Chapters 10-14 Flashcards
Diseases that can be spread from one person to another
communicable diseases
Also called a microorganism, is a living thing that cannot be seen with the naked eye
microbe
Most microbes cause no harm and are actually essential for healthy living: called ____
normal (resident) flora
Some microbes, however, can cause illness and are known as _____
pathogens
Sometimes microbes can be considered normal flora in one part of the body and pathogens in another, these types of microbes are called _____
opportunistic microbes
When _____ finds its way out of the intestines and into another part of the body where it is not normal flora, such as the bladder, it can cause an infection
Escherichia coli
- bacteria
- viruses
- fungi
- parasites, helminths, protozoa
Are classifications of _____
microbes
_____ cause cause many of the infections you will encounter in the health care setting
-its ability to adapt to all sorts of environments is proof of this life forms ability to survive
bacteria
Scientist classify and name _____ in many different ways:
- by their shape
- by the way they arranged themselves in a colony
- by the way they stain (how they react to the dye to make them more visible)
bacteria
Although bacteria usually consist of only one cell, they often group together to form _____
colonies
Round bacteria are called _____
cocci
Rod shaped bacteria are called ____
bacilli
Spiral shaped or curved bacteria are called _____
sprilla
Pairs of bacteria indicated by the prefix _____
diplo-
Chains of bacteria indicated by the prefix _____
strepto-
Grape like clusters of bacteria indicated by the prefix ____
staphylo-
Need oxygen to live
aerobic
Die if oxygen is present
anaerobic
Some types of bacteria can surround themselves with a hard shell called _____, and enter a state of inactivity
-these types of bacteria are hard to kill using the standard techniques
endospores
Once the inactive bacteriums best growing conditions become available, the bacterium will become ____ again
active
- tetanus (lockjaw)
- botulism (food poisoning)
- strep throat
- some bladder infections
- some skin infections
- Rocky Mountain spotted fever
- typhus
- some types of pneumonia
- some infections of the reproductive and urinary systems
Are illnesses caused by _____
bacteria
Are the smallest of all microbes: ____
-can only be seen using a special kind of microscope called an ____
viruses
electron microscope
Many illnesses can be caused by ____ such as:
- common cold
- fever blisters
- chicken pox
- hepatitis
- AIDS
viruses
Are a group of plant like organisms that scientist have classified together because of certain characteristics, including the make up of their cell walls
fungi
Illnesses caused by ____:
- ringworm (tinea corporis)
- athletes foot (tinea pedis)
- thrush
- candidiasis
fungi
Live in or on a host such as a plant or animal and use that host for food and protection
parasites
Illnesses caused by ____
- scabies (mites)
- pediculosis (lice)
parasite
Other types of parasites:
- pinworms, tapeworms, roundworms are ____
- malaria caused by bite of mosquito, amebic dysentery is a type of diarrhea caused by drinking water are ____
helminths
protozoa
Many microbes share the earth with us, then why are we not always sick? The body has a defense system that protects us from infection called ____
immune system
Our main ______ is healthy, intact skin and mucous membranes
- skin that is without cuts, scrapes, or wounds physically prevents pathogens from entering the body
- mucous membranes line all of the organ systems that come in contact with the outside world (respiratory, digestive, urinary, and reproductive systems)
nonspecific defense mechanisms
Is a pathogen gets past the first line of defense and an infection results, the body activates a _____
-fever, inflammation, warmth, and redness at the site of infection: a normal response to infection
general immune response
The immune system also has the ability to develop specialized proteins called ____, which help our bodies to fight off specific microbes
antibodies
A person develops ____ following exposure to the microbe
_____ expose the body to the microbe, stimulating antibody production without causing actual illness
antibodies
vaccines
An ____ is a drug that is able to kill bacteria or make it difficult for them reproduce and grow
antibiotic
_____ first antibiotic used in WWII
penicillin
Resistant to one or more classes of antibiotics
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin-resistant enterococci (VRE)
Are easily spread from person to person via the hands
multidrug-resistant organisms (MDROs)
Some good bacteria are destroyed when using antibiotics to treat infections, resulting in infections
_____ major cause of health care associated diarrhea
Clostridium difficile (C. diff)
Although antibiotics have given us more options for treating infectious disease than we had in the past, they do not work against all pathogens all of the time
The best policy is clearly to _____ infection in the first place
infection
An illness caused by a pathogen
infection
Infections that can be easily transmitted from one person to another through casual contact
contagious
For a person to get a communicable infection, six key conditions muse be met
Theses six key elements are known as the _____
chain of infection
Eliminating any one of the six key elements breaks the chain and _____ the spread of infection
prevents
- pathogen
- reservoir
- portal of exit
- method of transmission
- portal of entry
- susceptible host
This is known as ____
chain of infection
A ____ is a place where something is stored
reservoir
Indirect transmission occurs when a noninfected person comes into contact with a non-living object that has been contaminated by pathogens, these objects are called _____
fomites
- very young: immune system not developed
- very old: immune system not as active with aging
- poor general health: body defenses already weak, certain medications and tx affect immune system
- stress and fatigue: lack of rest and emotional stress
- indwelling medical devices: increased risk of infections by providing a portal of entry
These are all ____
susceptible host
Infections people get while a pt or resident: ____
- health care worker can get while providing care
- also called ____
health care-associated infections (HAIs)
nosocomial infections
Most common method of transmission: ____
hands
All health care facilities follow basic practices that are designed to decrease the chance that an infection will be spread from one person to another, these practices are called ____
infection control
These are 4 major methods of _____:
- medical asepsis
- surgical asepsis
- barrier methods
- isolation precautions
infection control
____ involves physically removing or killing pathogens, and is primarily achieved through processes involving soap, water, antiseptics, disinfectants, or heat
- sanitization
- antisepsis
- disinfection
- sterilization
medical asepsis
_____ is the word we use to describe practices associated with basic cleanliness, such as:
- hand hygiene
- cleansing of eating materials and other surfaces with soap and water
- providing clean linings and clothing
- practices physically removing pathogens preventing their spread
sanitization
____ takes sanitation one step further by actually killing microbes or stopping then from growing
antisepsis
An ____ is a chemical that is capable of killing a pathogen, or preventing it from growing
-can be used on skin: rubbing alcohol, iodine, alcohol-based hand rub
antiseptic
____ involves the use of stronger chemicals to kill pathogens
- too strong to use on skin
- use on non-living objects
disinfection
____ most common thorough method of killing microbes
-used on objects that must be completely free of any microbe, such as surgical instruments, hypodermic needles, or intravenous (IV) catheters
-items are places in autoclave or soaked in chemicals
to destroy all microbes
-boiling is not an effective method
sterilization
_____ have several advantages:
- quicker than washing hands
- gentler on skin
- can be used anywhere
alcohol-based hand rubs
_____ used for procedures that involve entering a persons body
- surgical procedures
- injections
- insertion of IV catheter
- insertion of urinary catheter
surgical asepsis
A ____ is an object that physically prevents microbes from reaching a health care providers skin or mucous membranes
barrier
Barriers used in infection control, called ____ include:
- gloves
- gowns
- masks
- protective eyewear
personal protective equipment (PPE)
____ most common used barrier method
gloves
The most common error made by people who wear gloves is becoming too comfortable with the fact that they are protecting themselves, and forgetting to protect _____
others
A ____ should be used when it is likely that your uniform will be soiled with body fluids
gown (paper or fabric)
____ prevents you from breathing in microbes through your nose or mouth, and are worn when there is a chance that you will be exposed to pathogens that are transmitted through the air or in droplets of saliva
-____ are the most commonly used but in TB pts a special high filtration one is used
mask
surgical mask
____ face shields and other types of protective eyewear are used to protect your eyes from substances that may splash
googles
Sequence to put on _____:
- gown
- mask
- eyewear
- gloves
PPE
Sequence to remove ____:
- gloves
- eyewear
- gown
- mask
PPE
Guidelines based on a pathogens method of transmission that we follow to contain the pathogen and limit others exposure to it
-include when a person is known to have a disease that is transmitted a certain way, air, droplets, direct contact
isolation (transmission based) precautions
Specifically used to protect health care workers from pathogens that are transmitted in blood, they are used for everyone
standard precautions
Used when caring for people infected with pathogens that can be transmitted thought air
airborne precautions
Used when caring for people with diseases caused by pathogens that are transmitted by direct exposure to droplets released by mouth or nose (coughing, sneezing)
droplet precautions
Used when caring for people with diseases caused by pathogens that are transmitted directly or indirectly
contact precautions
Disease producing microbe that is transmitted through:
- blood
- body fluids
bloodborne pathogens
Are liquid or semi-liquid substances produced by the body such as:
- blood
- urine, feces
- vomitus, saliva
- drainage from wound
- sweat tears
- semen, vaginal secretions
- cerebrospinal fluid and amniotic fluid
- breast milk
body fluids
Ways ____ are transmitted:
- needle sticks
- cuts from contaminated, broken glass
- direct contact between infected blood and broken skin, mucous membranes, or the eyes
- sexual intercourse
- blood transfusion
bloodborne pathogens
Diseases caused by ____:
- Hep B, C, and D
- acquired immunodeficiency syndrome (AIDS)
- Malaria
- syphilis
- ebola
_____ and ____ pose the most occupational risk to a health care worker
bloodborne pathogens
Hepatitis and AIDS
Inflammation of the liver, the organ that removes toxic substances from the bloodstream
- caused by a viral infection, chemicals, drugs, or drinking alcohol
- some infections are mild, producing no lasting effects on the liver
- others are chronic and affect the livers ability to function over time, if liver failure is severe, the person will die unless he or she receives a liver transplant
Hepatitis
Is not a bloodborne pathogen, transmitted through the oral-fecal route
Hep A
Virus lives in the digestive of an infected person and leaves the body through feces
oral-fecal route
Bloodborne pathogen, serious threat to healthcare workers, virus is found in blood, as well as other body fluids such as semen and vaginal secretions
Healthcare workers can acquire through:
- needle sticks
- cuts from contaminated objects
- exposure of broken skin
Hep B
People can be infected by the virus and never develop symptoms but are able to transmit it to another person
carrier
Bloodborne pathogen and is most common chronic viral Hep in the US
Hep C
Bloodborne pathogen found only in people who already have Hep B
-vaccinations against Hep B can prevent this
Hep D
Not a bloodborne, spread through oral-fecal route
- common in country with poor sanitation controls
- no vaccination for this
Hep E
Bloodborne pathogen that:
- transmitted through body fluid and blood
- causes AIDS
- affects bodies immune system
People with AIDS do not die from the virus itself, they die from infections that the body can no longer fight off
-no cure or vaccines
HIV—Human immunodeficiency virus
The human immune system ___ and ____ pathogens
recognizes and destroys
_____ are special white blood cells (leukocytes)
-one type recognize and kill cells infected by viruses
-the other type produce substances that help other cells
in the immune system to defend the body against the pathogens
T cells
____ invades the T cells
- uses the T cells to multiply and copy itself
- eventually kills the T cell and moves on to repeat the process in other T cells
- invades the cells that form new T cells causing the body to produce T cells that can not recognize pathogens
The body then becomes unable to recognize and fight off infections, leading to the condition known as ___
HIV
AIDS
HIV, HBV, and HCV pose an occupational risk to health care workers
For these reasons, in the health care field, every pt or resident must be treated as if he or she may be infected with a bloodborne pathogen–thus, the term ____
standard precautions
A _____, _____, _____ are worn if the possibility exists that blood or other body fluids could splash or spray
mask, face shield, and goggles
Sharps, such as needles and razors, are disposed of properly in ____ approved containers
OSHA
Broken glass is never handled, it is ____ or ____ for disposal
Spills of blood and other body fluids must be cleaned up promptly with an approved ____ _____
____ must be worn when cleaning up spills
swept or vacuumed
cleaning agent
personal protective equipment
Hands must be washed when you remove your gloves
_____ is the single most important method of preventing the spread of infection
handwashing
- Employees must receive training on the risk associated with bloodborne pathogens and the methods they can use to safeguard themselves
- Employers must make the Hep B vaccine available to workers who are at risk free of charge
- Employers must provide adequate PPE as required by the emplyees duties
OSHA Bloodborne Pathogens Standards
_____ _____ _____, such as special ventilation systems, procedures for the disposal of liquid waste, and procedures for handling contaminated linen and trash must be in place to protect both employee and pts or residents
environmental control methods
An updated ____ _____ _____ must be in place in case an employee is exposed to blood or other body fluids
- stated what actions must be taken if employee is exposed
- must be available in written form
- must be available to all employees
It is the employees responsibility to report any exposure incidents, the employer is responsible for arranging appropriate medical tests for tx
exposure control plan
Disease producing microbes that are transmitted through the air
- spreads when an infected person coughs or sneezes, and another person inhales the air containing the suspended pathogens
- measles, chicken pox, and TB
- vaccines are available for chicken pox and measles
- no vaccines for TB
- pose an occupational risk to health care workers
airborne pathogens
Infection caused by bacteria present in the sputum of an infected person, spread by airborne droplets when the person coughs, sneezes, speaks, or sings
- close contact with a person is most likely means yu will contract it
- infects the lungs, kidneys and bones
A positive skin test indicates a person has either been exposed or vaccinated for it
-additional test such as blood test or chest xray may be done to confirm a person actually has it
tuberculosis (TB)
____ precautions:
- pts or residents known or suspected to be infected with an airborne pathogen are to be placed in private rooms with special _____ ____
- health care workers should wear mask when working with someone with TB
- If the healthcare worker has not been exposed to ___ or ____ (and is therefore not immune) they are at risk for these diseases and a mask should be worn
airborne
measles or chicken pox
Airborne precautions:
- A _____ should be placed over the pts or residents face to transport them
- transport of the pt should be kept to a _____
- all precautions for preventing the transmission of TB should be implemented
surgical mask
minimum
An ____ is an unintended, unexpected event that has the potential for causing bodily harm
An ____ is an occurrence that is considered unusual, undesired or out the ordinary that disrupts the usual routine of the pt, or resident, or the facility
Both can involve pts, residents, staff, or visitors
accident
incident
Facilities are required by ____ to maintain an environment that lowers the risk of accidents and incidents
Facilities achieve this by providing adequate supervision and assistance to pts and residents
OBRA
Some factors that place people at risk for ____ are:
- age
- medication effects
- paralysis
- poor mobiilty
- sensory impairment
- limited awareness of surroundings
accidents
Risk factor: _____
Infants are helpless
- accidental suffocation
- falls
Young children lack knowledge about things that are dangerous
- falls
- burns
- poisoning and drowning
The elderly are at high risk for accidents because of the physical and mental effects of the aging process
age
Risk factor: ____
Many medications can affect the ability of a person to be safe incuding
- pain meds
- meds that affect blood pressure
Effects of meds can be
- dizziness
- sedative effect
medication
Risk factor:
The person is unable to move or feel part of the body is called ____
- caused by a spinal cord injury or stroke
- puts person at risk of falls, burns, and other injuries
paralysis
Paralysis from the waist down ____
Paralysis from the neck down ____
Paralysis on one side of the body ____
paraplegia
quadriplegia
hemiplegia
Risk factor: ____
Factors associated with ____ are
- pain and stiffness from arthritis
- condition that can cause a person to shuffle his feet when he walks (stroke)
- injuries or surgeries involving the leg
poor mobility
Risk factor: ____
Visual impairment can lead to
-falls, accidental poisoning
Hearing impairment can lead to
-road accidents, suffocation or fire accidents, accidental poisoning
Impaired sense of touch can lead to
-accidental burns
Impaired sense of smell can lead to
-food poisoning, suffocation, or fire accidents due to gas leak
sensory impairment
Risk factor: ____
Confusion and disorientation caused by reactions to meds, head injury, dementia, and other medical conditions can lead to accidents
A person who is unconscious or comatose is totally unable to respond to their environment and needs assistance to remain safe
limited awareness of surroundings
____ requirements that all staff must be alert for any potential unsafe condition
OBRA
____ changes of aging
- effects of medical condition
- environmental conditions
Neurological changes -takes longer to regain balance or change course Sensory changes -sense decrease with age, more difficult to detect and respond to danger Musculoskeletal changes -weaker, fatigue easily Urinary changes -increased frequency, incontinence Respiratory changes -shortness of breath during physical activity Skin changes -increased bruising and skin tears
physical
Effects of ____ or ____:
-chronic health conditions, treatment or both can increase risk for accidents or incidents
Medications effects
-decreased blood pressure can cause dizziness when standing. may fall
medical condition or treatment
A new resident is confused and disoriented by the change of ____, increased risk of accident or incidents
Many residents with varying degree of disabilities in one place
Long term care facilities are very busy, increased risk environmental hazards: clutter, slippery surfaces, poor listening, sun glare
environmental conditions
Many accidents can be prevented
Most safety measures require an ____ ____ which helps protect others
extra step
_____ are the leading cause of fatal and nonfatal injuries in the US among elderly
The most common causes are:
-functional decline
-hospital admission
-emotional trauma
-eventual placement in a nursing home facility for older people
falls
Preventing ____:
- elderly have decreased sense of touch
- check water temp with thermometer before allowing pt or resident to get in tub, water between 105 F and 115 F (40.5 C and 46 C)
- water for a bedbath can be hotter, between 110 F and 115 F (43.3 C and 46 C)
burns
- instruct the resident to check water temp if bathing self before getting in
- use extreme care with heat applications
- warn people with hot food or drink
- use cups with lids, if pt or resident is weak or unsteady
- follow guidelines when using electrical appliances
Preventing _____
burns
Occurs when a person becomes trapped in the side rail or between the side rail and mattress
- can result in severe injury or death
- residents who are confused or have physical disabilities at the highest risk
- always use side rails as ordered in the nursing care plan
- perform frequent checks
- use safety devices correctly
entrapment
Elderly are at risk
-poor eyesight, confusion, decreased sense of taste or smell
Takes too much or the wrong meds
To minimize risk:
-properly store household chemicals
-keep household cleaners and chemicals locked up
-make sure all containers are clearly marked with contents
-provide help with reading labels
accidental poisoning
An accident should be reported immediately and an _____ should be completed promptly
- it is to completed in an objective and nonjudgemental way, without blaming anyone
- used by quality assurance department
- important for follow up
- may show trend and suggest changes to prevent future accidents
incident (occurrence) report
_____ are used to:
- restrict persons freedom of movement
- prevent a person from reaching parts of their body
- confine a person to a bed or chair
- prevent movement of a specific body part
restraints
Device that is attached to or near a persons body to limit a persons freedom or movement to access their body
-wrists
-ankles
-chest
-waist
-arms and elbows
Some types of chairs or attachments to chairs can act as restraints
The side rails of beds or tightly tucked sheets can act as restraints
Not permitting a person free access to other rooms or parts of the facility is also considered a form of restraint
physical restraints
Any medication that alters a persons mood or behavior
- sedatives or tranquilizers
- used to calm an anxious, combative, or agitated person
- not used for staff convenience
- should not be used in so high dose to make a person sleepy or unable to function to normal fashion
chemical restraints
Situations where the use of ____ may be appropriate:
- fall risk but will not stay in bed or chair and cant call for help
- a wanderer
- person tries to remove tubing
- combative person
- person going through withdrawal
- suicide precaution
restraints
Guidelines from OBRA, Joint Commission, FDA
- thorough assessment by health care team
- benefits of using restraints must outweigh risks
- improper use: false imprisonment
- must understand and follow facilities policies
- failure to follow policies could result in litigation
using restraints
Complications associated with using _____:
- strangulation, can lead to death
- bruises, nerve damage, skin abrasions
- permanent tissue damage from impaired blood flow
- broken bones
- pneumonia, pressure ulcers, and blood clots
- incontinence
- mental effect such as agitation, increased confusion, humiliation, and embarrassment
restraints
_____ must be sought and used before retraining
-must document use
Alternatives:
-provide environment where person feels safe and secure
-volunteers to sit with and interact with resident
-pressure sensitive bed, sounds alarm
-wandering monitoring system attached to wheelchair or wrist or ankle, sounds alarm
restraint alternatives
- provide frequent attention
- explain procedure and reassure person
- get help from family members
- use postural supports
- use bed control bolsters instead of side rails
restraint alternatives
- only a doctor can order a restraint
- follow facilities policies regarding application and use of restraints
- only a RN or LPN can apply a restraint
- nursing assistants are responsible for providing care while person is restrained
- report sign of trouble
applying restraints
Types of ____:
- vest
- wrist
- ankle
- lap
- waist (belt)
restraints
Changing ____ helps us stay comfortable and prevents complications resulting from speading long periods of time in the same ____
In health care setting, a person may need to get into a certain ____ to have a procedure done, or to recover from one
position
A person may be unable to shift ____ without help because of:
- surgery
- body cast
- traction
- total or partial paralysis
- unconsciousness or come
- weakness from disease or disability
positions
Some of the most serious ____ affect the skin, bones and muscles, lungs, and the heart are:
- pressure ulcers (skin)
- contractions (bones and muscles)
- pneumonia (lungs)
- blood clots (heart)
complications
Proper positioning is necessary for good ____ and may help relieve some of the discomfort associated with a persons medical condition
-person is positioned so their spine is not twisted or crooked
body alignment
To check for ____, imagine a line that connects nose, breastbone, and pubic bone, and continues between the knees and ankles
The line should be straight whether the person is lying on his or her back, side or abdomen
alignment
_____ are needed to keep the person in proper body alignment
- learning to position these supports correctly is essential
- proper use helps to keep your pts safe and comfortable
supportive devices
\_\_\_\_ include: -pillows -rolled sheets -rolled towels -rolled blankets Designed specifically for the purpose of offering support
supportive devices
When a person is laying on their back
supine (dorsal recumbent) position
The head of the bed is elevated 45 to 60 degrees
Fowler’s
Head of the bed is elevated 30 to 45 degrees
semi-Fowlers
Head of the bed is elevated 60 to 90 degrees
high-Fowlers
Pt is laying on abdomen and head is turned to on side
Prone
Extreme side lying position that is almost prone
Sims
Proper ____ holds a persons body in correct alignment while they are sitting in a chair
sitting position
Pt is lying on their side
lateral
People who are being moved in bed are particularly at risk for ____ and ____ injuries if they are not moved properly
shearing and friction
Caused by pulling a person across a sheet or other surface that offers resistance
-the skin is dragged in a direction opposite that of the underlying tissue and muscles, injuring the blood vessels and connective tissue under the skin and resulting in skin breakdown
shearing
Occurs when two surfaces, such as a sheet and the persons skin, rub against each other
-can injure the skin and contribute to a skin breakdown
friction
Risk of ____ and ____ can be minimized by rolling or lifting
shearing and friction
Procedures for _____ a person include:
- moving a person to the side of the bed
- helping a person to move up in bed
- raising a persons head and shoulders
- turning a person onto his or her side
- logrolling a person
repositioning
When moving a person in bed always use a _____
-check for wrinkles underneath the person after moving
lift sheet
Used to move a who has had back surgery or an injury to neck or spine
logrolling
Persons ability to stand on one or both legs
weight bearing
A webbed or woven belt with a buckle that is used to assist a weak or unsteady person with standing, walking, or transferring
When used to help a person walk it is called a ____
transfer belt
gait belt
A person who needs a transfer may feel weak, shaky, frightened, or embarrassed
-always explain the ____ procedure
transfer
_____ are common during the act of transferring
The use of _____ is an effective way to help prevent work related injuries
-lift sheets
-side rails
-transfer boards
-roller boards
-mechanical lifts
accidents
assist devices
Transferring with _____:
- make sure no broken or missing parts
- wheels turn smoothly and any safety straps are secure
- braked hold well
- foot rest are folded up and swiveled to the side or removed before setting or removing pt
wheelchair
_____ are used to transport people to other parts of the facility for surgery or diagnostic testing, also used on critically ill and comatose pts
stretchers
_____ is the first step for someone who is going to get out of bed and walk, it allows time for the heart and blood vessels to make up for the change in position
-when a person has been in bed, for a long time, sitting up and then standing causes blood to flow to the legs and away from the head causing dizziness and fainting
dangling
____ should be specially fitted to the individual and not shared to ensure safety
- walkers
- canes
- crutches
devices
