exam 2 chapter 25 Infection control Flashcards
What is the most significant and most common infection-causing agent in health care institutions?
bacteria
define infection
a disease state that results from the presence of pathogens
define pathogen
disease producing microorganism
Infection occurs as a result of a cyclic process made up of 6 components, list them
- Infectious agent
- Resevoir
- Portal of exit
- Means of transmission
- Portals of entry
- Susceptible host
Name the 3 infectious agents
- bacteria
- viruses
- fungi
3 shapes of bacteria?
- cocci (spherical)
- bacilli (rod-shaped)
- spirochettes (cork-screw)
bacteria can be categorized as gram + or gram negative based on their reaction to what?
Gram stain
Which bacteria, Gram + or Gram -, have a thick cell wall that resists decolorization, and are stained violet?
gram-positive +
Which bacteria has a chemically more complex cell wall, is it gram+ or gram-?
gram -
Gram - negative bacteria do not stain
true or false?
true
How are antibiotics classified?
- specifically effective against only gram + organisms
- broad spectrum (effective against several groups of microorganisms)
List the three ways pathogens can be transmitted
(means of transmission)
direct contact
indirect contact
airborne route
Name the United States agency responsible for investigating, preventing, and controlling disease
CDC
Centers for Disease Prevention and Control
What are aerobic bacteria?
require oxygen to live and grow
Bacteria that can live without oxygen are classified as what?
anaerobic
What’s the smallest of all microorganisms, visible only with an electron microscope?
viruses
What causes the common cold, hepatitis B and C and AIDS?
viruses
What are the plant-like organisms that are present in air, soil, and water?
fungi
What affects an organism’s potential to produce disease
dose: number of organisms
virulence: ability to survive
host resistance: competence of person’s immune system
Length and intimacy of contact between person and microorganism (exposure)
What would be considered a reservoir for microorganisms?
- other people
- animals
- soil
- food, water, milk
- inanimate objects
what causes athletes foot, ring worm, and yeast infectons?
fungi
(molds and yeasts)
Antifungals are used to treat fungi-associated infections but why is that not always a solution?
many infections due to fungi are resistant to treatment
What disease occurs when a parasite infects a certain type of mosquito that feeds on humans?
Malaria
define virulence
ability to cause disease
What does the acronym SARS stand for?
the disease with the masks
(first infected humans in china 2002)
severe acute respiratory syndrome
What are the common portals of exit?
- respiratory
- gastrointestinal
- genitourinary tracts
- breaks in skin
- mucous membranes
- blood and tissue: transplacental
define endemic
a disease that occurs with predictability in one specific region or population
Name and explain the 4 stages of infection
- Incubation period: pathogen entrance, appearance of first symptoms, organisms growing and multiplying
- Prodromal Stage: Person is Most infectious, vague and nonspecific signs of disease
- Full stage of illness: presence of specific signs and symptoms of disease
- Convalescent period: recovery from infection
When antivirals are given during the _________ stage of infection from certain viruses, these medications can shorten the Full Stage of the illness (when signs and symptoms would be present)
Prodromal stage
Name the opportunist organism that normally resides in our intestinal tract
E. coli
define reservoir when talking about microorganisms
natural habitat of the organism
What kinds of factors can affect host susceptibility?
- intact skin and mucous membranes
- normal pH levels
- body’s white blood cells
- age, sex, race, heredity factors
- immunization, natural or acquired
- fatigue, climate, nutritional, and general health status
- stress
- use of invasive or indwelling medical devices
Indirect contact as a way of transmission means what?
involves personal contact with an inanimate object, such as touching a contaminated instrument
Define Vector
ex: mosquito, tick ,lice; nonhuman carriers that transmit organisms from one host to another by injecting salivary fluid when a human bite occurs
airborne particles are ____ than 5 mcm
droplets are _______ than 5 mcm
airborne are less than 5 mcm
droplet particles are greater than 5 mcm
Cardinal signs of acute infection?
- redness
- heat
- swelling
- pain
- loss of function
What is the normal range for White Blood Cell count?
5,000-10,000/mm3
What Lab data would indicate infection?
- elevated WBC count
- increase in specific types of white blood cells
- elevated erythrocyte sedimentation rate
- presence of pathogen in urine, blood, sputum, or draining cultures
What are the 5 Moments for Hand Hygiene (WHO)?
Name three specific bacteria that are normal flora?
Staphylococcus, streptococcus, E. coli
What type of bacterial flora is loosely attached on skin and removed with relative ease, like contact with another person or object
Transient
What are the four categories responsible for the majority of Hospital-Acquired Infections (HAI’s)?
> Urinary Tract Infections
> Surgical site Infections
> Bloodstream Infections
> Pneumonia
(USDHHS)
One of the body’s first line of defense against infection is your ______ _____
normal flora
In addition to the normal flora that inhabit various body sites, name the other 2 defense systems that help a person combat infection.
- Inflammatory response
- Immune response (susceptibility)
define Iatrogenic
when an infection is a direct result from a treatment or diagnostic procedure
Most HAI’s are caused by bacteria such as E. coli, Staphylococcus aureus, Streptococcus faecalis, Pseudomonas aeruginosa, and Klebsiella species.
true or false?
true
When is an infection referred to as exogenous?
when the organism that caused the infection is acquired from other people.
When is an infection referred to as endogenous?
when the organism that caused the infection comes from the microbial life harbored in that person
(endo: within)
Are all Health Care -Associated infections (HAI’s) iatrogenic?
no
What does VRE stand for?
Vancomycin-Resistant Enterococci
What type of infection is the most common type to cause HAI’s and accounts for more than 30% of HAI’s in acute care hospitals?
(CAUTIs)
catheter-associated urinary tract infections
What is the name for a group of evidence-based best practices that have proven positive outcomes when implemented together to prevent infection?
bundles
List the Risk Factors for Vancomycin-Resistant Enterococci
- compromised immune systems
- recent abdominal or chest surgery
- presence of urinary or central IV catheter
- prolonged antibiotic use, especially with vancomycin
- lengthy hospital stay, especially in an ICU
CDC recommendations to prevent C. difficile Infection
- prescribe antibiotics cautiously
- use contact precautions for patients confirmed or suspected of having CDI
- use effective hand hygiene
- have room and nondisposable equipment cleaned with bleach or other appropriate disinfectant
- upon transfer out of the facility, notify the new facility about the C. difficile infection
Name the three antibiotic resistant organisms that emerged because of overuse of broad spectrum antibiotics?
MRSA (methicillin-resistant staphylococcus aureus)
VRSA (vancomycin-resistant staphylococcus aureus)
carbapenem-resistant Enterobacteriaceae (CRE)
Have C. diff rates and associated deaths risen or delined in the past few years?
risen (numbers increasing)
Who is most at risk for C. diff?
Older adults who are receiving medical care and taking antibiotics
What are some common signs and symptoms of C. diff?
watery diarhhea, fever, mild abdominal cramping
A new requirement to report CDI was scheduled to take effect in 2013 in the United States.
true or false?
true
List the factors determining use of sterilization and disinfection methods
> Nature of organisms present
> Number of organisms present
> Type of equipment
> Intended use of equipment
> Available means for sterilization and disinfection
> Time
When dealing with the nature of organisms present, what does the CDC recommend when treating supplies, linens, and equipment in a healthcare setting?
CDC recommends that all supplies, linens, and equipment be treated as if the patient were infectious
List the PPE supplies
Gloves
Gowns
Masks
Protective eyewear
Disinfection destroys all pathogens except for what?
spores
When boiling as a method for sterilization and/or disinfection, how long do you need to boil for?
Are spores and all viruses destroyed by boiling?
10 minutes
no
what types of items would you sterilize with dry heat ?
is dry heat used in the health care setting?
metal items
not used in healhcare
What administration enforces that healthcare employees have all the equipment and supplies neccessary to minimize/prevent exposure to infectious material (PPE)?
OSHA
Occupational Safety and Health Administration
How far can aerosols travel?
about 3 feet
According to CDC guidelines, what type of mask do you have to wear to prevent the transmission of diseases like multi-drug resistent TB, SARS or Influenza?
(NIOSH approved)
N95 respirator
or
HEPA
(High-efficiency Particulate Air filter respirator)
N95 respirators filter out particles as small as _ mcm with __% efficiency
(% is obvious)
1 mcm
95%
What does Aseptic technique include?
Includes all activities to prevent or break the chain of infection
What is the clean technique?
(is it medical or surgical asepsis)
medical asepsis
What is the sterile technique?
(is it medical asepsis or surgical asepsis)
surgical asepsis
Which type of Asepsis would you use in the OR, labor and delivery areas, certain diagnostic testing areas, patient bedside while inserting urinary catheters, sterile dressing changes, or preparing or injecting medication?
surgical asepsis
Teaching patients to use medical asepsis at home includes doing what?
* wash hands before preparing/eating food
* prepare foods at high enough temps
* use care with cutting boards/utensild
* keep food refrigerated
* wash raw foods and veggies
* wash hands after using bathroom
