Foundations Exam 1 Flashcards
infection
invasion of a susceptible host by pathogens or microorganisms, resulting in disease
colonization
occurs when microorganism invades host but does not cause infection
patients in healthcare settings are at increased risk for acquiring infection because…
lower resistance to pathogens, increased exposure, invasive procedures, resistance
symptomatic
infection accompanied by clinical symptoms
asymptomatic
infection without clinical signs/symptoms
most important technique used in preventing and controlling the transmission of infection
hand hygiene
the CDC now recommends what as an alternative to hand washing?
alcohol-based waterless antiseptics (unless hands are visibly soiled)
Explain the chain of infection.
Host > Infectious agent > Reservoir > Portal of exit > mode of transmission > portal of entry > repeat.
Susceptibility to an infectious agent depends on…
An individual’s degree of resistance to pathogens
Reservoir
A place where microorganisms survive, multiply, and await transfer to a susceptible host
Exit portal
a source of exit from the reservoir
examples of exit portals
skin wounds, respiratory tract, urinary tract, blood, GI tract
immunocompromised
having an impaired immune system
virulence
the ability to produce disease
aerobic bacteria
require oxygen for survival and for enough multiplication to cause disease
anaerobic bacteria
thrive on little or no free oxygen
bacteriostasis
prevention of growth and reproduction of bacteria
bactericidal
destructive to bacteria
Four stages of the infectious process
incubation period, prodromal stage, illness stage, convalescence stage
incubation period
time between pathogen entry and first symptoms. patient contagious, but don’t know it (dangerous stage).
prodromal stage
time from development of nonspecific signs and symptoms to development of more specific signs and symptoms
illness stage
time when patient manifests signs and symptoms specific to the type of infection
convalescence
time when acute symptoms disappear
what precautions do you take when an infection becomes localized?
standard precautions, PPE, and hand hygiene to prevent spread to other body areas
what does PPE consist of?
gown, mask, goggle, gloves
Explain difference between localized and systemic infection.
Localized affects one body area, systemic affects entire body and can be fatal if undetected/untreated
normal flora
microorganisms that reside in the body
where are normal flora located?
skin, saliva, oral mucosa, intestinal walls
body organ defense mechanisms
A number of body organ systems have unique defenses against infection. For example, the airways are lined with moist mucous membranes and cilia, which rhythmically beat to move mucus or cellular debris up to the pharynx to be expelled through swallowing
how do normal flora help the body resist infections?
it helps by releasing antibacterial substances and inhibiting multiplication of pathogenic microorganism
body defenses against infection
normal flora, body system defenses, inflammation
inflammatory response
protective cellular and vascular reaction that helps neutralize pathogens and repair body cells
how does inflammation help the cells in response to injury or infection?
it delivers fluid, blood products (i.e. platelets, WBCs), and nutrients to injured areas. neutralizes and eliminates pathogens or dead (necrotic) tissues and establishes a means of repairing body cells and tissues
the accumulation of fluid appears as…
edema (localized swelling)
signs and symptoms of infection
usually include fever, leukocytosis, malaise, anorexia, nausea, vomiting, and lymph node enlargement
leukocytosis
increase in circulating WBCs in response to WBCs leaving the blood stream.
phagocytosis
the process of destroying and absorbing bacteria
inflammatory exudate
the accumulation of fluid, dead cells, and WBCs that forms at the site of infection
what carries inflammatory exudate away (usually)?
lymph system
serous exudate (color)
yellowish clear color
serosanguinous exudate (color)
pink, thinner consistency than sanguinous
sanguinous exudate (color)
red, bloody, thicker than serosanguinouso
purulent exudate (describe)
thick, white-yellow-green-tan colors, odorous. contains WBCs and bacteria
if inflammation is chronic, normal tissue will be replaced by what?
granulation tissue, which is not as strong and may leave a scar
signs of inflammation?
redness, heat, swelling, sometimes pain.
signs of inflammation and localized infection are…
identical
HAIs (healthcare associated/acquired infections)
result from the delivery of healthcare in a healthcare setting. occur as the result of invasive procedures, antibiotic administration, the presence of multidrug-resistant organisms, and breaks in infection prevention and control activities
What increases risk for HAIs?
HANDS!, elderly, multiple illnesses, poor nourishment, low resistance to infection, invasive procedures, medical therapies, long hospitalizations, and increased contact with HC personnel.
ways to prevent HAIs
Meticulous hand hygiene practices, use of chlorhexidine washes, and other advances in intensive care unit (ICU) infection prevention
HAIs and cost
HAIs sig. increase costs. Insurance won’t cover cost of treating certain HAIs like UTIs with Foley catheters (hospital responsible for infection, so responsible for $ for tx)
biggest risk factor for HAIs
contact with hc personnel hands
major sites for HAI infections
traumatic or surgical wounds, respiratory and urinary tracts
asepsis
absence of pathogenic microorganisms
aseptic technique
practices/procedures that help reduce the risk for infection
medical asepsis
aka clean technique. includes procedures for reducing number of organisms present and preventing transfer of organisms
surgical asepsis
aka sterile technique. isolates the operative area from unsterile environment to prevent contamination of open wounds or maintain sterile field for surgery.
when do you use soap and water versus hand sani/chlorohexidine?
soap and water when hands are visibly soiled or patient has c.diff.
when do you wash hands?
when enter/exit room or before/after patient contact, after removing gloves, after using restroom, before eating, throughout day, no artificial nails or nail polish.
standard precautions
prevent and control the spread of infection; apply to all blood, body fluids, non intact skin, and mucous membranes. use generic barrier techniques for all patients.
hand hygiene
instant alcohol hand sanitizer when providing patient care, washing hands when soiled, performing surgical scrub.
hand washing
washing hands with soap and water for 15-20 sec, rinsing under stream of water
when to wear gloves
when touching body fluids, membranes
when to wear gowns
isolation, incontinence, risk for splashing/coughing fluids
when to wear mask
isolation (droplet), risk for splashing/coughing fluids
when to wear eye protection
risk for splashing/coughing fluids
disinfection versus sterilization
disinfection: eliminates many or all microorganisms from inanimate objects (except bacterial spores)
sterilization: elimination or destruction of all microorganisms including bacterial spores
cough etiquette
cover nose/mouth with tissue–promptly dispose of it. place surgical mask on pt if they can tolerate it. hand hygiene when in contact with resp. infection pts. separate >3ft with resp. infection pts. cough into gloved hands unless soiled, then cough into elbow away from pt.
if cough over sterile field
not sterile anymore
isolation
separation and restriction of movement of patients with contagious infections/diseases
implications of isolation (for patient and staff)
psychological implications: loneliness isolation environment (neg. pressure rooms, etc), PPE, specimen collection, bagging trash/linen, patient must wear mask for transport (transport limited to essentials)
types of isolation
airborne, droplet, contact, protective
airborne precautions
protect against:
droplet precautions
protect against: bigger droplet (>5 microns) transmitted infections within 3-6 ft. of pt.
require: private room, surgical mask, dedicated equipment
contact isolation
protects against: direct contact-transmitted infections
requires: gloves/gowns, special disposal of trash/linen (biohazard), dedicated equipment
protective isolation
protects: immunocompromised pts. from outside infections
requires: + airflow room, no fresh/dried flowers or fruit, respiratory mask, gown, gloves
PPE proper sequence for donning and doffing
donning: gown, mask, goggles, gloves
doffing: gloves, goggles, gown, mask
who monitors infection rates?
Joint Commission, CDC, Center for Medicare reimbursement
What does patient safety in healthcare settings do?
reduces incidence of illness/injury, prevents extended LOS, improves functional status, increases patients sense of well-being
a safe environment
meets patients physical, psychosocial needs; applies to all places pts receive care, includes pt and provider well-being, reduces risk of injury and transmission of pathogens, maintains sanitation, reduces pollution
largest safety issue for patients
medication errors
sentinel events
unexpected occurrence involving death or serious physical injury (loss of limb/functions)
nurse’s role in patient safety
assessing factors, maintain safe environment, provide patient teaching
factors influencing patient safety
age, lifestyle, occupation (exposure), social behavior (risk taking), environment (safety, exposures)
greatest age group @ risk of home accidents that result in severe injury
children
risks for school aged children
@ risk at home, school, and traveling to/from school
risks to adolescents safety
car accidents, suicide, drug/alcohol abuse
adult safety risks
mostly lifestyle (drinking, drugs, exercise, diet, work stress/env, domestic violence, car accidents
elderly safety risks
falls, car accidents, elder abuse, sensorimotor changes, fire
major cause of injury for those >64 years…
falls
risk factors for falls
age, hx of falls, impaired balance, altered gait/posture, weakness, medication, walking aids, orthostatic hypotension, slow run time, unfamiliar environment
how do you perform a controlled fall?
stand feet apart for support base, extend one leg and let patient slide against it to floor (“break fall” with leg), bend knees and lower patient to floor as they fall
types of restraints
physical (wrist ties, vests) and chemical (alters behavior)
negative outcomes of restraints
lowers cognitive ability, skin breakdown, contractures, incontinence, depression, delirium, anxiety, aspiration, breathing difficulties
where do you tie restraints?
to bed frame, NOT RAILS. always use quick release knot
cardiac effects of immobility
increased workload @ heart, orthostatic hypotension, venous stasis, thrombus formation (clotting)
respiratory effects of immobility
decreased respiration rate and depth, impaired gas exchange, pooling of secretions
