exam 1 Flashcards
What are antimicrobials used for?
To treat infectious diseases
What is the definition of an antibiotic?
A chemical produced by one microbe that can harm other microbes
What is an antimicrobial agent?
Any agent that can kill or suppress microorganisms
What does selective toxicity refer to?
Toxic to microbes but harmless to the host
What are the two commonly used classification systems for antimicrobial drugs?
- Classification by susceptible organism
- Classification by mechanism of action
What are the two types of spectrum in antibiotic classification?
- Narrow spectrum
- Broad spectrum
What is the difference between bactericidal and bacteriostatic drugs?
- Bactericidal: Directly lethal to bacteria
- Bacteriostatic: Slows bacterial growth without causing cell death
What is acquired resistance to antimicrobial drugs?
When organisms develop resistance over time to one or more drugs
Name some organisms with microbial drug resistance.
- Enterococcus faecium
- Staphylococcus aureus
- Enterobacter species
- Klebsiella species
- Pseudomonas aeruginosa
- Acinetobacter baumannii
- Clostridium difficile
What is a superinfection?
A new infection that appears during the course of treatment for a primary infection
What are some strategies to delay the emergence of drug resistance?
- Promote adherence to appropriate prescribing guidelines
- Reduce demand for antibiotics among healthy adults
- Emphasize adherence to prescribed antibiotic regimens
What factors are considered in the selection of antibiotics?
- Identify organism
- Drug sensitivity
- Host factors
What is empiric therapy?
Antibiotic therapy for patients before the causative organism is positively identified
What must be ensured about antibiotics regarding dosage and duration?
Antibiotic must be present at the site of infection for a sufficient length of time
What is prophylactic use of antimicrobials?
Agents given to prevent infection rather than to treat an established infection
What is a principal adverse effect of penicillins?
Allergic reaction
What structural feature do penicillins have?
A beta-lactam ring
What is the mechanism of action of penicillins?
Weakens the cell wall, causing bacteria to take up excessive water and rupture
What are broad-spectrum penicillins also known as?
Aminopenicillins
Name two broad-spectrum penicillins.
- Ampicillin
- Amoxicillin
What are beta-lactamase inhibitors?
Agents that extend antimicrobial spectrum when combined with penicillinase-sensitive antibiotics
What is the therapeutic use of vancomycin?
Severe infections only, including MRSA and Clostridium difficile
What are the adverse effects of vancomycin?
- Ototoxicity
- ‘Red man’ syndrome
- Thrombophlebitis
- Thrombocytopenia
What are tetracyclines used to treat?
- Infectious disease
- Acne
- Peptic ulcer disease
- Periodontal disease
- Rheumatoid arthritis
- Mycoplasma pneumonia
- Lyme disease
- Anthrax
- Helicobacter pylori
What is a significant adverse effect of tetracyclines?
Yellow discoloration of bones and teeth
What is the mechanism of action of macrolides?
Inhibition of protein synthesis
What are aminoglycosides primarily used for?
Aerobic gram-negative bacilli infections
What is a key side effect of fluoroquinolones?
Tendon rupture
What is the primary use of rifampin?
Tuberculosis (TB)
What color can rifampin cause bodily fluids to turn?
Bright red-orange
What are the adverse effects of metronidazole?
- Neurotoxicity
- Allergy
- Superinfections
What is an infection?
Results when a pathogen invades tissues and begins growing within a host (human)
Pathogens can include bacteria, viruses, fungi, and protozoa.
Define colonization in the context of infections.
Presence and growth of microorganisms within a host without tissue invasion or damage
This means that while microorganisms are present, they do not cause harm or disease.
What is a communicable disease?
Disease that can be easily transmittable from one person to another
What are symptomatic and asymptomatic conditions?
- Symptomatic - if symptoms are present and seen
- Asymptomatic – if symptoms aren’t seen
List the components of the Chain of Infection.
- Infectious agent
- Reservoir
- Portal of exit
- Modes of transmission
- Portal of entry
- Susceptible host
What is the role of normal floras in infection?
Normal floras can provide a defense against infection by occupying niches that pathogens might otherwise exploit.
What defenses does the body have against infection?
- Normal floras
- Body system defenses
- Inflammation
What are the symptoms of infection?
- Malaise
- Enlarged lymph nodes
- Nausea/Vomiting
- Redness
- Swelling
- Heat
- Pain
- Tenderness
- Fever
- Increased WBCs
What is a health care-associated infection (HAI)?
Infections that occur as a result of invasive procedures, antibiotic administration, multidrug-resistant organisms, and breaks in infection prevention and control activities
Differentiate between transient and resident bacterial flora.
- Transient: attached loosely on skin, removed with relative ease
- Resident: found in the creases in skin, requires friction with brush to remove
What factors influence infection prevention and control?
- Age
- Nutritional status
- Stress
- Disease process
- Medications
What is the normal white blood cell (WBC) count?
Normal value is 5,000 to 10,000/mm3
What are neutrophils and their normal percentage?
Normal = 60%–70%. Increased in acute infections that produce pus.
What is the nursing diagnosis for infection?
- Risk for Infection
- Impaired Nutritional Status: Deficient Food Intake
- Impaired Oral Mucous Membrane
- Social Isolation
- Impaired Tissue Integrity
What are common goals of care for infection control?
- Preventing further exposure to infectious organisms
- Controlling or reducing the extent of infection
- Maintaining resistance to infection
- Verbalizing understanding of infection prevention and control
What is medical asepsis?
Clean technique to reduce the number of pathogens
What is surgical asepsis?
Sterile technique to keep the area free from microorganisms
Identify common infections that require airborne precautions.
- Tuberculosis (TB)
- Measles (Rubeola)
- Varicella (Chickenpox)
- Disseminated Herpes Zoster
- COVID-19 (in certain cases)
What is the purpose of droplet precautions?
To prevent the transmission of infectious agents spread through large respiratory droplets.
List diseases that require droplet precautions.
- Influenza
- Pertussis
- Mumps
- Rubella
- Meningococcal Meningitis
- Diphtheria
- Respiratory Syncytial Virus (RSV)
What are contact precautions?
Used to prevent the spread of infectious agents transmitted through direct or indirect contact.
Identify diseases that require contact precautions.
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin-resistant Enterococcus (VRE)
- Clostridioides difficile (C. diff)
- Respiratory Syncytial Virus (RSV)
- Norovirus
- Scabies
- Lice
What is a Protective Environment (PE)?
A specialized infection control strategy designed to protect immunocompromised patients from infections caused by environmental pathogens.
Who requires a Protective Environment?
- Patients with severe neutropenia
- Hematopoietic stem cell transplants
- Solid organ transplants
- Severe combined immunodeficiency
- High-dose chemotherapy or radiation therapy
What are the principles of surgical asepsis?
- Performing sterile procedures
- Donning and removing caps, masks, and eyewear
- Opening sterile packages
- Preparing a sterile field
What should be included in standard precautions?
- Used in the care of all hospitalized patients
- Apply to blood, body fluids, secretions, and excretions
- New additions include respiratory hygiene and safe injection practices
What are the three types of transmission-based precautions?
- Airborne
- Droplet
- Contact
What factors impact the immune system?
- Congenital abnormalities
- Acquired health problems
- Environmental factors
- Age
- Medical and surgical interventions
What are the most common multidrug-resistant organisms (MDROs)?
- Methicillin-resistant Staphylococcus aureus
- Vancomycin-resistant Enterococcus
- Carbapenem-resistant Enterococcus
What is the significance of hand hygiene in infection control?
It is crucial for preventing the transmission of pathogens.
Fill in the blank: Infection prevention and control includes _______.
[methods such as hand hygiene, disinfection, sterilization, and standard precautions]
What does MRDO stand for?
Multidrug-resistant organism
MRDOs are microorganisms that have become resistant to certain antibiotics.
Name three common MRDOs.
- Methicillin-resistant Staphylococcus aureus
- Vancomycin-resistant Enterococcus
- Carbapenem-resistant Enterococcus
What is CA-MRSA?
Community-Associated Methicillin-resistant Staphylococcus aureus
CA-MRSA causes infections in healthy, non-hospitalized people.
List four health teaching strategies to prevent MRDO infections.
- Perform frequent hand hygiene
- Avoid close contact with people with infectious wounds
- Avoid large crowds
- Use good overall hygiene
What problems can result from inadequate antimicrobial therapy?
- Incorrect choice of drug
- Inadequate dosing
- Noncompliance/nonadherence
- Bacteremia
- Septic shock
True or False: Septic shock is a result of inadequate blood flow to body tissues and organs.
True
What are some assessment cues to recognize in patients with potential infections?
- History: age, current illness, drug use
- Physical assessment: travel history, signs and symptoms
- Psychosocial assessment: stress
- Laboratory assessment: culture and sensitivity, WBC count
Fill in the blank: The __________ is a test to measure inflammation in the body.
ESR (erythrocyte sedimentation rate)
What are some management strategies for hyperthermia?
- Eliminate underlying cause of fever
- Destroy causative microorganism
- Drug therapy with antimicrobials
- Antipyretics: Tylenol, NSAIDs
- External cooling: ice packs
- Fluid administration
What are expected outcomes for a client with an infection?
- Body temperature within baseline
- No complications such as dehydration and sepsis
- Adherence to drug therapy regimen
Name four types of Health Care Associated Infections (HAIs).
- Pneumonia
- Bacteremia
- Urinary Tract Infection
- Surgical Site Infections
What is a common cause of catheter-associated urinary tract infections (CAUTIs)?
Indwelling urinary catheters
Especially prevalent in older adults.
What can trigger pneumonia?
- Infectious organisms
- Inhaling irritating organisms
How many cases of pneumonia occur annually in the US?
2 to 5 million cases
This results in approximately 50,000 deaths per year.
List some health promotion strategies for pneumonia prevention.
- Vaccination
- Avoid crowded places during flu season
- Cough, turn, move, deep breathe
- Clean respiratory equipment
- Avoid pollutants
- Stop smoking
- Eat healthy diet
- Drink 3L of water daily
What are the symptoms of urinary tract infections?
- Dysuria
- Urgency
- Frequency
- Increased temperature
- Confusion in older adults
What is the main complication of surgical site infections?
Wound infections after surgery
Usually results from contamination during surgery or preoperative infection.
What virus causes chickenpox and shingles?
Varicella-zoster virus
What are some symptoms of gastroenteritis?
- Diarrhea
- Vomiting
- Self-limiting to ~3 days
List prevention strategies for gastroenteritis.
- Handwashing
- Sanitize surfaces
- Proper food and beverage preparation
What is a common consequence of untreated bacteremia?
Sepsis
