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Fundamentals (Nurs 113) > Defense And Immunity (Exam 2) > Flashcards

Defense And Immunity (Exam 2) Flashcards

1
Q

What is the Chain of Infection?

A
  1. The infectious agent
  2. The reservoir
  3. Portal if exit
  4. Means of transmission
  5. Portal of entry
  6. Susceptible host
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2
Q

What is the infectious agent?

A

This could be bacteria, virus or even parasites

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3
Q

What is the reservoir?

A

This is where the the infectious agent lives. This could be people, animals, soil etc

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4
Q

Portal of exit

A

Where the infectious agent escape from the reservoir.
Blood, tissue, respiratory tract

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5
Q

Mode of transmission

A

Could be through contact through touch
Droplets: sneeze and cough

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6
Q

Susceptible host

A

Babies
People who are hospitalized
The elderly

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7
Q

What factors affect a patient risk for infection? (7)

A
  1. Skin integrity: breakdown of the skin
  2. The pH level of the GI and GU tract
  3. Integrity and the number of the white blood cells (WBC): the patient should have enough white blood cells. It provides protection against infection
  4. Age, sex, race and heredity
  5. Immunizations
  6. Level of fatigue, stress level and health habits
  7. Invasive or indwelling medical devices: Foley catheter, tracheostomy
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8
Q

Who is more susceptible to infection?

A

Pregnant women
Women are more susceptible to UTI
Older adults

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9
Q

What does stress do to the immune system?

A

It decrease suppresses the immune system

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10
Q

What are health care associated infections (HAIs)?

A

This is when a patient acquires infection while their stay at the hospital

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11
Q

What is standard precautions

A

This is the regular precaution that is taken to avoid or prevent infection.
Includes following hand hygiene techniques
Wearing gloves

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12
Q

Name all of the transmission based precautions

A

Airborne, contact and droplet

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13
Q

Droplet precautions

A

Rubella, mumps,
Hand hygiene
Mask
Eyewear

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14
Q

Airborne precautions

A

TB, varicella, measles
Patient must be in area with negative air pressure
All doors and windows closed
Hand hygiene
N95 mask

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15
Q

Contact precautions

A

C-Diff, MRSA
Place the patient in a private room

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16
Q

Surgical asepsis

A

This is sterile
Unsterile means that the object is contaminated
Hold objects above the waist level
Never walk away or turn your back from the sterile fields
Eliminates all microorganisms

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17
Q

Medical asepsis

A

This is the clean technique
Reduces the spread and number of microorganisms

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18
Q

What are the signs and symptoms of infection

A

Redness
Swelling
Inflammation
Fever
Diarrhea
Cramps
Warmth
Pain
Weight loss

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19
Q

CLOSTRIDIODES DIFFICILE

A

Also known as C-Diff
Is caused by bacteria and commonly affects older adults

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20
Q

What population is more likely to be affected by c-diff

A

Older adults

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21
Q

Signs snd symptoms of c-diff

A

Watery diarrhea, fever, mild abdominal pain and cramping

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22
Q

What are some precautions of c-diff

A

Disinfect everything after you’re finished
Always wash hands!!!!!!!!
Sanitizing don’t work
Gown and cloves
Private room

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23
Q

Is c-diff precaution disinfection or sterilization

A

Disinfection

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24
Q

Name some functions of the skin

A

Protection
Temperature regulation
Psychosocial
Sensation
Absorption
Elimination
Vitamin d production
Immunolgic

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25
What factors might affect skin integrity?
If the skin is unbroken or unbroken Resistance of injury to the skin Adequate circulation Adequate nutrition
26
Factors affecting skin integrity for children
Skin is thinner and weaker Skin and mucous membrane easy to break
27
Factors affecting skin integrity for adults older
Dry skin Thin which makes is easier to damage A decrease in elasticity Have delayed time in healing Sensation ti pain and pressure is reduced Unevenly pigmented
28
Name some other factors that might affect skin integrity
Lifestyle Body piercing Dehydration or malnutrition Reduced sensation Diabetes Bed rest Casts Medication
29
What are some implementations for older adults
Do not apply tape to the skin unless it is necessary Check the skin frequently for signs if pressure injury Padding to the bony prominences Apply lotions and moisturizers where it is necessary Encourage hydration to the patient Do skin assessment Eliminate use of harsh soaps Check pressure points for redness every 30 minutes
30
Name the phases of wound healing
1. Hemostasis 2. Inflammatory phase 3. Proliferation phase 4. Maturation phase
31
Hemostasis
The initial stage where the blood clot is formed Blood vessels constrict forming a blood clot
32
Inflammatory phase
Phagocyte engulf
33
Proliferation phase
Repair phase New tissue is built to fill the wound space
34
Maturation phase
Wound is remodeled Scar is formed
35
What are the local factors that affect the wound healing?
Pressure Desiccation (dehydration) Maceration (over hydration) Trauma Edema Infection Excessive blessing Necrosis Presence of biofilm
36
What is desiccation
This is dehydration
37
What is maceration
This is over hydration of the wound
38
Biofilm
This is when bacteria grow in clumps on the wound
39
What systemic factors affect wound healing?
Age Circulation & oxygenation Nutritional status Medication and health Status Immunosuppression
40
Incision
Cutting or sharp instrument
41
Contusion
Blunt instrument and the over lying skin remains intact Injury to the underlying tissue A bruise
42
Abrasion
Friction Rubbing or scrapping epidermal layers of the skin Like a scratch
43
Laceration
Tearing of the skin and tissue with blunt or irregular instruments Usually happen with accidents
44
What are HAI
This is hospital acquired infection
45
How long does it take for symptoms of wound infection become apparent?
2-7 days after surgery
46
What are the signs and symptoms of infection
Prulent drainage Increased drainage from the wound Pain Redness Swelling Increased body temperatures White blood cell count increased Discoloration of the wound Delayed healing
47
What is a hemorrhage
This is dislodged clot from the wound site
48
How long does the hemorrhage take to occur
The first 48 hours
49
Dehiscence vs evisceration
Dehiscence is the partial or total separation of a wound layers as a result of excessive stress on the wound that are not healed Evisceration is when the abdominal wound completely separate with protrusion of the viscera through the incision area
50
Who are more at risk for evisceration
Obese, malnourished, smoke tobacco,use anticoagulants,etc
51
What are some intervention that reduce the risk of wound complications
1. Encourage intake of fluids 2. Good sources of protein 3. Perform sound cleansing and irrigation 4. Remove staples and sutures 5. Administer med 6. Document
52
What is a pressure injury
Caused by prolonged pressure of the skin
53
Who is usually affected by pressure injury
Those confined to bed Sit in wheel chair long time
54
Factors and risk for pressure injury development
External pressure Friction and shear: pulling and pushing Immobility Nutrition and hydration Moisture: too much hydration Mental status Age: older patient
55
Shearing forces
Me layer of the skin slides over the other
56
What are the common sites development of pressure injury
Bony prominences: scapula, greater trochanter, etc
57
Stage 1 pressure ulcer
The skin is intact over the bony prominence Nonblanchable redness
58
Stage 2 pressure injury
Partial thickness of loss of the dermis Ruptured or intact blister Dermis is exposed looks like a blister
59
Stage 3 pressure injury
Full thickness tissue loss Slough and eschar may be seen Maceration: the skin is too wet
60
Stage 4 pressure injury
Full thickness tissue loss with exposed/ palpable bone cartilage, ligament, tendon, fascia, or muscle You can see the bone
61
Unstageable
Base of the ulcer is covered by slough and/ eschar. The eschar must be removed before it can be staged Eschar must be debridement
62
Deep tissue injury
Purple or maroon localized area of discolored intact skin or blood blister due to the underlying tissue from pressure or shear
63
Braden scale
19-23: no risk 15-18: mild risk 13-14: moderate risk 10-12: high risk Less than 9: very high risk
64
Nursing process: Assessment (ongoing)
History and physical Skin assessment Pin assessment: before and after Common drains
65
Types of drains
Penrose (open) Jackson Pratt (closed) Hemovac (closed) T tube (closed)
66
Wound assessment
Always do sight and smell
67
Color of wound tissue: red, yellow, and black
Red: healthy Black: dead tissue that should be removed Yellow or slough: purulent drainage or dead tissue that should be removed
68
Appearance of the wound. What should you be looking for?
Assess the length, width, depth, wound edges, tunneling , undermining , odor
69
What are the different kinds of drainage
Serous: clear Sanguineous: bloody Serosanguineous: pink. A mixture of serum and blood Purulent: smelly rotten, sign of infection
70
Common nursing diagnosis
1. Impaired skin integrity 2. Risk for impaired skin integrity 3. Impaired mobility 4. Ineffective tissue perfusion 5. Risk for infection 6. Imbalanced nutrition 7. Body image disturbance 8. Hopelessness 9. Pain 10. Knowledge deficit
71
An example of smart outcome
Patient will remain afebrile, with the absence of redness imprudent drainage at the surgical site for the entire shift
72
Some nursing interventions for skin
Maintaining aseptic technique Teach the patient about signs and symptoms of an infection Proper hand hygiene Monitor for Signs and symptoms of infection Monitor temperature every 4 hr Reposition patient for every 2 hr Use padded devices at pressure point Consult with wound care specialists Document Assess for pain Administer medication ROM
73
Check pressure points for injury every?
30 minutes

Fundamentals (Nurs 113) (11 decks)

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