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NUR210 > Exam 2 module 3 part 2 > Flashcards

Exam 2 module 3 part 2 Flashcards

chapter 20, promote asepsis part 2

1
Q

What factors increase host susceptibility to infection?

A

Anything that weakens the body’s defense system and factors that increase exposure to pathogens

Examples include working at a daycare facility or being a nurse.

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2
Q

What is the role of IgM?

A

First antibody to appear when an antigen is encountered and involved in agglutination with incompatible blood types.

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3
Q

What is the most common immunoglobulin in the body? What is unique about it?

A

IgG.It can cross the placenta to provide temporary immunity (natural passive) to the infant

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4
Q

How long does it take for IgG to be produced in response to an initial infection?

A

At least 10 days.

its a slow moving war horse.

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5
Q

Which immunoglobulin can cross the placenta?

A

IgG.

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6
Q

What is the primary function of IgE?

A

Responsible for the allergic response.

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7
Q

Where is IgA found?

A

In mucous membranes of the intestines, respiratory and urinary tracts, saliva, tears, and breast milk.

IgA provides additional immune protection
by secreting around the body openings.

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8
Q

What additional protection does IgA provide?

A

Secreting around the body openings.

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9
Q

What is the function of IgD?

A

Forms on the surface of B cells and traps potential pathogens to prevent replication.

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10
Q

Why are young children considered vulnerable hosts?

A
  • Their immune systems are immature and have had limited exposure to pathogens (underdeveloped spleen before age 5)
  • Children frequently have more infections when they begin contact with people outside their family, such as when they start daycare or school.
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11
Q

What happens to the immune response as people age?

A

The immune response declines with aging. Also skin becomes less elastic and more prone to breakdown.

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12
Q

What creates an easy portal of entry for infectious microorganisms? Examples?

A

A break in the skin. Breaks can be caused by surgical procedures, injuries, skin breakdown, insect bites, or IV device insertion.

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13
Q

How does recuperation from infection or injury affect the body?

A

It limits the physical resources available to combat a new pathogen.

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14
Q

What is a major risk factor for pulmonary infections? Why?

A
  • Smoking.
  • Smoking interferes with normal respiratory functioning, including chest movement and the ability to cough or sneeze.
  • Chemicals in tobacco immobilize cilia; thus, secretions pool in the lower airways, creating a favorable environment for bacteria to live and replicate.
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15
Q

What is the impact of smoking and vaping on leukocytes long term?

A

They compromise the antibacterial function of leukocytes. Chronic exposure to secondhand smoke increases the risk for respiratory infection, ear and sinus infection, meningitis, and postsurgical and nosocomial infections

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16
Q

What effect does excessive alcohol use have on nutrition both acutely and chronic?

A
  • It curbs hunger, leading to inadequate diet and deficiencies in vitamins, minerals, and proteins.
  • Over time, excessive alcohol use is toxic to the liver and to the cells lining the intestinal mucosa of the esophagus and GI, which can lead to inflammation, infection, and injury.
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17
Q

How do inhaled substances affect the respiratory system?

A

They affect respiratory cilia similarly to tobacco.

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18
Q

Overall, how do substances that affect energy and orientation (who, where, time, why) will……?

A

decrease food intake, activity, rest, and hygiene.

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19
Q

What is the risk associated with injecting substances?

A

It leads to breaks in skin integrity, increasing the risk of infection.

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20
Q

How does the number of sexual partners relate to infection risk?

A

The more sexual partners a person has, the greater the risk of acquiring sexually transmitted infections and cervical cancer.

Microbes are transmitted via semen, vaginal secretions, or blood that is present during sexual intercourse.

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21
Q

How are microbes transmitted during sexual intercourse?

A

Via semen, vaginal secretions, or blood.

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22
Q

What role do environmental factors play in infection risk?

A

They can increase exposure to pathogens, irritate respiratory airways, or cause breaks in the skin.

**work setting **(e.g., preschool teacher, healthcare worker) OR living situation (e.g., skilled nurse care, parents with young children who are in preschool).

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23
Q

In what settings can increased exposure to pathogens occur?

A

In work settings like preschool teaching or healthcare, and living situations like skilled nursing care.

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24
Q

What are MDROs?

A

Microbes that have mutated to develop resistance to one or more classes of antimicrobial drugs

Associated with serious illness, increased hospitalization, and higher death rates.

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25
Q

What has been the trend in the prevalence of MDROs in U.S. hospitals over the past several decades?

A

Increased steadily

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26
Q

What is one of the most significant challenges in treating patients with severe infectious diseases?

A

Antibiotic resistance

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27
Q

What are the implications of MDRO infections?

A

Limited treatment options, serious illness, increased mortality, longer hospital stays, and higher costs

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28
Q

Name a type of MDRO associated with hospitals that is resistant to vancomycin. How is it spread?

A

Vancomycin-resistant enterococci (VRE), spread by failure to follow infection control measures

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29
Q

How are Methicillin-resistant S aureus (MRSA) infections primarily spread?

A

Skin-to-skin contact, especially in crowded living conditions

can cause sepsis, pneumonia, surgical site infections. it can survive on objects.

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30
Q

What types of infections can MRSA cause?

A
  • Skin and soft tissue infections
  • Bloodstream infections (sepsis)
  • Pneumonia
  • Surgical-site infections
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31
Q

What is a major risk factor for developing C difficile (C diff.) infections? Who is the MC population?

A

anyone prolonged treatment with antibiotics. Elderly, IC

found in feces

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32
Q

What is a characteristic of C diff. spores?

A

spres can survive for days on doorknobs and toilet seats (inanimate objects)

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33
Q

List other significant MDROs.

A
  • Multidrug-resistant tuberculosis (MDR-TB)
  • Penicillin-resistant S pneumoniae
  • Multidrug-resistant E coli
  • Klebsiella pneumoniae
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34
Q

What are some risk factors for MDRO infections?

A
  • Previous exposure to antibiotics
  • Impaired body defense
  • Severe illness
  • Invasive procedures and devices
  • Repeated hospitalization, especially ICUs
  • Advanced age
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35
Q

What are symptoms of MDRO infections?

A
  • Wounds that are slow or fail to heal with antibiotics
  • Fever
  • Swelling
  • Redness
  • Excessive warmth
  • Pain
  • Drainage
  • Diarrhea
  • Abdominal cramping
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36
Q

What diagnostic tests are used for MDRO infections?

A
  • Cultures and sensitivities of wound and skin, blood, sputum, urine, cerebral spinal fluid (CSF)
  • Complete blood count (CBC) with differential
  • Screening cultures at admission or on specialty units (ICU)
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37
Q

What should be strictly adhered to for all patient contact with MDROs until cultures are negative?

A

Guidelines for hand hygiene, glove use, and isolation precautions

MDROs refer to multidrug-resistant organisms.

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38
Q

What is important to ensure regarding patient areas?

A

They are cleaned well and often

Frequent cleaning helps reduce infection risks.

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39
Q

Which surfaces should be disinfected frequently?

A

High-touch surfaces such as bedrails, door handles, and sinks

For C difficile, use a bleach-containing disinfectant.

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40
Q

What type of room should be used for patients with MDROs?

A

Private rooms as needed

If a private room isn’t available, place with a patient with the same MDRO.

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41
Q

What personal protective equipment should be worn for all contact with MRDO patients and contaminated items?

A
  • Gowns and gloves
  • Use masks and eye protection, especially when splashes are possible.

This is essential to prevent the spread of infection.

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42
Q

What should be done with noncritical equipment used for patients with MDRO infection?

A
  • Dedicate it for use with individuals with MDRO infection
  • Examples include stethoscopes and thermometers.
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43
Q

What should patients and caregivers be taught to limit the spread of infection?

A

Meticulous hand hygiene and standard precautions

Education on these practices is crucial for infection control.

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44
Q

Who should be excluded from activities involving close contact?

A

Those unable to keep infected wounds covered and practice strict handwashing

Activities include daycare and contact sports.

Activities include daycare and contact sports.

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45
Q

What emotional needs should be considered for patients with MDROs?

A

Patients may feel ‘dirty’ or embarrassed by the odor of wound infection

Sensitivity to emotional needs is important for patient care.

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46
Q

What measures can be provided to relieve boredom for isolated patients?

A

Activities to engage them

Isolation can reduce sensory input and lead to boredom.

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47
Q

What should be encouraged regarding visitors to isolated patients?

A

Spread out visits and be mindful of the patient’s loneliness

This helps combat feelings of isolation.

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48
Q

True or False: Patients with MDROs should not be socially isolated.

A

False

Patients may face social isolation due to others’ fear of infection.

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49
Q

What are the patient and nurse goals when treating a patient with a MDRO

A

Patient:
* reach no sign of localized infection, fever, inflammation.
* reach a point where the patient verbalizes that they are more comfortable.
* patient copes with isolation.

Nurse: use MDRO prevention measures and recognize signs of infection

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50
Q

Specific protocol for MDRO (taking action)

A
  • Adhere strictly to guidelines for hand hygiene, glove use, and isolation precautions for all patient contact until cultures are negative.
  • Observe standard precautions for all patients.
  • Ensure patient areas are cleaned well and often.
  • Disinfect high-touch surfaces (bedrails, door handles, sink).
    For C difficile: use a bleach-containing disinfectant.
  • Use private rooms as needed.
  • Wear gowns and gloves for all contact patient and contaminated items.
  • Dedicate noncritical equipment (stethoscope, thermometer) to use for individuals with MDRO infection.
  • Use masks and eye protection, especially when splashes are possible.
  • Assign patient to single room if available. If not, place with a patient with the same MDRO.
  • Special measures to prevent lower respiratory infections in intubated patients.
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51
Q

Patient education for specific MRSA infection

A

For Clients Infected With Community-Acquired MRSA
Teach patient and caregiver:

  • Take antibiotics as prescribed and take all the doses.
  • Contact your provider if the infection does not improve after a few days of antibiotic use.
  • Do not use antibiotics prescribed for someone else; do not give your drugs to others.
  • Follow your provider’s recommendations for flu and pneumonia vaccinations. This will decrease your use of antibiotics.
  • KEY POINT: Be sure your providers clean their hands before touching you.
  • Wash your hands often with soap and water. Wash for 20 seconds.
  • Use 60% alcohol-based hand sanitizer if soap and water are not available or hands are not visibly soiled.
  • Avoid sharing personal items (e.g., towels, makeup, combs, clothing).
  • Watch for signs of infection (e.g., drainage or inflammation of a wound); contact your provider at once.
  • Cough and sneeze into your elbow, and wash your hands after using a tissue.
    For Clients Infected With MRSA
    Teach patient and caregiver:
  • Keep all wounds clean and covered with bandages.
  • When changing a dressing: Do not touch the wound with your bare hands. Wear gloves.
  • Immediately discard the soiled dressing and gloves in a plastic bag where no one else can touch them.
  • Wash your hands after removing the gloves.
  • Do not touch other people’s wounds or dressings.
  • Avoid close-contact activities until your skin infection is healed, unless you can ensure that your sore will not come in contact with another person.
  • Shower daily, using antibacterial soap if your healthcare provider advises it.
  • Wash your clothing, towels, and bedding separately from other family members’ items. Use warm or hot water and bleach, if possible. Use warm or hot setting on the dryer.
  • Wash exercise clothes after each use.
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51
Q

patient education for all MDRO

A

Teach patient and caregiver:

  • Ways to limit further spread of infection to close contacts, including meticulous hand hygiene and standard precautions.
  • Difference between bacterial and viral infection.
  • Importance of avoiding overuse of antibiotics.
  • Those unable to keep infected wounds covered and practice strict handwashing should be excluded from activities involving close contact with others (e.g., daycare, contact sports).
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52
Q

How to show care to patients with MDRO?

A
  • Be sensitive to patients’ emotional needs, as many feel “dirty” or are embarrassed by the odor of wound infection. Others may become angry or depressed during extended isolation.
  • Provide measures to relieve boredom (isolation reduces sensory input).
  • Patients may be socially isolated because other people fear they will be infected.
  • Encourage visitors to spread out visits and be mindful of patient’s loneliness.
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53
Q

What condition can prevent antibodies and T cells from reaching pathogens?

A

Poor circulation

Poor circulation damages tissue, making it easier for pathogens to enter and thrive.

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54
Q

Which diseases impair peripheral circulation and increase infection risk in extremities?

A

Uncontrolled hypertension and diabetes mellitus

These conditions make patients prone to infection.

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55
Q

What is leukemia?

A

A form of cancer of the blood that increases the production of abnormal WBCs

These abnormal WBCs are ineffective in combating infection.

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56
Q

How does HIV affect the immune system?

A

It infects T cells, reducing the ability to fight off secondary infections

A patient with AIDS has a significantly compromised immune response.

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57
Q

What is the purpose of medications that reduce the immune response?

A

To prevent rejection in organ/tissue transplants and treat conditions like allergies, arthritis, lupus, and IBS

For most patients, decreased immunity is an unwanted side effect.

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58
Q

Which common medications can decrease the immune response?

A
  • NSAIDs, such as ibuprofen is immunosuppresive and usually an unwanted side effect
  • chemotherapy
  • antibiotics because it destroys normal flora
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59
Q

What is a potential side effect of chemotherapeutic agents?

A

Decreased production of WBCs or production of abnormal WBCs

This can lead to increased susceptibility to infections.

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60
Q

What dietary components can help fight off infection?

A

Fruits, vegetables, nuts, seeds, and lean meats

These foods contain essential nutrients like beta-carotene and vitamins A, B, C, and E.

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61
Q

Fill in the blank: A sedentary lifestyle contributes to the risk of various health issues, including _______.

A
  • reduced immunity

Physical activity promotes circulation and immune function.

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62
Q

How does sleep affect the immune system?

A

It allows the body to produce antibodies and cytokines

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63
Q

What emotional states can depress the immune system’s effectiveness?

A

Prolonged stress, anxiety, depression, and grief

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64
Q

True or False: Urinary catheterization and IV’s can lead to increased risk of infection.

A

True. It injures the mucosa which allows pathogens into the bladder or body

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65
Q

What is unique about skin color with someone who has poor circulation and MDRO?

A

Patients with poor peripheral circulation often have skin discoloration, rather than
signs of inflammation, when experiencing an infection.

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66
Q

What should be promoted for clients who have had surgery and general anesthesia?

A

Coughing and deep breathing on a regular basis.

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67
Q

What type of oral care should be provided for clients being mechanically ventilated?

A

Special oral care designed to prevent ventilator-associated pneumonia.

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68
Q

Why should older adults, especially frail ones, be encouraged to get immunizations?

A

To acquire immunity from some communicable diseases, such as influenza.

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69
Q

How can healthcare workers protect themselves from HAIs?

A

By receiving immunizations.

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70
Q

What role do community health nurses play in disease transmission?

A

Limit disease transmission through surveillance, tracking disease patterns, and prompt treatment.

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71
Q

What should be assessed regularly for clients with breaks in the skin or surgical incisions?

A

Regular assessment for infection.

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72
Q

Why are clients and caregivers at less risk for infection at home than in the hospital?

A

Limited exposure to others with illness and shared potential pathogens and antibodies.

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73
Q

What basic principles should clients understand to protect their health?

A

Medical asepsis, personal hygiene, and infection control.

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74
Q

What lifestyle factors strengthen host defense and help break the chain of infection?

A

Healthful nutrition, good hydration, adequate hygiene, rest, exercise, stress reduction, and immunizations.

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75
Q

What is the importance of adequate nutrition during an acute infection?

A

To replace lost stores, maintain production of WBCs, and repair damaged tissues.

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76
Q

What hygiene practices should be encouraged to decrease bacterial count on the skin?

A

Frequent handwashing and regular showering or bathing.

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77
Q

What should be provided for the immunocompromised or bed-bound hospitalized patient?

A

Daily bedside baths using filtered tap water and disposable basins.

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78
Q

What is the recommended amount of sleep for most people?

A

6 to 9 hours per night.

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79
Q

What are the consequences of too little or excessive exercise?

A

Too little causes circulation to slow; excessive leads to fatigue and joint injury.

Excessive exercise leads to fatigue and joint injury.

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80
Q

What is the key point regarding immunization coverage in the population?

A

At least 85% of the population must be immunized to protect the entire population from the disease.

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81
Q

Fill in the blank: Nutrition is important for replacing lost stores during an acute infection, including _______.

A

[protein, vitamins, minerals, and water]

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82
Q

What nursing diagnosis is indicated for patients who are higher than usual risk for infection and need interventions to help prevent infection?

like poor nutrition for example

A

Risk for Infection

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83
Q

What are NOC standardized outcomes for diagnosis of Risk of Infection?

A

NOC standardized outcomes for a diagnosis of Risk for Infection include:
* Community Risk Control
* Communicable Disease
* Immune Status
* Immunization Behavior
* Infection Severity
* Risk Control: STDs
* Wound Healing: Primary Intention * Wound Healing: Secondary Intention

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84
Q

If a patient already has an infection, what are the NIC standardized interventions?

A
  • Communicable Disease Management
  • Immunization/Vaccination Management
  • Incision Site Care
  • Infection Control
  • Surveillance
  • Teaching: Safe Sex
  • Wound Care
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85
Q

What should be used to disinfect the home environment?

A

Antiseptic, antibacterial wipes or sprays, or a diluted bleach mixture to wipe down frequently touched surfaces.

The diluted bleach mixture can be stored for a month in an opaque container.

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86
Q

How are procedures performed in the home typically different from those in the hospital?

A

Clean procedure instead of sterile technique

An example is urinary catheterization.

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87
Q

What should be assessed for signs of infection?

A

Fever, chills, fatigue, lymph gland enlargement, delayed healing, drainage, warm/reddened/tender skin

Teach clients and family members about the signs and symptoms of infection and when to report these findings to their primary care provider.

These are common indicators of infection.

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88
Q

When should clients and family members report signs of infection?

A

When they notice symptoms such as fever, chills, or delayed healing

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89
Q

What vaccinations should be obtained before international travel?

A

COVID-19, malaria, dengue, rickettsiosis, hepatitis, Zika virus

Particularly important for travel to Africa, South Central Asia, or Central America.

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90
Q

When should hands be washed according to basic infection prevention measures?

A

Before, during, and after preparing food; before eating; after using the bathroom; after coughing/sneezing; after treating wounds; after contact with animals or trash

This includes multiple situations to prevent infection.

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91
Q

What methods can prevent pathogen growth in foods?

A

Cooking at high temperatures, storing in a cool place, using highly concentrated solutes

Examples include salting meat and preserving fruit.

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92
Q

What personal care items should not be shared?

A

Towels, washcloths, toothbrushes, combs

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93
Q

How should dishware and utensils be cleaned?

A

In a dishwasher with hot water and detergents

This method is sufficient for decontamination.

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94
Q

What is the recommended duration for washing hands with soap and water?

A

20 seconds

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95
Q

What should be done after using a public bathroom?

A

Do not touch surfaces and wash hands thoroughly

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96
Q

What should be carried and used in public places for hand hygiene? What do you. dowhen you get home?

A

Antibacterial hand gel

wash when getting home

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97
Q

What should patients ask healthcare providers to do before touching?

A

Wash their hands

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98
Q

What does asepsis mean?

A

Absence of contamination by disease-causing microorganisms

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99
Q

What does medical asepsis refer to?

A

Procedures that decrease the potential for the spread of infections

medical asepsis includes hand hygiene, environmental cleanliness, standard precautions, and protective isolation.

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100
Q

What are the key components of medical asepsis in healthcare settings?

A
  • Hand hygiene
  • Environmental cleanliness
  • Standard precautions
  • Protective isolation
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101
Q

How does cutting corners in asepsis affect patient safety?

A

It can put the patient and possibly the nurse at risk for a serious infection

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102
Q

What is the single most important activity for preventing and controlling infection?

A

Hand hygiene

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103
Q

What was the WHO’s first global patient safety challenge?

A

Reduction of HAIs with the theme ‘clean care is safer care’

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104
Q

What are the five key factors involved in handwashing?

A
  • Time
  • Water
  • Soap
  • Friction
  • Drying
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105
Q

How long should hands be washed in a nonsurgical setting?

A

At least 15 seconds for soap-and-water wash

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106
Q

How long should hands be washed when using an alcohol-based handrub?

A

20 to 30 seconds

107
Q

What is the recommended washing duration in a surgical setting?

A

2 to 6 minutes, depending on the product used

108
Q

What type of water should be used for handwashing?

A

Warm water

109
Q

What type of soap should be used for hand hygiene?

A

Agency-approved soap

110
Q

What is the CDC’s recommendation for routine hand cleansing?

A

60% alcohol-based solution for routine hand cleansing

111
Q

When should soap and water be used instead of alcohol-based solutions?

A

When there is potential for contact with bacterial spores

112
Q

What is the definition of cleaning in medical asepsis?

A

Removal of visible soil (organic and inorganic) from objects and surfaces

113
Q

What does disinfection do?

A

Removes pathogens on inanimate objects by physical or chemical means

114
Q

True or False: Failure to perform standards of care can result in medical negligence.

A

True

115
Q

What must be done immediately if there are spilled liquids or dirty surfaces?

A

Clean them immediately

116
Q

What happens to an object when it comes in contact with a contaminated surface?

A

It becomes contaminated or unclean

117
Q

soap reccommendations

A

Use agency-approved soap. The CDC (2002) recommends using a 60% alcohol-
based solution (rubs, sprays, gels) for routine hand cleansing, and plain or antimicrobial soap and water when hands are visibly dirty. Iodine compounds are also effective but usually too irritating for regular hand hygiene.

If there is a potential for contact with bacterial spores (e.g., when caring for a client with a C difficile infection), you must wash your hands with soap and water; alcohol-based solutions are not effective against spores

118
Q

Standards for drying

A

Use single-use towels or hand dryers to remove all moisture after washing the hands. If using antimicrobial hand gels, apply and rub hands until dry.

119
Q

Define a clean environment.

A

A clean environment includes the surfaces in a patient’s room, as well as supplies, equipment, and other objects brought into the room. The floor, soiled dressings, used tissues, sinks, commodes, and bedpans are examples of contaminated items. An object becomes contaminated or unclean if it comes in contact with a contaminated surface—or if you suspect, for whatever reason, that it may contain pathogens. Agency policies determine whether a reusable item is cleaned, disinfected, or sterilized, based on how the item is used.

120
Q

Define cleaning.

A

Removal of visible soil (organic and inorganic) from objects and surfaces. In healthcare agencies, it is usually accomplished manually or mechanically using water with detergents or enzymatic products formulated to inhibit microbial growth.

Any spilled liquids, dirty surfaces, or potentially contaminated areas should be cleaned immediately. Items must be cleaned thoroughly before they can be disinfected or sterilized.

121
Q

Define disinfecting.

A

Removes pathogens on inanimate objects by physical or chemical means, including steam, gas, chemicals, and ultraviolet light.

122
Q
A
123
Q

What are the three levels of disinfection that chemical germicides can achieve?

A
  1. High-level disinfection
  2. Intermediate-level disinfection
  3. Low-level disinfection

High-level disinfection kills all organisms except high levels of bacterial spores. Intermediate-level disinfection kills bacteria, mycobacteria, and most viruses. Low-level disinfection kills some viruses and bacteria.

124
Q

What is the definition of semicritical items in the context of disinfection?

A

Semicritical items are those that contact mucous membranes or nonintact skin and must be free of all microorganisms except bacterial spores.

Semicritical items must at least be disinfected, and sometimes sterilized.

125
Q

What are some examples of semicritical items?

A
  • Reusable devices, such as flexible endoscopes
  • Respiratory therapy equipment
  • Anesthesia equipment

These items require higher levels of disinfection due to their contact with mucous membranes.

126
Q

What are noncritical items in the context of disinfection?

A

Noncritical items are supplies and equipment that come in contact with intact skin but not mucous membranes and do not carry a high risk of infection transmission.

They can be decontaminated where they are used.

127
Q

List examples of noncritical items.

A
  • Bedpans
  • Stethoscopes
  • Blood pressure cuffs

Noncritical items do not require high-level disinfection.

128
Q

What are examples of noncritical environmental surfaces?

A
  • Floors
  • Food utensils
  • Bed linens
  • Bedrails

These surfaces are typically cleaned but do not require disinfection as often as critical or semicritical items.

129
Q

What is sterilization?

A

The elimination of all microorganisms (except prions) in or on an object.

130
Q

What are the most common sterilizing methods used in hospitals?

A
  • Autoclaving with moist heat
  • Gas or vapor (e.g., ethylene oxide gas at low heat)
  • Dry heat
  • Ozone
  • Liquid chemicals (e.g., peracetic acid)
  • Low-temperature hydrogen peroxide gas
131
Q

When is sterilization used?

A

When absolute purity of an object or surface is critical.

132
Q

What are critical items in the context of sterilization?

A

Items that pose a high risk for infection if contaminated with any microorganism.

133
Q

Give examples of critical items that require sterilization.

A
  • IV catheters
  • Needles for injections
  • Urinary catheters
  • Surgical instruments
  • Some wound dressings
  • Chest tubes
134
Q

True or False: Prions can be eliminated through standard sterilization methods.

A

False

135
Q

What are the two tiers of protection according to CDC guidelines?

A

Standard precautions and transmission-based precautions

These tiers are outlined by Siegel et al. (2007)

136
Q

What do standard precautions apply to?

A

Care of all patients

Assumes every patient may be colonized or infected

137
Q

What must healthcare providers assume about every patient?

A

That every patient is potentially colonized or infected with an organism

This is crucial for applying standard precautions

138
Q

What are transmission-based precautions used for?

A

Patients with known or suspected infection or colonization with pathogens

This is the second tier of protection

139
Q

What are the modes of transmission for pathogens?

A

Contact, droplet, or air

Each mode requires a different approach to prevent infection

140
Q

What measures should be instituted for all transmission-based precautions?

A

Measures to counteract negative effects of isolation on patients

These include addressing anxiety, depression, stigma, reduced staff contact, and preventable adverse events

141
Q

True or False: Standard precautions apply only to patients with known infections.

A

False

Standard precautions apply to all patients

142
Q

Fill in the blank: Transmission-based precautions are for patients with known or suspected _______.

A

[infection or colonization with pathogens]

143
Q

What special class of patients are neutropenic?

A

stem cell transplant patients, who are neutropenic (and therefore immunocompromised) secondary to chemotherapy.

Patients with compromised immunity are more likely to become infected by pathogens harbored in their own bodies than from pathogens transmitted by other people (Siegel et al., 2007). Therefore, except for the special situation described, standard and transmission-based precautions should protect even unusually vulnerable patients from organisms brought in by healthcare workers and visitors.

144
Q
A
145
Q

What are Standard Precautions?

A

Use with all clients, in all settings, regardless of suspected or confirmed presence of infection.

Standard precautions are designed to prevent the transmission of infections in any healthcare setting.

146
Q

What are Transmission-Based Precautions?

A

Use for patients known or suspected to be infected or colonized with infectious agents.

These precautions are applied in addition to standard precautions.

147
Q

What is the principle behind Transmission-Based Precautions?

A

Routes of transmission for some microorganisms are not completely interrupted using standard precautions alone.

They are necessary for effective infection control.

148
Q

What body fluids are considered potentially infectious according to Standard Precautions?

A

All blood, body fluids, secretions, excretions except sweat, nonintact skin, and mucous membranes.

This emphasizes the need for protective measures in all patient interactions.

149
Q

List some components of Standard Precautions.

A
  • Hand hygiene
  • Use of gloves
  • Gown
  • Mask
  • Eye protection
  • Face shield
  • Safe injection practices

These components help prevent the transmission of pathogens.

150
Q

True or False: Standard Precautions completely protect against microorganisms spread by contact, droplets, or through the air.

A

False

Standard precautions alone do not provide complete protection against all transmission routes.

151
Q

What new element has been added to Standard Precautions for patient protection?

A

Respiratory hygiene and cough etiquette, safe injection practices, wearing a mask during special lumbar puncture procedures.

These measures are intended to enhance patient safety in healthcare settings.

152
Q

What are Contact Precautions?

A

For organisms spread by direct contact with the patient or their environment.

This is the most common form of transmission in healthcare.

153
Q

What are Droplet Precautions?

A

For pathogens spread through close respiratory or mucous membrane contact with respiratory secretions (e.g., sneezing, coughing, talking).

These pathogens do not remain infectious over long distances.

154
Q

What are Airborne Precautions?

A

For pathogens that are very small and remain infectious over long distances when suspended in the air.

They can be transmitted through air currents, requiring specific protective measures.

155
Q

What must be done to equipment before entering a protective isolation room?

A

Equipment must be disinfected before it is taken into the room

This is critical to prevent the spread of infection.

156
Q

How should linens and dishes be handled in a protective isolation setting?

A

Take linens and dishes directly to the protective isolation room and hand them to someone wearing protective clothing

This ensures that contamination is minimized.

157
Q

What is the protocol for disinfecting equipment in transmission-based isolation?

A

Disinfect the equipment on removal from the room

This is necessary to prevent the spread of infectious agents.

158
Q

What should be done with linens or nondisposable items removed from a transmission-based isolation room?

A

Place them in special isolation bags

This prevents contamination during transport.

159
Q

How should contaminated disposable equipment and materials be disposed of?

A

Place them in special isolation bags

This helps contain potential infectious materials.

160
Q

How many healthcare workers are required for the disposal of used isolation supplies?

A

Two healthcare workers are required

This ensures safety and proper handling of contaminated items.

161
Q

What is the role of the worker inside the isolation room?

A

The worker inside the room wears protective clothing and handles only contaminated items

This minimizes the risk of exposure.

162
Q

What does the second worker do during the disposal process?

A

The second worker stands at the door and holds the isolation bag open

This allows for safe disposal without contamination.

163
Q

What should the first worker do when placing items inside the isolation bag?

A

Place items inside the bag without touching the outside of the bag

This prevents contamination of the bag’s exterior.

164
Q

What is done if the isolation bag contains linens?

A

The isolation bag is closed and placed in a laundry hamper

This ensures safe transport for laundering.

165
Q

How should an isolation trash bag be handled?

A

Securely close the isolation trash bag and place it in a special isolation trash container

This prevents contamination and protects waste handlers.

166
Q

What is the purpose of special disposal methods for isolation waste?

A

To prevent these objects from going into a landfill, where they could become a reservoir of infection

This is crucial for public health and safety.

167
Q

What should you do with disposable needles and syringes after use?

A

Place them in special disposable sharps containers immediately after their use.

168
Q

True or False: You should recap a contaminated needle.

A

False

169
Q

What type of items should be placed in sharps containers?

A

Disposable needles, syringes, and other sharp items, such as broken glass.

170
Q

What are laboratory specimens considered to contain?

A

Blood and body fluids, which are always considered contaminated.

171
Q

Where should you label the specimen container?

A

In a clean area before taking it to the patient.

172
Q

Who should collect the laboratory specimen?

A

A healthcare worker wearing appropriate protective clothing.

173
Q

What should you do with the specimen after it is collected?

A

Place it in a special transport bag.

174
Q

Fill in the blank: Do not allow the outside of the transport bag to touch any _______.

A

contaminated item, including your gloves.

175
Q

What does the term sterile mean?

A

Without life; no infectious organisms

Sterility applies to inanimate objects like surgical equipment, gauze, and wound irrigation fluid.

176
Q

What is surgical asepsis?

A

Creation of a sterile environment and use of sterile equipment

It is also known as sterile technique and differs from medical asepsis.

177
Q

How does surgical asepsis differ from medical asepsis?

A

Surgical asepsis is more complex and not required for all patients

Medical asepsis focuses on reducing the number of microorganisms.

178
Q

What methods can be used for sterilization?

A

Special gases or high heat

These methods are used for surgical equipment and implanted devices.

179
Q

What is required to create a sterile area?

A

Extensive cleaning by housekeeping personnel using special solutions

All health personnel must wear appropriate surgical attire and perform a surgical hand scrub.

180
Q

What is modified sterile technique?

A

Use of nonsterile procedure gloves with sterile supplies

This technique is used for bedside procedures like tracheostomy care and wound care.

181
Q

What does sterile technique involve?

A

Use of sterile gloves and sterile supplies

Supplies include drapes, wound dressings, instruments, and water.

182
Q

What is clean technique?

A

Use of clean hands or nonsterile gloves and clean supplies

Examples of clean supplies include tap water.

183
Q

What is a surgical scrub?

A

Modification of the handwashing procedure involving an extended scrub of the hands

It uses a sponge, nail cleaner, and bactericidal scrubbing agent.

184
Q

What is the purpose of a prewash before a surgical scrub?

A

To remove dirt and microorganisms before the scrub

It is required for all methods of surgical scrubbing.

185
Q

What is the transmission area for droplet isolation?

A

6 feet from the patient

You can speak to the patient at the door without a mask.

186
Q

What is the primary goal of wearing surgical attire in healthcare units?

A

To protect the patient from infection transmitted by healthcare workers.

187
Q

In which units is surgical attire required?

A

Burn units, labor and birth units, surgical wards, intensive care units (ICUs), nurseries, and oncology wards.

188
Q

What type of surgical attire do staff wear upon arrival at the unit?

A

Clean surgical attire, or scrub suits.

189
Q

True or False: Scrub suits can be worn outside the healthcare unit.

A

False.

190
Q

What should be worn over scrub suits when leaving the unit?

A

A covering.

191
Q

List additional precautions that should be taken when wearing clean surgical attire.

A
  • Disposable hat
  • Shoe coverings
  • Face masks
192
Q

What is required for personnel engaged in surgery or certain invasive procedures?

A

Sterile surgical attire.

193
Q

What should you do first when preparing for a surgical procedure?

A

Change into scrub apparel.

194
Q

Fill in the blank: After changing into scrub apparel, you must apply _______.

A

shoe coverings.

195
Q

What should be worn if there is potential for spray of fluids during a procedure?

A

A face mask with eye shield.

196
Q

What is the method of applying gloves after donning a surgical gown?

A

Closed gloving.

197
Q

What is the method of gloving for procedures that do not require full surgical attire?

A

Open gloving.

198
Q

True or False: Once you don sterile gloves, you can touch non-sterile items.

A

False.

199
Q

What must be done before donning a surgical gown?

A

Perform the surgical scrub.

200
Q

Examplin sterililty injections

A

when administering an injection, you prepare the patient, cleanse the injection site, and remove the needle cap using standard precautions. You do not don sterile gloves, but for the rest of the procedure you observe sterile technique by taking care not to touch or otherwise contaminate the exposed needle

201
Q

What is the purpose of routine handwash?

A

Remove soil and transient microorganisms from all surfaces of the hands in 15 seconds.

202
Q

What agents are used in antiseptic handwash?

A

Water and antimicrobial soap (e.g., chlorhexidine, iodine, and iodophors). 15 seconds.

203
Q

What is the duration for antiseptic handrub?

A

Until the hands are dry.

alcohol based handrub

204
Q

What is the purpose of surgical antisepsis?

A

Remove or destroy transient microorganisms and reduce resident flora from hands and forearms.

205
Q

Fill in the blank: Antiseptic handwash uses water and _______.

A

[antimicrobial soap].

chlorhexidine, iodine, and iodophors

206
Q

What is the minimum duration for surgical antisepsis?

A

2 to 6 minutes, following manufacturer instructions.

207
Q

True or False: Routine handwash requires the use of antimicrobial soap.

A

False.

208
Q

What are the two methods for surgical antisepsis?

A
  • Water and antimicrobial soap (e.g., chlorhexidine, iodine, and iodophors)
  • Water and nonantimicrobial soap followed by long-acting, alcohol-based surgical hand-scrub product.

always hands and forearms

209
Q

What variations exist in setting up sterile fields?

A

Opening a package of supplies wrapped in a sterile disposable cover or using a larger, reusable or disposable sterile drape.

210
Q

What is the purpose of antiseptic handrub and antiseptic handwash?

A

Remove or destroy transient microorganisms and reduce resident flora from hands.

211
Q

Difference between purpose of antiseptic handwash vs routine handwash

A

RHW - Remove soil and transient
microorganisms

ASHW- Remove or destroy transient microorganisms and reduce resident flora (persistent activity)

212
Q

What is the sterile status of the inside of urinary catheter kits?

A

The inside is sterile

The outside of these packages is considered clean.

213
Q

What should be considered unsterile when using a drape?

A

A 1-inch margin around the drape

Even if it remains on a horizontal surface.

214
Q

What happens if an object falls partly on a sterile field?

A

It is no longer sterile.

215
Q

How should sterile liquids be added to a sterile field?

A

By gently pouring them into a container on the field.

216
Q

What is the purpose of an impermeable membrane in sterile drapes?

A

Serves as a barrier to moisture and prevents wicking.

217
Q

What should you do if excess fluid runs off the sterile field?

A

The field becomes contaminated.

218
Q

What is the consequence of a wet sterile field?

A

It does not provide a barrier to microorganisms.

219
Q

What should you assume about an item if there is any doubt about its sterility?

A

Consider it contaminated.

220
Q

What is the first guideline to avoid common breaks in sterility?

A

Never reach across a sterile field.

221
Q

What should you avoid wearing to maintain sterility?

A

Jewelry that dangles or can fall into the sterile field.

222
Q

What should you do with long hair to maintain sterility?

A

Keep it pulled back or covered by a head covering designed for sterility.

223
Q

What should you do if your gown is soaked through?

A

Change your gown or reinforce with additional sterile drapes.

224
Q

What should you avoid doing to maintain sterility when working near a sterile field?

A

Avoid splashing any kind of solution onto the sterile field.

225
Q

Why should doors be kept closed in a sterile area?

A

To prevent turbulent airflow from contaminating the area with airborne microbes.

226
Q

What should you check before using equipment packaged for sterility?

A

Ensure it has been sterilized properly.

227
Q

How should wounds be cleaned and sterile sites prepared?

A

From clean to dirty.

228
Q

What should you do when witnessing someone else contaminate a sterile field?

A

Identify the break and cover the area with sterile drapes or replace with new sterile setup.

229
Q

What is the primary task of the infection prevention nurse?

A

To minimize the number of infections in the healthcare facility.

230
Q

What must infection preventionists keep current with?

A

Information about pathogens, antibiotic resistance, and infection control.

231
Q

What additional role does the infection prevention nurse fulfill?

A

Functions as an epidemiologist, tracking down the source of HAIs.

232
Q

What is the role of the infection prevention team regarding regulations?

A

Enforce compliance with federal, state, and local regulations related to infection control and prevention.

233
Q

What should you do if exposed to bloodborne pathogens?

A

Minimize exposure by washing the area thoroughly, notify appropriate people, complete an injury report, and seek medical attention.

234
Q

What laboratory work should be done for someone exposed to bloodborne pathogens?

A

Baseline laboratory work to check for hepatitis and HIV.

235
Q

What does the infection preventionist arrange if the patient source is known?

A

Arrange to have the patient tested.

236
Q

What factors determine subsequent testing and preventive treatment after exposure?

A

The type of exposure and what is known about the source and the injured person.

237
Q

What will the infection prevention team provide after an exposure event?

A

Counseling and recommendations as soon as possible.

238
Q

What is bioterrorism?

A

The intentional release, or threatened release, of disease-producing organisms or substances for causing harm.

239
Q

List three illnesses with recognized bioterrorism potential.

A
  • Anthrax
  • Botulism
  • Smallpox
240
Q

Fill in the blank: The six illnesses with recognized bioterrorism potential include anthrax, botulism, _______.

A

[pneumonic plague]

241
Q

True or False: Viral hemorrhagic fevers are considered to have bioterrorism potential.

A

True

242
Q

What type of injuries are discussed in Chapters 21 and 23?

A

Preventing needlestick injuries.

243
Q

blood or bodily fluid exposure steps

A

BOX 20-4 If You Are Exposed to Blood or Other Body Fluids
If you are stuck by a needle or other sharp or get blood or other potentially infectious materials in your eyes, nose, mouth, or on broken skin:
1. Immediately flush the exposed area with water and clean any wound with
soap and water or a skin disinfectant, if available.
2. Report the exposure immediately to the supervisor in the agency. If you are
a student, also report immediately to your instructor.
3. Seek immediate medical attention. Consent to testing and follow-up
treatment as advised.
4. Complete an incident or injury report.
5. Attend counseling sessions provided by the agency.

244
Q

What is a key factor in minimizing the effects of a biological event?

A

The ability to quickly recognize unusual disease patterns and detect the presence of infectious diseases

245
Q

What skills are essential for nurses in recognizing outbreaks?

A

Direct, clinical observation skills

246
Q

What should nurses assess in addition to an individual patient’s condition?

A

Clusters of symptoms

247
Q

What questions should nurses keep in mind to recognize outbreaks?

A
  • Am I seeing an unexpected number of infectious diseases?
  • Am I seeing similar cases that are not responding to medical treatment?
  • Are healthcare workers who come in contact with infectious patients becoming ill?
248
Q

Who should be notified after identifying a suspicious pattern of disease?

A

The institution’s interventionist or safety officer

249
Q

What actions should be taken if the infectious organism is unknown?

A

Samples must be preserved for future analysis

250
Q

What are the essential principles of infection prevention and control measures in an epidemic?

A

Hand hygiene and standard precautions

251
Q

How should patients with similar symptoms be cared for?

A

By a minimum number of healthcare personnel using appropriate isolation precautions

252
Q

What precautions should be implemented if the etiology and transmission route of the causative organism are unknown?

A

Standard, contact, and airborne precautions

253
Q

What is the best way to prevent illness from a virus?

A

Avoid exposure to the virus

254
Q

What should individuals do when they are sick, especially during the contagious phase?

A

Stay at home and wear a face mask when near others

255
Q

What is the recommended distance for social distancing?

A

At least 6 feet away from others

256
Q

What is a safer environment for socializing to avoid airborne illnesses?

A

Outdoors

257
Q

What should be done to clean hands effectively?

A

Thorough handwashing with soap and running water for 20 seconds

258
Q

What should be used if water is not available for handwashing?

A

An alcohol-based hand sanitizer (at least 60% alcohol)

259
Q

What should individuals do when sneezing or coughing?

A

Sneeze or cough into a clean tissue or bent elbow

260
Q

What should be avoided to prevent the spread of germs?

A

Touching eyes, nose, mouth, and direct contact like handshakes

261
Q

What health habits should be practiced to reduce the risk of infection?

A
  • Get plenty of sleep
  • Eat nutritious food
  • Drink plenty of water
  • Be physically active
  • Manage stress
262
Q

What is an important aspect of preparing clients for a pandemic disease outbreak?

A

Teaching risk assessment and everyday preventive actions

263
Q

True or False: Healthcare professionals often fail to comply with infection prevention guidelines.

A

True

264
Q

What role do nurses have in infection prevention?

A

Integrate the best current evidence with clinical expertise

NUR210 (12 decks)

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