Fund nursing 50 week 1.2 Flashcards
illness stage (illness last hours to days)
time is also variable. symptoms manifest, hours to days to months.
convalescence period
period of healing, can be short or long depending on the illness.
MDR (multidrug resistant) TB occurs because
people don’t finish their TB treatments
Antibiotic Resistant Microorganisms - why does this exist? (and examples)
eat animals who received antibiotics. ppl may buy off market, may demand from provider, overuse of antibiotics
• MRSA (methicillin-resistant staphylococcus aureus)
• VRE (vancomycin-resistant enterococci)
• MDR (multidrug resistant) TB
Healthcare Associated Infection (HAI) just the definition
acquired in a healthcare setting.
Healthcare Associated Infections - common ones (Cath has pneum at site of c.Dif)
Catheter associated urinary tract infections
(CAUTI) most common: Pericare very
important!
MInimize use of indwell (sp) catheters)
Ventilator-associated pneumonia (VAP)
Surgical site infection (SSI)
Central line associated bloodstream infection
Clostridium Difficile Infection (CDI) (infection of GI tract) too much antibiotic therapy or cross-contamination from patient to patient
Major Cause of infection
Insufficient Hand Hygiene
• Cost - repeat hospitalization, time off work, cost to hospitals. also an emotional cost,
• Medicare No Pay Rule for HAI
assessment
complete thorough history
looking for signs and symptoms of infection, condition that may predispose someone to infection. ie chemo, signs of localized or systemic infection
Nursing History
• Physical Assessment
• S/S localized infection
• S/S systemic infection
• Laboratory Tests
See Common Tests for Evaluating
Presence/Risk for Infection.
WBC’s:
Differential:
ESR (sed rate): inflammatory process
• Cultures
• Urine and Blood (sterile procedure)
• Normal Value: sterile without
microorganism growth (no growth at all)
• Wound, Sputum, Throat (Not sterile, have normal flora there)
• May detect normal flora
• Obtain Cultures before Antibiotics are
started*****(bc antibodies will kill everything before you identify it) patient on broad-spectrum before finding out what infection is
Interventions - (the weakest link needs intervention)
• Primary goal is to prevent onset and spread of infection
• Break the Chain of Infection
• Weakest Link: Transmission (can fight this through hand hygiene)
The Joint Commission (2022) (needed for licensing)
•Prevent infection recommendation from Joint Commission -
“Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or the World Health Organization….”
look at CDC
hand hygiene link if you haven’t
Recommended Hand Hygiene
Technique
•Handrubs
•Gel in Gel Out!!!!
• Apply to palm of one hand,
rub hands together covering
all surfaces until dry (until DRY)
• Volume: based on
manufacturer
Handwashing
• Wet hands with water, apply
soap, rub hands together for at
least 15 seconds
• Rinse and dry with disposable
towel
• Use towel to turn off faucet
Hand washing with soap and water is required when caring for patients infected with
Clostridium difficile because of spores - C. Diff is NOT killed by alcohol rub=
lotions
you need lotion, but make sure it’s compatible w/ hospital. Don’t use community lotion
Gloving
Wear gloves when it can be reasonably anticipated that contact with blood or other potentially infectious materials, mucous membranes, nonintact skin, or potentially contaminated intact skin (e.g., of a patient incontinent of stool or urine) could occur - (this is a critical thinking moment)
Remove gloves after caring for a patient
Do not wear the same pair of gloves for the care of more than one patient
Glove use does not replace hand hygiene action!!
wear gloves for injections?
always
can gives meds with or without gloves?
with gloves bc you’re touching the tablet w/out gloves
interventions - types of asepsis
Medical Asepsis (clean technique):
Surgical Asepsis (sterile technique):
when in the hospital, DO NOT TOUCH
anything on the porter - the cleaning- cart (cart somewhere in hospital)
Interventions to prevent transfer of
microorganisms and HAI
• Maintain clean environment.
• Personal attention to hand hygiene
before and after every contact with a
patient or object.
• Use personal protective equipment
whenever indicated.
• Use and dispose of sharps safely.
• Nurses failure to be meticulous with
aseptic technique will place the client
at risk for infection that can impair
recovery
Isolation guidelines - just hand hygiene
CDC Guidelines (1996) Two Tiered Approach:
Tier One: Use Standard Precautions,
hand hygiene and appropriate PPE
Applies to all body fluids (except sweat),
non-intact skin, mucous membranes
Standard precautions for all patient care
• Perform hand hygiene
• Use PPE whenever is expectation of
possible exposure to infectious material
• Follow respiratory hygiene/cough etiquette
principals
• Ensure appropriate patient placement
• Properly handle and clean and disinfect
patient care equipment. Clean and disinfect
the environment appropriately
• Handle textiles and laundry carefully
• Follow safe injection practices
• Ensure healthcare worker safety, including
proper handling of needles and other sharps
Box 24-4
just hand hygiene- you know it
covid 19
Vaccination with booster
Surveillance and Detection
Isolation, Quarantine, and Containment
Standard, Contact and Airborne Precautions
Proper Hand washing, Cough, and Respiratory
Etiquette
Selection and Appropriate Use of Personal
Protective Equipment (PPE)
covid 19 symptoms
• Illness: Students who are ill or develop
COVID-19 symptoms as defined by the
CDC need to stay home from school
• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea
stages of infection
Incubation Period
Prodromal Stage
Illness Stage
Convalescence
prodromal (the prodrome is achy)
How you feel the day before you get sick. Achy, I’m coming down with something, low grade fever. most multiplication of disease and the most infectious stage.
incubation period
variable, depending on the type of organism you are infected with. Time of exposure to the time of symptoms.
incubation period of common cold (short cold)
about 24 hours
incubation period of varicella (varicella good times)
18 - 22 days
MRSA (methicillin-resistant staphylococcus aureus) is now…
in the community, out of the hospital. you need to finish your antibitoics. its also cultural, many ppl feel they need antibitioic so they buy it off market, or demand antibiotics from provider.
patient is on what type of antibiotic when trying to figure out what type of infection they have?
broad spectrum
best way to prevent spread of infection
hand hygiene
aseptic technique (aseptic clients)
practices that keep client as free from microoganisms as much as possible
medical asespsis (cleaning technique)
procedures for reducing the number of organisms present and preventing the transfer of organisms
surgical asepsis (sterile technique) (surgically clean the objects)
practices designed to maintain objects free from pathogenic organisms
ticks - direct or indirect
indirect - vector
E. Coli - direct or indirect?
both, contaminated food or feces
Hep B - direct or indirect?
direct, indirect possible but unlikely. blood, feces, body fluid
HIV direct or indirect?
direct.
TB contact
airborne, sputum
salmonella - direct or indirect?
both. intestinal tract animals and humans. diarrhea (food = indirect) (human to human = direct)
staph - direct or indirect?
both. skin surface, mouth, nose
undiagnosed or transmissible respiratory infection - do this w/ ppl in the hospital
offer a surgical mask, maintain more than 3 ft of separation.
if airborne…
private room w/ negative air pressure, 6 -12 air changes per hour, monitor filtration if air is recirculated. keep door closed. wear a respirator w/ TB patients.
if patient has vacirella (chicken pox) or ruebella (measles)…
wear respiratory protection unless person has immunity
droplet precaution
place patient in private room if possible. wear PPE, change gloves after contact w/ infected material. limit movement in and out of room. avoid sharing patient equipment
HAI - exogenous
develop infection outside of you, tetanus
HAI - endogenous
endogenous - w/in you, flora on skin (yeast) IV inserted and now you have a bloodborne infection.
HAI - Iatrogenic (the latro procedure)
infection as a result of a procedure (can be endog or exdog)
ex. of exogenous HAI bloodborne, cohorting w/ covid)
(bloodborne from IV therapy, or patient cohorted w/ another infected patient, Covid spread in facilities) community acquired pneumonia
