
Q

prevention of indirect transmission

A
  • hand hygiene, stethoscope cleaning
  • cleaning per protocols
  • clean water/food
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17
Q

Indirect vector

A

born transmission by living source other than humans
- vectors: fleas, mice, mosquitos, rats, ticks
- disease examples: lyme disease, malaria, plague, zika
- prevention: insect repellents, rodent control

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18
Q

airborne transmission

A
  • dust or droplet nuclei carry pathogen through air
  • small particles in air for long time and large distance inhaled/deposited on host mucous membranes
  • disease examples: measles, chickenpox, tb
  • prevention: high effeciency particulate air (HEPA) respirators
  • must have your own fit tested HEPA respirator
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19
Q

portal of entry

A
  • entry into susceptible host
  • portals: respiratory tract, skin, mucoumembranes, gastrointestinal tract, genitourinary tract, placenta
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20
Q

susceptible host

A
  • occurs from defense breakdown
  • increased risk: burns, chronic disease, immunocompromised, invasive procedures, malnourishment, stress, young or old age
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21
Q

body’s defense mechanisms

A
  • skin and mucous membranes
  • cilia
  • gastric acid
  • immunoglobulins
  • leukocytes and macrophages
  • lysozymes
  • interferon
  • inflammatory response
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22
Q

inflammatory response

A
  • vascular response
  • inflammatory exudate
  • phagocytosis and purulent exudate
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23
Q

immune system

A
  • body’s final defense against infection
  • immune cells and lymphoid tissue
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24
Q

infection

A

results when immune system protection fails

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25
Q

localized infection

A
  • microbes in one area
  • pain, redness, swelling, site warmth
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26
Q

sepsis

A
  • dysregulated host response to infection
  • can be life threatening
  • organ damage
  • can lead to septic shock: decreased bp
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27
Q

laboratory assessment

A
  • gram staining
  • culture and sensitivity (C&S)
  • antibody test
  • complete blood count w/ differential
  • erythrocyte sedimentation rate (ESR)
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28
Q

immunity

A
  • natural immunity: species specific
29
Q

innate immunity

A

hereditary

30
Q

acquired immunity

A

exposure
vaccination
immunoglobulin injection

31
Q

infectious mononucleosis

A
  • epstein barr virus usual cause
  • contagious
  • symptomatic in teens, young adults
  • extreme fatigue, anorexia, chills, red sore throat, headache, high fever, tonsils w/ white coating
  • supportive care
32
Q

ebola virus disease

A
  • direct contact transmission
  • use hand hygiene, specialized PPE
  • symptoms appear in 2-21 days
  • fever, headache, diarrhea, vomiting, abdominal pain, muscle pain, unexplained bruising/bleeding
  • supportive care only
  • complications: joint and vision problems
33
Q

zika virus disease

A
  • transmitted by infected aedes specis mosquitos
  • use hand hygiene, contact precautions
  • symptoms: fever, headache, rash, muscle/joint pain, conjunctivitis
  • supportive care: acetaminophen, fluids, rest
  • complications: Guillain-Barre syndrome, birth defects
34
Q

community infection control

A
  • world health organization
  • centers for disease control and prevention
  • local health depts
  • home health nurses
35
Q

infection control in health care agencies

A
  • community acquired infection
  • healthcare associated infections
36
Q

health care associated infections

A
  • infection from care in healthcare agency
37
Q

risk factors for healthcare associated infections

A
  • host’s condition
  • multiple antibiotic therapy
  • high risk units
38
Q

common pathogens of health care associated infections

A
  • escherichia coli
  • staphylococcus aureus
  • pseudomonas aeruginosa
39
Q

asepsis

A

freedom from organisms

40
Q

medical asepsis

A

clean technique

41
Q

surgical asepsis

A

sterile technique

42
Q

ultraviolet environmental disinfection

A
  • UV light used to disinfect pt care areas and rooms after traditional cleaning
43
Q

infection prevention: standard precautions

A
  • assume all pts infectious
  • blood, body fluids, bdy substances
  • hand hygiene, gloves, gowns, masks, goggles, face shields
44
Q

infection prevention: transmission based precautions

A
  • specific infectious diseases
  • used w/ standard precautions
45
Q

precautions for vancomycin-resistant enterococci

A
  • private room required
  • gloves must be worn by all hospital personnel entering room
  • wash hands on entering and leaving room
  • gowns: required if contamination of clothing is likely
  • decontaminate all equipment used in the room before removal from the room
46
Q

risk factors for respiratory tract infections

A

invasive tubes

47
Q

prevention of respiratory tract infections

A
  • oral hygiene
  • coughing and deep breathing
  • ventilator asociated pneumonia bundles
48
Q

risk factors for genitourinary tract infection

A

urinary catheters

49
Q

prevention of genitourinary tract infections

A
  • appropriate use of urinary catheters
  • intermittent catheterization
  • strict aseptic technique
  • secure tubing as directed
  • closed system
  • drainage bag below bladder level
50
Q

prevention of surgical wound infections

A
  • sterile technique used for dressing changes
  • monitor wound
51
Q

antibiotic resistant infections: methicillin resistant staphylococcus aureus (MRSA)

A
  • difficult to treat
  • high mortality rate
  • treatment: vancomycin hydrochloride
52
Q

VRE

A
  • direct/indirect transmission
  • difficult to treat
  • treatment: combination antibiotic therapy
  • isolation when hospitalized
53
Q

treatment of infections

A
  • type of organism guides drug selection: antibiotics, antivirals, fungals
  • monitor peak/trough levels
54
Q

antibiotics

A

bacterial infections

55
Q

antivirals

A

viral infections

56
Q

antifungals

A

fungal infections

57
Q

antibiotic associated diarrhea

A
  • upset of balance of natural gut microbiota
  • harmful bacteria increase
  • toxins cause inflammation
  • watery stools result
  • may resolve when antibiotic stopped
58
Q

clostridium difficile

A
  • gram positive bacterium
  • overgrowth w/ imbalance in normal gut microbiota
  • often from antibiotic therapy
  • serious cause of AAD
  • psuedomembranous colitis, a life threatening condition, may result
  • transmitted by the fecal oral route
  • handwashing essential
  • alcohol based rubs not effective
  • antibiotic treatment stopped
  • treatment: metronidazole or vancomycin
59
Q

fecal microbiota transplantation

A
  • treatment for c diff infection
  • restores healthy gut bacteria
  • rapid, dramatic results to restore health
  • screened healthy donated feces
  • transplanted via colonoscopy, sigmoidoscopy, nasogastric or nasoenteric tube, enema, esophagogastroduodenoscopy, or oral capsules
  • stool substitutes under study: purified intestinal bacterial cultures, more acceptable to patients
60
Q

nursing responsibilities for care of pts w/ infections

A
  • check allergies
  • monitor side effects
  • check for signs of superinfection
  • monitor peak/trough levels
61
Q

patient education for infections

A
  • take all medication as prescribed
  • report side effects
62
Q

respiratory tract infections

A
  • data collection: signs and symptoms, sputum culture
  • nursing diagnosis: risk for infection
63
Q

implementation

A
  • coughing and deep breathing
  • oral care: toothbrush or suction-type toothbrush and fluoride toothpaste
  • hydrate
  • manage pain
  • elevate head of bed 30 degrees or more for tube feeding
64
Q

evaluation of respiratory tract infections

A
  • oxygen saturation above 90%
  • decreased dyspnea
  • respirations not labored
  • free of infection signs/symptoms
65
Q

GI tract infections

A
  • data collection: signs and symptoms, dehydration, stool culture
  • nursing diagnosis: risk for infection
66
Q

implementation for Gi tract infections

A
  • hydrate
  • follow standard precautions
  • evaluation: free of infection and GI symptoms
67
Q

Genitourinary tract infections

A
  • data collection: signs and symptoms, urinalysis, urine culture
  • nursing diagnosis: risk for infection
68
Q

implementation of genitourinary tract infections

A
  • avoid use of urinary catheters
  • use sterile technique to insert urinary catheters
  • avoid contamination when emptying urinary catheter bags
  • report symptoms
69
Q

evaluation of genitourinary tract infections

A
  • normal urine output w/out symptoms

PNC 102 lecture (42 decks)

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