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CIC Exam > Employee Health > Flashcards

Employee Health Flashcards

0
Q

Name diseases with post exposure intervention.

A 
TB
Rubella
Neiserria meningitidis
Hep A & B
Varicella zoster
Pertussis
HIV
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1
Q

Name 10 vaccine preventable diseases.

A 
Hep A
Hep B
Influenza
Measles
Mumps
Rubella
Tetanus and diphtheria
Pertussis
Polio 
Varicella zoster
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2
Q

Name diseases with no post exposure intervention

A 
Herpes simplex
Cytomegalovirus
Meningitis
RSV
Rotavirus
Hep C
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3
Q

Factors to consider for work restriction

A 
Agent
Mode of transmission
Method of interruption of transmission
Population at risk
Educability and compliance of healthcare worker
Clinical status (s & s)
Degree & type of patients staff contact
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4
Q

What is QLFT ? Qualitative

A

Fit test that results in pass or fail, assess adequacy of respiratory fit.
Relies on individuals response to the test agent

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5
Q

What is QNFT? Quantitative

A

Assessment of the adequacy of the respirator fit by measuring the amount of leakage into the respirator

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6
Q

What is considered an TB Exposure?

A

HCW with face to face contact
Entering pt room (even if pt not present)
Specimen processing
Installing or maintaining environment where TB patient is located

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7
Q

TB exposure - when is the HCW tested?

Work restriction of HWC a with TB

A

Baseline & 10 weeks after exposure

Restrict from duty until proven non infectious.
PPD a converter - no work restriction

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8
Q

Interpretation of tuberculin skin test (tst)

A

> 10 mm is + test
Increase of > 10 mm without known exposure
5 mm with known exposure

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9
Q

When is latent TB detected?

A

Occurs after initial infection with M tuberculosis within 2-12 weeks
Tested by PPD purified protein derivative

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10
Q

What group should MMR vaccine not be given to?

A

Pregnant women or those who will become pregnant in 30 days

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11
Q

What are the Requirements for rubella immunity?

A

Documented immunization with live rubella vaccination
Or laboratory evidence of immunity

One dose of MMR a is recommended for those born before 1956 & no immunity

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12
Q

What are HWC requirements for measles immunity?

A

Born on or after 1957 if documented measles history, or 2 vaccinations, or serological evidence

Born before 1957- history of measles, 1 vaccination, serological evidence

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13
Q

How to manage measles exposure with no immunity

A

Give vaccination within 72 hours

Remove from work for 5 days after first exposure to 21 days after last exposure

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14
Q

Who had immunity to Mumps?

A

MD diagnoses of mumps
2 doses of live vaccine
Serological immunity

Give employees 2 doses of MMR with no immunity

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15
Q

Define N. Meningitidis exposure

A

HCW with direct intimate contact
Mouth to mouth
Assisting with intubation
Auctioning

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16
Q

What is the recommended prophylaxis for N. Meningitis exposure?

A

Cipro (adults/non pregnant women)
Cefotaxime IM - children / pregnant women
Rifampin - PO (children or adults)

Give lab workers the injection

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17
Q

What to do with Hep B non responders?

A

Give additional 3 doses and retest.
If still non responder test HCW for HBSAg.
Non responders in dialysis should be tested q 6 months
Boosters of HBV vaccine are not necessary
If unvaccinated & exposed - give HBIG within 24 hours

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18
Q

Can HIV PEP be given to pregnant HCW

A

YES

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19
Q

What is exposure requirements for varicella?

A

Day 10 - 21 monitor daily for S/S. If fever, upper respiratory symptoms, or rash exclude from duty & give vaccine.
Varicella zoster immune glob in can be given to < 15 years or > 15 years if immunocompromised or pregnant

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20
Q

Define scabies exposure

Work restriction

A

Prolonged skin to skin contact.
Contact precautions
S/S of employees
Restrict from work if pt contact until cleared by medical MD

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21
Q

Define Steps for pertussis exposure

A

Highly contagious
Employees should receive one dose of Tdap.
Prophylactic 500 mg erythromycin QID
Or one tablet trimthoprim-sufplfamethoxazole BID

22
Q

Worker restriction for conjunctivitis.

A

Restrict from pt contact until discharge ceases.

23
Q

Work restriction for Cytomeglovirus

A

None

24
Q

Work restriction for diarrhea

A

Restrict from pt care or food handling until symptoms resolve.

25
Q

Work restrictions for diphtheria

A

Remove from work until anti microbial completed and 2 negative cultures 24 hours apart

26
Q

Work restriction for enterovirus

A

Remove from work with infants, neonates, or immunocompromised patients until no symptoms

27
Q

Work restrictions for Hep A

A

Restrict from pt contact and food handling for 7 days after onset of jaundice.

28
Q

Hep A vaccination

A

Laboratory and primate worker

1 mL IM at 0 and 6 month

29
Q

Work restrictions for Hep B or HIV

A

When infectious restrict from invasive procedures.

hep B - no exposure prone procedures unit Hep B e antigen is negative

30
Q

Hep C work restrictions?

A

None. Refer to state federal regulations

31
Q

Work restriction for herpes

A

Genital- none
Whitlow- pt contact until lesions heal
Facial- restrict from care of high risk patients

32
Q

Work restriction for measles

A

Active- exclude for 7 days after rash appears

Post exposure - day 5 to day 21 remove from work. 7 days after rash

33
Q

Work restriction for meningococcal infection

A

24 hours after start of effective therapy

34
Q

Work restriction for parvovirus

A

Restrict pregnant worker for caring with patients with aplastic crisis, chronic anemia in immunosuppressive

35
Q

Work restrictions for pertussis

A

Active - 5 days after effective therapy

Post exposure - none if as asymptomatic. If symptomatic 5 days restriction

36
Q

Work restriction for varicella?

A

Active- exclude from work until lesions are dry /crusted.

Post exposure - remove from work day 10 - day 21(day 28 if VZIG was given)

37
Q

Shingles work restriction

A

Cover lesions, restrict from high risk patients until crusted over.
Routine vaccination for those over 60

38
Q

What is the work restriction for Mumps

A

Exclude from work until 9 days of parotitis.

Post exposure - day 9 to 26 after exposure or until 9 days after onset of parotitis.

39
Q

How to determine exposure rate

A

Total # of injuries in 1 year / total # of occupied beds / average daily census

Total # injuries by RN in 1 year / total # FTE RN employed in a year

Number of injuries from a device type in 1 year / number of that device type used or purchased in a year.

41
Q

What is the name of the blood assay test used to detect TB?

A

QuantiFERON TB Gold

42
Q

What is the work restriction for an employee with laryngeal or pulmonary TB?

A

Exclude until receiving adequate drug therapy, cough resolved, & 3 negative sputum smears for AFB.

43
Q

How to calculate a TB conversion rate among employees

A

Divide # conversions/# tested x 100

44
Q

How to interpret baseline PPD reading (TST)

A

> 10 mm is positive for baseline test

45
Q

What is the work restriction for pediculosis? Lice

A

Restrict fro pt contact until treated and free of lice.

46
Q

Work restriction for rubella

A

Remove until 5 days after rash appears

Post exposure - day 7 to 21

47
Q

Work restriction for scabies?

A

No patient contact until cleared by medical evaluation

48
Q

Known exposure to TB what is considered a positive test?

A

> 5 mm when person had 0

> 10 mm

49
Q

Work restriction for strep A

A

No pt contact or pt environment, or food handling until 24 hours of effective treatment

50
Q

Acute infection early

A

HBSAG +

51
Q

Hep B false +

A

Total anti- HBc +

52
Q

Hep B chronic infection

A

HBSAG +

Anti - HBc +

53
Q

Labs for hep B past infection/immunity

A

Anti- HBc +

Anti- HBs +

54
Q

HIV infection

A

Gradual decline in t-lymphocytes (CD4)

CIC Exam (9 decks)

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