Funda midterm (lectures) Flashcards
Patient Quality and Safety
A fundamental concern of nurses, which extends from the bedside to the home to the community, is preventing injuries and assisting the injured
Safety
Factors Affecting Safety are
-Age and Development
- Lifestyle
- Mobility and Health Status
- Sensory and Perpetual alterations
- Emotional State
- Cognitive awareness
- ability to communicate
- safety awareness
- environmental factors
What are the Joint Commission’s 2019 National Patient Safety Goals for Hospitals and Nursing Care Centers
- Improve the accuracy of patient identification
- Improve the effectiveness of communication among caregivers
- Reduce the harm associated with clinical alarm systems
- reduce the risk of healthcare-associated infections
- Reduce the risk of patient and resident harm resulting from falls
- prevent healthcare-associated pressure ulcers
- the hospital identifies safety risks inherent in its patient population
- universal protocol for preventing wrong site, wrong procedure, and wrong person surgery
Give an Adult Safety Measures in the given situation:
In reinforcing motor vehicle safety , if alcohol is consumed use the method
Designated drivers
Give an Adult Safety Measures in the given situation:
Avoiding excessive sun radiation by limiting _____, using ______, wearing _______.
exposure, sun-blocking agents, protective clothing
Is a single temporary event that consists of uncontrolled electrical neuronal discharge of the brain that interrupts normal brain function
Seizure
Are devices used to reduce or prevent physical activity of a client or a part of the body when the client is unable to remove the device
Restraints
Identify the Restraint type:
Use of an intervention or device that hinders the client from moving or restricts the individual from contact with his or her body
Physical
Identify the Restraint type:
Using a medication to control behavior or to restrict the client’s freedom of movement and is not a standard treatment for the client’s medical or psychologic condition
Chemical
Identify the Restraint type:
Involuntary confinement of a client alone in a room or area from which the client is physically prevented from leaving
Seclusion
Infection Prevention and Control
Collective vegetation in a given area
Resident Flora
Microbial species that can be cultured from body surfaces under certain circumstances
Transient Flora
What are the four major mo’s causing infections in humans
Bacteria, viruses, fungi, parasites
Growth of MO’s in body tissue where they are not usually found
Infection
Detectable alteration in normal tissue function
Disease
No clinical evidence of disease
Asymptomatic/Subclinical
Ability to produce disease
Pathogenicity
Can be transmitted to an individual
Communicable Disease
Cause disease only in susceptible individuals
Opportunistic pathogen
Freedom from disease-causing microorganisms
Asepsis
Identify the type of Asepsis:
Practices intended to confine a specific MO to a specific area
Medical
Identify the type of Asepsis:
practices that keep an area or object free from all MOs
Surgical
Identify the type of infection:
Process by which strains of microorganisms become resident flora
Colonization
Identify the type of infection:
Limited to specific part of the body where to MO’s remain
Local infection
Identify the type of infection:
MO’s spread and damage different parts of the body
Systemic infection
Identify the type of infection:
Culture of the individuals blood reveals MO’s
Bacteremia
Infections that originate in any healthcare setting
Healthcare-associated infections
Infection origination from the client themselves
Endogenous
Infection from the hospital environment and hospital
Exogenous
Serious infection that occurs when MOs enter the bloodstream through a large catheter placed in a large vein
Central line-associated blood stream infection (CLABSI)
Any infection involving any part of the urinary system
Catheter-associated urinary tract infection (CAUTI)
An infection that occurs after surgery in the part of the body where the surgery took place
Surgical site infection
(SSI)
A lung infection that develops in a person on a machine used to help the client breathe
Ventilator Associated pneumonia (VAP)
Chain of infection steps
- Etiologic agent
- Reservoir
- Portal of Exit
- Mode of Transmission
- Portal of Entry
- Susceptible Host
Identify the step of chain infection based on the factors:
*Number of organisms present
*Virulence and potency
*Ability to enter the host’s body
*Susceptibility of the host
*Ability to live in the host’s body
Etiologic agent
Identify the step of chain infection based on the factors:
*Sources of MO’s such as:
*Humans/ Carriers
*Plants
*Animals
*Medical equipment
*General environment
Reservoir
What are the direct modes of transmission
Direct contact and Droplet spread
What are the indirect modes of transmission
Airborne, vehicle-borne, vector borne
Occurs through skin-to-skin contact, kissing, and sexual intercourse
Direct contact
Spray with relatively large, short-range, aerosols produced by sneezing, coughing, or even talking
Droplet Spread
Occurs when infectious agents are carried by dust or droplet nuclei suspended in air
Airborne
Indirectly transmit an infectious agent include food, water, biologic products, and fomites
Vehicle
Such as mosquitoes, fleas, and ticks may carry an infectious agent through purely mechanical means or may support growth or changes in the agent
Vector
A break in the skin can readily serve as a ______
Portal of entry
Is any individual who is at risk for infection
Susceptible host
Is someone at increased risk, an individual who for one or more reasons is more likely than others to acquire an infection
Compromised host
What are the factors affecting susceptibility?
- impairment of immune system
- age
- clients receiving immune suppression treatment
- immune deficiency conditions
Body defense against infection that protect the individual against all MOs
Non-specific
Body defense against infection directed against identifiable infectious agent
Specific
First line of non specific defense
Intact skin and mucous membranes
Local and nonspecific defensive response of the tissues to an injurious/ infectious agent
Inflammatory response
Injurious agents are classified as?
- Physical agents
- Chemical Agents
- Microorganisms
What are the 3 stages of Inflammatory Response?
- Vascular and Cellular responses
- Exudate production
- Reparative Phase
Substance that induces a state of sensitivity or immune responsiveness
Antigen
Originate from own body
Autoantigen
Also called humoral immunity as it resides in the B lymphocytes and mediated by antibodies produced by B cells
Antibody mediated
Also called immunoglobulins are part of the body’s plasma proteins
Antibodies
Antibodies are produced by the body in response to an antigen
Active
Type of Active antibody that are formed in the presence of active infection in the body
Active Natural
Type of Active antigen that are administered to stimulate antibody production
Active Artificial
Antibodies are produced by another source, animal, or human
Passive
Type of Passive antibody that are transferred naturally from an immune mother to her baby through the placenta or in colostrum
Passive Natural
Type of passive immune serum from an animal or another human is injected
Passive Artificial
This testing involves measurement of several hepatitis B virus HIBV-specific antigens and antibodies.
Hepatitis B serologic testing
Occurs through T cell system
Cell-mediated
3 types of Cell-mediated
- Helper
- Cytotoxic T cells
- Suppressor T cells
Is considered one of the most effective infection prevention measures
Hand hygiene
Is a chemical preparation used on skin or tissue
Antiseptic
Is a chemical preparation, such as phenol or iodine compounds, used on inanimate objects
Disinfectant
Preparation destroys bacteria
Bactericidal
Preparation prevents the growth and reproduction of some bacteria
Bacteriostatic
Process that destroys all microorganisms including spores and viruses
Sterilization
Steam under pressure to attain temp higher than boiling point
Moist Heat
Ethylene oxide destroys MOs by interfering with metabolic process
Gas
Most practical and inexpensive, some spores and viruses are not killed. Min 15 mins for disinfection at home
Boiling Water
Ionizing and non-ionizing, rays do not penetrate deeply
Radiation
Used for clients known to have or suspected of having serious illnesses transmitted by airborne droplet nuclei smaller than 5 microns. Ex. Measles, varicella, and tuberculosis
Airborne precaution
Used for clients known to have or suspected of having serious illnesses transmitted by particle droplets larger than 5 microns. Ex. Diphteria, mycoplasma pneumonia, pertussis, mumps, rubella
Droplet precaution
Used for clients known to have or suspected of having serious illnesses easily transmitted by direct client contact or by contact with items in the client’s environment
Contact precaution
A specific type of aseptic technique with a unique theoretical and clinical practice framework based upon the original concept of key-part and key-site protection.
Aseptic non-touch technique
The critical part of equipment that comes into contact with a key site
Key part
A part of the body that is at risk of contamination if ANTT is not used
Key site
ANTT
A – Always ensure hands are decontaminated effectively prior to
the procedure
N – Never contaminate key parts of sterile materials/equipment or
the patient’s susceptible key sites
T – Touch non-key parts with confidence
T –Take appropriate infection prevention and control precautions
e.g. use of PPE, safe waste management
Vital Signs
Vital signs include what?
- body temp
- pulse
- respiration
- blood pressure
What is commonly assessed alongside vital signs
- pain
- oxygen saturation
Reflect the balance between heat produced and heat lost from the body
Body temperature
Temperature of the deep tissues of the body
Core body temperature
Temperature of the skin, subcutaneous tissue and fat
Surface temperature
What are the factors affecting body temperature
- Age
2, Diurnal Variations - Exercise
- Hormones
- Stress
- Environment
What is the normal temperature
36-37.5 C
Temperature above the usual range
Pyrexia
Very high fever
Hyperpyrexia
Normal temperature
Afebrile
Alternates at regular interval normal and fever
Intermittent fever
Fluctuating above normal temperature
Remittent fever
Short febrile periods with 1 or 2 days of normal temperature
Relapsing
Result of excessive heat and dehydration
Heat exhaustion
Core body temperature below lower limit of normal
Hypothermia
What are the different sites of body temperature measurements
- oral
-rectal
-axillary
-tympanic membrane
-temporal artery
Wave of blood created by contraction of the left ventricle of the heart
Pulse
Is the ability of the arteries to contract and expand
Compliance
Volume of blood pumped into the arteries by heart and equals the result of the SV x HR/min
Cardiac output
Excessively fast heart rate >100
Tachycardia
Less than 60bpm
Bradycardia
Pattern of beats and intervals between beats
Pulse rhythm
Irregular rhythm
Arrhythmia/ Dysrhytmia
Refers to breathing out or the movement of gases from the lungs to the atmosphere
Ventilation