Exam 2 Module 3 Flashcards
chapter 20, promote asepsis part 1
1
Q
What is infection?
A
Invasion of and multiplication in the body by a pathogen.
2
Q
What are the goals of infection prevention and control?
A
- Protect patients from infections
- Meet professional standards and guidelines
- Protect yourself and others from diseases
- Reduce the severity of illness and complications resulting from infection
3
Q
What does HAI stand for?
A
Healthcare-associated infections.
4
Q
What is a nosocomial infection?
A
Infections acquired in the hospital.
5
Q
What is the approximate prevalence of HAIs among hospitalized patients?
A
Approximately 1 of every 31 hospitalized patients.
6
Q
Which infection is considered one of the most common and serious among HAIs?
A
Clostridium difficile.
7
Q
What are some reasons for the high incidence of healthcare-related infections?
A
- Many care providers can transmit pathogens
- Ill patients are vulnerable to infection
- Invasive procedures can introduce microbes
8
Q
What is the primary goal of the U.S. Department of Health and Human Services regarding HAIs?
A
To keep patients from acquiring healthcare-associated infections.
9
Q
What is the difference between transient flora and resident flora?
A
- Transient flora are temporary and can be removed by handwashing
- Resident flora are permanent inhabitants of the skin
10
Q
List the four factors that determine whether a person develops an infection.
A
- Virulence of the organism
- Host environment
- Number of organisms
- Host defenses
11
Q
What is a reservoir in the context of infection?
A
A source of infection where pathogens survive and multiply.
12
Q
What are the two types of reservoirs?
A
- Living organisms
- Nonliving reservoirs
13
Q
What is the ideal temperature for most pathogens?
A
35°C (95°F).
14
Q
True or False: Most pathogens can survive in the highly acidic environment of the stomach.
A
False.
15
Q
What is the role of the World Health Organization (WHO) in infection control?
A
Committed to reducing healthcare-associated complications and improving infection response.
16
Q
What is the significance of the Joint Commission’s Goal 7 for 2020?
A
To reduce the risk of healthcare-associated infections.
17
Q
Fill in the blank: The largest groups of pathogens are _______.
A
[bacteria, viruses, and fungi]
18
Q
What are multidrug-resistant organisms (MDROs)?
A
Pathogens that have developed resistance to multiple antibiotics.
19
Q
What does QSEN stand for?
A
Quality and Safety Education for Nurses.
20
Q
What is the role of normal flora in the human body?
A
- Aid in digestion
- Synthesize vitamins
- Limit growth of harmful bacteria
21
Q
What can happen to normal flora under certain conditions?
A
They may become pathogenic.
22
Q
Name one example of an anaerobic organism.
A
Clostridium tetani.
23
Q
What are microorganisms that live on or in the human body without causing harm called?
A
Normal flora
Normal flora can be beneficial or essential for human health and well-being.
24
Q
Where do the two types of normal flora come from?
A
- Transient flora
- Resident flora
Transient flora are acquired from contact with objects or people, while resident flora are permanent inhabitants.
25
What do normal flora do in the intestine?
* Aid in digestion
* Synthesize vitamin K
* Release vitamin B12, thiamine, biotin, niacin, and riboflavin
## Footnote
These functions are essential for maintaining health.
26
How do normal flora limit the growth of harmful bacteria?
By competing for available nutrients
## Footnote
This competition helps maintain a balance in the microbial community.
27
What are pathogens?
Microorganisms capable of causing disease
## Footnote
The largest groups of pathogens are bacteria, viruses, and fungi.
28
Name less common pathogens.
* Protozoa
* Helminths (commonly called worms)
* Prions
## Footnote
Prions are infectious protein particles causing neurological diseases.
29
When can normal flora become pathogenic?
When a patient is vulnerable to disease or they enter regions of the body they do not normally inhabit
## Footnote
For example, Escherichia coli can cause infection when in the urinary tract.
30
31
What are the six links in the chain of infection?
Reservoir, portal of exit, mode of transmission, portal of entry, susceptible host, and infectious agent
32
Define a reservoir in the context of infection.
A source of infection—a place where pathogens survive and multiply.
33
What are some examples of living reservoirs?
* Humans
* Animals
* Insects
* Carriers
34
What is a carrier?
A person capable of defending themselves from active disease but harboring pathogenic organisms without symptoms.
35
List examples of nonliving reservoirs.
* Soil
* Water
* Food
* Environmental surfaces
36
What characteristics of environments are supportive to microbes?
* Nutrients
* Moisture
* Temperature
* Oxygen
* pH and electrolytes
* Light
37
At what temperature do most pathogens thrive?
35°C (95°F)
38
True or False: Most pathogens require a moist environment to survive.
True
39
What is the ideal pH range for most pathogens?
5 to 8
40
Fill in the blank: Many bacteria and most protozoa and fungi are ______.
aerobic
41
What is an example of an anaerobic organism?
Clostridium tetani
## Footnote
causes tetanus when a spore enters the body through an open wound.
42
How does a fever help the body fight infection?
It can inhibit and even kill invading pathogens.
43
What role does ultraviolet light play in infection control?
It is used to remove pathogens from surgical instruments and disinfect drinking water.
## Footnote
remove pathogens such as Staphylococcus, Salmonella, and viruses from surgical instruments and other objects. It is also used to disinfect drinking water
44
What happens to the survival of pathogens when patients take antacids?
Stomach pH increases, removing the acidic defense and allowing organisms to multiply.
45
What is an example of a pathogenic bacteria that can multiply in food left at room temperature?
Salmonella enteritidis
46
Why is the human body considered the most common reservoir for pathogens?
It provides a warm, moist, dark environment.
47
pathogens require moisture for survival except for ---
spores that live without water (e.g., the Bacillus and Clostridium species, both of which cause foodborne disease).
48
49
50
51
What is a portal of exit?
A route through which a pathogen exits a reservoir, commonly through body fluids.
52
What is the most frequent portal of exit for human or animal reservoirs?
Body fluids.
53
How does the body expel pathogens from the respiratory system?
Coughing and sneezing.
54
What are common ways pathogens exit the gastrointestinal system?
Vomiting and diarrhea.
55
What role do wounds, bites, and abrasions play in pathogen transmission?
They provide an exit for body fluids that transport pathogens.
56
What are common healthcare-related exit routes for pathogens?
Puncture sites, drainage tubes, feeding tubes, and IV lines.
57
What is the most frequent mode of transmission of infection?
Contact (direct or indirect).
58
What is direct contact in the context of infection transmission?
Physical contact, sexual intercourse, or contact with wound drainage.
59
What is indirect contact?
Contact with a fomite, a contaminated object that transfers a pathogen.
60
Give examples of fomites.
* Shoes
* Eyeglasses
* Stethoscopes
* Contaminated needles.
61
What is droplet transmission?
Transmission when pathogens travel in water droplets expelled during exhalation, coughing, or sneezing.
62
How far can droplets typically travel?
Only a few feet.
63
What is airborne transmission?
When microorganisms float considerable distances on air currents to infect people.
64
Name some common airborne pathogens.
* Measles
* Tuberculosis
* Many fungal infections.
65
What is a vector?
An organism that carries a pathogen to a susceptible host.
66
What diseases are commonly transmitted by mosquitoes?
* Malaria
* Yellow fever
* Zika virus
* West Nile virus.
67
What are potential portals of entry for pathogens?
* Normal body openings (e.g., conjunctiva, nares, mouth)
* Abnormal openings (e.g., cuts, scrapes)
* Vector bites.
68
What defines a susceptible host?
A person at risk for infection due to inadequate defense against pathogens.
69
What factors can increase susceptibility to infection?
* Age (very young, very old)
* Compromised immune system
* Immune deficiency conditions (e.g., HIV, leukemia).
70
Fill in the blank: A susceptible host has _______ against the invading pathogen.
inadequate defense.
71
What are the two main classifications of infections based on location?
Local and Systemic
## Footnote
Local infections affect a limited region, while systemic infections spread throughout the body.
72
What is bacteremia?
The clinical presence of bacteria in the blood
## Footnote
It is a critical condition that can lead to septicemia.
73
What is the difference between primary and secondary infections?
Primary infection is the first infection; secondary infection follows a primary infection
## Footnote
Secondary infections often occur in immunocompromised patients.
74
Define exogenous and endogenous infections.
Exogenous infections are acquired from the healthcare environment; endogenous infections arise from the patient's normal flora
## Footnote
Treatment can trigger endogenous infections, as seen with yeast infections after antibiotics.
75
What characterizes acute infections?
Rapid onset and short duration
## Footnote
Examples include the common cold and urinary tract infections (UTIs).
76
What distinguishes chronic infections from acute infections?
Chronic infections develop slowly and last for an extended period, while acute infections are short-lived
## Footnote
Chronic infections can last for weeks, months, or years.
77
What are latent infections?
Infections that cause no symptoms for long periods, even decades
## Footnote
Examples include tuberculosis and HIV.
78
List the stages of infection progression.
* Incubation
* Prodrome
* Illness
* Decline
* Convalescence
## Footnote
Each stage varies in duration and intensity of symptoms.
79
What occurs during the incubation stage of an infection?
Successful invasion of the pathogen into the body and the first appearance of symptoms
## Footnote
This stage may last from a day to several months or years.
80
What is the prodromal stage characterized by?
The first appearance of vague symptoms
## Footnote
Not all infections have a prodromal stage.
81
What happens during the illness stage of an infection?
Signs and symptoms of the disease appear
## Footnote
If immune defenses are ineffective, this stage can result in death.
82
What is convalescence?
The stage where healing begins as the number of microorganisms approaches zero
## Footnote
This stage can take from a few days to over a year, depending on the severity of the infection.
83
True or False: An endemic condition occurs at a stable rate in a particular environment.
True
An endemic condition occurs at a stable, predictable rate within a particular environment, region, or population. Malaria in some areas of Africa is an example of endemic disease.
84
What defines an outbreak?
A sudden increase in the number of people with a condition that is greater than expected
## Footnote
Outbreaks are usually limited to small areas.
85
What is the difference between an epidemic and a pandemic?
An epidemic spreads over a large geographic area; a pandemic affects a large number of people worldwide
## Footnote
Examples of pandemics include COVID-19 and H1N1 influenza.
86
Fill in the blank: An __________ is an outbreak of a disease that spreads over a large geographic region.
epidemic
## Footnote
Epidemics can also be defined within a specific population group.
87
Why should nurses be aware of emerging pathogens and diseases?
Continental and intercontinental travel allows for spreading emerging diseases
## Footnote
Travelers can act as reservoirs for pathogens, facilitating transmission.
88
What are emerging infectious diseases?
Newly identified diseases caused by unrecognized microorganisms or known organisms causing new responses
## Footnote
Examples include AIDS (unknown before 1980) and COVID-19 (unknown before 2019)
89
What can cause a disease to be classified as emerging?
Diseases occurring in new geographic areas or settings
## Footnote
Examples include Ebola virus in western Africa and C difficile moving from hospital-acquired to community settings
90
What is an example of a microorganism extending its host range to humans?
Avian influenza, H1N1 virus, Zika virus
## Footnote
Zika virus can cause birth defects when acquired during pregnancy
91
What happens when known diseases increase dramatically in incidence?
They may result from poor compliance with public health measures
## Footnote
Examples include mumps and cholera outbreaks due to failed immunization and water treatment
92
Why is the influenza virus difficult to eradicate?
It shows a high mutation rate and rapidly yields new strains
93
What is a bioterrorism-related example of an emerging pathogen?
Contamination of mail with Bacillus anthracis (anthrax)
94
What type of pathogens does the WHO prioritize for lack of medical countermeasures?
Emerging pathogens such as SARS-CoV-2, Ebola virus, Zika virus, SARS, MERS, Crimean Congo hemorrhagic fever
95
Which virus is known for being exceedingly contagious?
Measles
96
What is a significant challenge in treating severe infectious diseases?
Antibiotic resistance
97
What are the three lines of defense the human body has against infectious disease?
1. Anatomical features
2. Protective biochemical processes
3. Immune responses
98
What characterizes the primary and secondary lines of defense?
They are nonspecific and do not adapt their response to specific invaders
99
What is the primary defense in the human body?
The structural barriers of the human body that prevent organisms from entering. This includes skin, mucous membranes, and other physical barriers.
100
What role does normal flora play in the body? What happens if we use an antibioitc?
It helps maintain a balance that prevents the overgrowth of pathogens. When we use antibiotics to treat an infection, it kills the bacteria causing the infection + the normal flora. Once the normal flora are removed, a secondary infection aka "superinfection" can occur (like C diff)
101
How does intact skin function as a barrier?
It prevents the entry of many pathogens and maintains a healthy balance of normal flora so it keeps bad bacteria from multiplying
## Footnote
Healthy skin acts as a first line of defense.
102
What is the function of mucous membranes in the respiratory tree?
They trap pathogens, which are then expelled from the body
## Footnote
The respiratory system uses cilia and coughing to clear pathogens.
103
What protective mechanism do the eyes have against infections?
Tears produced by lacrimal glands contain lysozyme, an antimicrobial enzyme
## Footnote
Tears help wash away infective organisms.
104
What is the role of saliva in oral health? What else in the mouth fights pathogens?
Saliva contains lysozyme (just like tears) and helps wash microbes from the teeth and gums.
the normal flora of the mouth compete with invading organisms for nutrition, thus keeping the microorganisms in check.
105
How does the gastrointestinal tract defend against pathogens?
* The stomach's acidic environment destroys many pathogens and bile in the small intestine has antimicrobial action
* Normal peristalsis, diarrhea, and vomiting can elimate invading pathogens (think food poisoning gives u these symptoms)
* Normal flora secrete antibacterial substances
## Footnote
Peristalsis, diarrhea, and vomiting help eliminate pathogens.
106
What is the function of mucus in the genitourinary tract and the anus?
* It adheres to pathogens to promote their excretion through urine and stool
* The acidity of urine and the normal flora in the vagina also contribute to defense.
* the vagina is also super acidic so it keeps flora in balance
## Footnote
semen can disrupt the acidity of the vagina because semen is basic pH, which can cause bacterial vaginosis (more bad than good bacteria)
107
True or False: Broad-spectrum antibiotics can eliminate normal flora. What complication can this cause?
True
## Footnote
This can increase the risk of superinfections.
108
Fill in the blank: The _______ in the nose filter the upper airway.
hairs
## Footnote
These hairs help trap and expel pathogens.
109
What are primary defenses (listed)?
* Normal flora of the body
* Skin
* Respiratory Tree
* Eyes
* Mouth
* GI tract
* GU tract
* Anus
110
What is included in the respiratory tree and describe its defenses
* The nares, trachea, and bronchi are covered with mucous membranes that trap pathogens, which are then expelled.
* The nose contains hairs that filter the upper airway; the nasal passages, sinuses, trachea, and larger bronchi are lined with cilia that sweep towards the exit
* Coughing and sneezing forcefully expel organisms from the respiratory tract.
111
What happens when pathogens dodge the primary defense?
They begin to release wastes and secretions and cause the breakdown of cells and tissues.
## Footnote
This activates a set of secondary defenses.
112
What is phagocytosis? What cells do this and what is their machinery?
* The process by which phagocytes **engulf** and destroy pathogens directly by releasing **enzymes** that lead to their destruction.
* Phagocytes are specialized white blood cells (WBCs).
## Footnote
Phagocytes can also signal other WBCs to aid in eliminating microorganisms.
113
What is the complement cascade?
* Complement proteins in the blood trigger the release of chemicals that attack pathogen cell membranes.
* punctures the cell membranes of pathogens so they rupture
* Signals basophils to release histamine which starts inflammation mechanism
114
What is the role of histamine in inflammation?
Histamine (and other proteins) prompts inflammation by dilating blood vessels and increasing their permeability.
## Footnote
This allows more phagocytes, antimicrobial chemicals, oxygen, and nutrients to the affected area.
115
What are the classic signs and symptoms of inflammation?
* Localized **warmth** and **erythema** (redness).
* From increased blood flow and interstitial fluid between cells
* Pain due to edema (interstitial fluid increased)
116
What causes edema during inflammation?
Fluid leaking from more permeable blood vessels accumulates in surrounding tissue.
## Footnote
Edema can prompt pain in the affected area.
117
What is a fever?
* A rise in core body temperature that increases metabolism and inhibits pathogen multiplication.
* It helps start the protein cascade for immune system
118
At what temperature do many clinicians believe **treatment** for fever is **necessary**? Why?
Greater than 38.9°C (102°F).
Low-grade fevers are considered a natural defense mechanism.
119
What mneumonic helps you remember the proportion of white blood cell types? Name the proportions of each.
Never Let Monkeys Eat Bananas
| Neutrophils>Lymphocytes>Monocytes>Eosinophils>Basophils
## Footnote
N 55-70
L 20-35
M 3- 8
E 1-3
B 0.5 - 1
120
What percentage of total WBCs do Basophils represent?
0.5%–1%
121
What percentage of total WBCs do Neutrophils represent?
55%–70%
## Footnote
can attack some healthy cells because they are so aggressive
122
What is the primary function of Basophils?
Release histamine and heparin granules as part of the inflammatory response. Able to see them during INFECTIONS but not during normal conditions
123
What percentage of total WBCs do Eosinophils represent?
1%–3%
124
What role do Eosinophils play in the immune system?
Involved in allergic reactions and control inflammation; limited role in phagocytosis. seen during PARASITIC infections but not during normal conditions.
125
What is pus composed of?
Collection of dead neutrophils
126
What percentage of total WBCs do Lymphocytes represent?
20%–35%
## Footnote
attack viruses and invovled in specific immunity. have to be presented antigens to attack. antigens are pathogen bits after being taken apart by phagocytes/neutrophils.
127
What is the primary function of T cells?
Responsible for cell-mediated immunity; recognize, attack, and destroy antigens
128
What is the primary function of B cells?
* Responsible for humoral (antibody) immunity; produce immunoglobulins to attack and destroy antigens which target a pathogen specifically
129
What percentage of total WBCs do Monocytes represent?
3%–8%
130
What is a key function of Monocytes?
* Able to phagocytize directly and differentiate into macrophages.
* Phagocytes help clean up damaged or injured tissue.
* Percentage increases in **tuberculosis**, protozoal, and rickettsia (ticks) infections.
131
What happens to the percentage of Monocytes during tuberculosis, protozoal, and rickettsia infections?
Increases
132
Fill in the blank: Neutrophils can be aggressive and can kill some healthy cells, which is why the collection of dead neutrophils is called _______.
pus
133
True or False: Eosinophils are commonly found in the body.
False
134
Not for test - just understanding. Explanation from my immune system class.
Monocytes, as we discussed, are immature phagocytes that move through the bloodstream in proportionately smaller numbers unless there is an active infection. Some monocytes will migrate into tissues where they take on specific mature macrophage forms relevant to that organ (such as Kupffer cells in the liver). These macrophages, once mature, remain in small numbers in the tissue and can be some of the first to recognize an invading pathogen. However, new monocytes are not recruited to the tissue unless there is a major issue present.
Neutrophils, on the other hand, are present in relatively high proportions in the bloodstream compared to other leukocytes. In the event of infection or inflammation, neutrophils are rapidly recruited to address the insult, and are therefore the predominant macrophage early in the inflammatory/immune response. Over time, the body will recruit additional monocytes to the area of concern, leading to macrophages to eventually become the predominant phagocyte after a couple of days.
This is why, if you google "Which phagocyte is the first responder to an infection," you are likely to see both answers. Macrophages and other tissue-resident cells such as mast cells and dendritic cells are already on the scene when the initial incident occurs and may start to respond by taking actions such as releasing cytokines, but neutrophils will be the primary first responders in terms of phagocytosis and fighting infection early in the immune response.
135
List of secondary defenses
* Phagocytosis
* Complement cascade
* Inflammation
* Fever
136
What is the primary function of antibodies in immunity?
Neutralize or destroy toxins or destroy disease-producing organisms
## Footnote
Antibodies are crucial for protecting the body against infections.
137
Define active immunity.
Occurs when the body makes its own antibodies or T lymphocytes to protect against a pathogen
## Footnote
Active immunity is a natural response to infection or vaccination.
138
What is passive immunity? What are examples?a
Achieved when a person receives antibodies from another source rather than producing them themselves
## Footnote
Examples of passive include blood transfusions and mother's milk.
active immunity would be immunizations or fighting an infection yourself
139
What is specific immunity?
The process through which immune cells learn to recognize and destroy **previously encountered** pathogens
## Footnote
This is why individuals rarely get certain diseases, like measles, more than once.
140
What types of cells are involved in specific immunity?
Lymphocytes, specifically T cells and B cells
## Footnote
These cells are produced from stem cells in the red bone marrow.
141
Where do B cells mature?
In the bone marrow
## Footnote
B cells remain in the bone marrow until fully mature.
142
Where do T cells mature?
Travel from the red bone marrow to mature In the thymus
## Footnote
T cells migrate to the thymus for maturation.
143
What are the main sites where lymphocytes activate against pathogens?
Lymph nodes, spleen, tonsils
## Footnote
These are components of the lymphatic system.
144
True or False: Both B cells and T cells form in the bone marrow.
True
## Footnote
Both types of lymphocytes originate from stem cells in the bone marrow.
145
Fill in the blank: The receptors on the surface of lymphocytes allow them to recognize _______.
[invaders]
## Footnote
This recognition is crucial for the immune response.
146
Natural active immunity
Natural Active Immunity.
After a person becomes ill with an infection, the body produces its own antibodies to fight the disease-causing organism and protect from infection in the future (e.g., influenza).
147
Artificial Active immunity
An immune response occurs when the body is exposed to weakened or dead pathogens in a vaccine. The body then makes T cells or antibodies to keep from actually developing the illness (e.g., tetanus, measles). This type of immunity offers long-lasting or even lifetime protection.
148
Natural Passive Immunity
Immunity results when natural antibodies are passed from one body to another, such as from mother to baby through the placenta, or through breastfeeding.
149
Artificial Passive Immunity
Artificial Passive Immunity
Protection from infection is achieved when a person receives serum from another person or animal that has already produced antibodies against the pathogen (e.g., serum for treatment of rabies or botulism).
150
Describe celllular immunity
Cellular (cell-mediated) immune response acts directly to destroy infection-causing pathogens (i.e., viruses, fungi, protozoans, cancers) **without using antibodies but rather activating phagocytes and T cells**
1. The immune process starts when the body is exposed to a particular pathogen. Infecting
microbes in the body invade cells and signal for more microbes to take over.
2. Antigens are proteins on the outer surface of pathogens that evoke an immune response.
3. Along comes white blood cell phagocytes that engulf and swallow the pathogen.
4. After the pathogen is destroyed, the **phagocyte now displays pieces of itself on the antigens**
of the destroyed pathogen. This is known as an antigen-presenting cell (APC).
5. Now **memory T cells bind to the APC** to fight similar pathogens in the future. With subsequent infections, memory T cells are able to increase the speed and intensity of the T
cell to recognize similar intruders.
6. Nearby **helper T **cells come in and fight against the infecting agent by **activating T cells and alerting B cells** to get involved.
7. **Active T cells multiply** to fight the infection by releasing proteins and enzymes to destroy the pathogen. These are called **cytotoxic (killer) T cells.**
8. Suppressor T cells stop the immune response when the infection has been contained (also see Fig. 20-3).
151
Humoral Immunity
* circulating **antibodies** fight against pathogens.
* specialized WBCs
* Person is exposed to a pathogen. Helper cells in the bone marrow activate proteins, called **interleukins**, that cause **B cells to divide** into **memory** cells and **active** B cells.
* **Active** B cells produce Y-shaped **antibodies** that bind to a pathogen’s attachment site (**antigen**) to interfere with its ability to infect other cells. This process, called **neutralization**, does not destroy the pathogen; it just makes the pathogen **ineffective**.
* Antibodies also cause pathogens to clump together (**agglutination**), reducing their activity and increasing the likelihood that the clump will be detected and **phagocytized** by leukocytes.
* These antibodies signal leukocytes (macrophages and neutrophils) to come in and engulf the pathogen and break it down.
* Antibodies also fight infection by triggering inflammatory chemicals to destroy the pathogen. This is called the **complement cascade**.
* **Suppressor** cells **stop** the immune response when the infection is contained.
## Footnote
all about B cels and their production of antibodies
