Fundamentals Chap 28 Flashcards
What is a pathogen?
- Infectious agent
* Presence does not mean an infection will occur
What is colonization?
*Organism that multiplies w/in a host but does not cause an infection
What is an infectious disease?
- illness such as viral meningitis or pneumonia
- have a low to no risk for transmission
- can be serious for pt
What is a communicable disease?
*an infectious disease that is transmitted directly from one person to another
What is pH?
*acidity of the environment
What is the portal of exit?
*sites such as blood, mucus membranes, respiratory tract, genitourinary tract, and gastrointestinal tract
What is the major route for transmission?
*unwashed hands of a health care worker
What is virulence?
*ability to survive in the host or outside the body
What is susceptibility?
*individual’s degree of resistance to pathogens
What is immunocompromised?
*having an impaired immune system
What is a reservoir?
*a place where a pathogen survives
Who are carriers?
*persons who show no symptoms of illness but who have the pathogens that are transferred to others
Development of an infection occurs in a cycle that depends on what agents?
- infectious agent or pathogens
- reservoirs or source for pathogen growth
- port of exit from reservoir
- mode of transmission
- port of entry to a host
- susceptible host
What are the most common modes of transmission?
- direct
- indirect
- airborne
- droplet
- vehicle
- vector
What is bactericidal?
*a temperature or chemical that destroys bacteria
How is infection transferred by direct means?
*person to person (feces, oral) physical contact between source and susceptible host (touching pt feces and then touching your inner mouth or consuming contaminated food)
How does indirect mode of transmission occur?
*personal contact of susceptible host w/ contaminated inanimate object(Needles or sharp objects, dressings, environment)
How does droplet mode of transmission occur?
*large particles that travel up to 3 feet during coughing, sneezing, or talking and come in contact w/ susceptible host
What are the vehicles for modes of transmission?
- contaminated items
- water
- drugs, solutions
- blood
- food (improperly handled, stored, or cooked; fresh or thawed)
How does airborne mode of transmission occur?
*droplet nuclei or residue or evaporated droplets suspended in air during coughing, sneezing, or carried on dust particles
What is localized infection?
- a wound infection
- pt usually experiences localized symptoms such as pain, tenderness, and redness at wound site
- use standard precautions (ppe, hand hygiene)
What are the vectors of the mode of transmission?
external mechanical transfer (flies)internal transmission such as parasitic conditions between vector and host *mosquito, louse, ticks, fleas
What are the normal body defenses against infections?
- normal flora
- body systems defenses
- inflammation
How does the normal flora work?
- they general don’t cause harm when where they are suppose to be
- maintain a sensitive balance w/ other microorganism to prevent infection
What is systemic infections?
*an infection that affects the entire body instead of just a single organ or part and can become fatal if undected and untreated
How does inflammation work against infections?
- protective vascular reaction that delivers fluid, blood products, and nutrients to an area of injury
- cellular response of the body to injury, infection, or irritation
How does the body defenses work against infections?
*each organ system has defense mechanisms physiologically suited to its specific structure and function
How does vascular and cellular response work?
- rapid vasodilation occurs, allowing more blood near the location of the injury
- increase in local blood flow causes the redness and localized warmth at the site of inflammation
What is inflammatory exudate?
- accumulation of fluid and dead tissue cells and WBCs form at site of inflammation
- may be serous, sanguineous, or purulent
- usually cleared away by lymphatic drainage
What is acute inflammation?
*immediate response to cellular injury
What is exogenous?
- comes from microorganisms found outside the individual such as Salmonella, Clostriduim tetani, and Aspergillus
- they do NOT exist as normal floras
What are Health care-associated infections (HAIs), also called nosocomial?
- occur as the result of invasive procedures, antibiotic administration, the presence of multidrug-resistant organisms, and breaks in infection prevention and control activities
- these result from the delivery of health services in a health care facility
What is endogenous?
- occurs when part of the patient’s flora becomes altered and an overgrowth results
- often happens when a pt receives broad spectrum antibiotics that alter the normal floras(yeast, staphylococci, enterococci, and streptococci)
How does tissue repair work?
*healing involves the defensive, reconstructive, and maturative stage
What are the sites for health care associated infections?
urinary tractsurgical or traumatic woundsrespiratory tractbloodstream
How does age factors influence a patient’s susceptibility to infection?
*infants have immature defenses, breastfed babies have greater immunity, viruses are common in middle aged adults, older adult cell mediated immunity declines
How does nutritional status factors influence a patient’s susceptibility to infection?
*a reduction in the intake of protein, carbohydrates, and fats reduces the body’s defenses and impairs wound healing
How does stress factors influences a patient’s susceptibility to infection?
*basal metabolic rate increases; increase serum glucose levels and decrease anti-inflammatory responses with elevated cortisone levels
Identify some common nursing diagnoses that apply to patients at risk or who have an actual infection.(nursing diagnosis)
- risk for infections
- imbalanced nutrition: less than body requirements
- risk for impaired skin integrity
- social isolation
- impaired tissue integrity
- readiness for enhanced immunization status
How does disease process factors influence a patient’s susceptibility to infection?
*people with diseases of the immune system (leukemia, AIDS) and chronic diseases (AODM) have weakened defenses against infections
List the ways a nurse can teach patients and their families to prevent an infection from developing or spreading:(implementation)
- nutrition support
- rest
- maintenance of physiological protective mechanisms (personal hygiene)
- immunizations
- eliminating reservoirs of infection
- controlling ports of exit and entry
- avoiding actions that transmit microorganisms prevent bacteria from finding a new site in which to grow
What is concept of asepsis?
- absence of pathogenic (disease producing) microorganisms
* aseptic technique refers to practices/procedures that help reduce the risk for infection
What is medical asepsis?
- includes procedures for reducing the number of organisms
* hand hygiene, barrier techniques, and routine environmental cleaning are examples
List four common goals for a patient with an actual or potential risk for infection:(planning)
preventing exposure to infectious organismscontrolling or reducing the extent of infectionmaintaining resistance to infectionverbalizing understanding of infection prevention and control techniques (hand hygiene)
How does hand hygiene control or eliminate infectious agents?
*the act of washing hands with soap and water, followed by rinsing under a stream of water for 15 seconds
How does alcohol based hand rubs control or eliminate infectious agents?
*alcohol based hand rubs are recommended by Centers for Disease Control and Prevention to improve hand hygiene practices, protect health care workers’ hands, and reduce pathogens to patients
How does disinfection control or eliminate infectious agents?
*disinfection is a process that eliminates many or all microorganisms with the exception of bacterial spores from inanimate objects
How does sterilization control or eliminate infectious agents?
*sterilization is the complete elimination or destruction of all microorganisms, including spores
Bathing as an effective prevention and control of infection by:
*when bathing, use soap and water to remove drainage, dried secretions, and excess perspiration
Dressing Changes are effective prevention and control of infection by:
*changing dressing when they are soiled and wet
Contaminated articles effective prevention and control of infection by:
*place tissues, soiled dressings, or soiled linen in fluid resistant bags
Contaminated sharps are effective prevention and control of infection by:
*place all needles, safety needles, and needleless systems into puncture-proof containers
Bedside unit are effective prevention and control of infection by:
*keep surfaces clean and dry
Bottled solutions are effective prevention and control of infection by:
*do not leave bottle solutions open; date and discard them in 24 hours
Surgical wounds are effective prevention and control of infection by:
*keep drainage tubes and collection bags patent
The elements of a respiratory hygiene or cough etiquette are:
- education of health care facility staff and visitors
- posters and written material for agency and visitors
- education on how to cover your nose and mouth when you cough, using a tissue, and the prompt disposal of the contaminated tissue
- placing surgical mask on the patient if it will not compromise respiratory function or is applicable
- hand hygiene after contact with contaminated respiratory secretions
- spatial separation greater than 3 feet from persons with respiratory infections
What is standard precautions? tier 1
- designed for all patients in all settings regardless of the diagnosis
- they apply to contact with blood, body fluid, nonintact skin, and mucous membranes
What is isolation precautions? tier 2
- based on the mode of transmission of disease
* they are termed airborne, droplet, contact, and a new category, protective coverings
Drainage bottles and bags are effective prevention and control of infection by:
*wear gloves and protective eye wear and empty all drainage systems at the end of the shift
What is the rationale for ppe gowns?
*prevent soiling clothing during contact with patients
What is the rationale for ppe masks?
*should be worn when you anticipate splashing or spraying of blood or bloody fluid into your face and to satisfy droplet or airborne precautions
What is the rationale for ppe protective eye wear?
*should be worn for procedures that generate splashes or splatters
Identify some common waste materials that are considered infectious:
- blood
- urine
- wounds
- stool
What are the 9 responsibilities of infection control professionals?
- provide staff and patient education
- develop and review infection prevention and control policies and procedures
- recommend appropriate isolation procedures
- screen patient records
- consult with health departments
- gather statistics regarding the epidemiology
- notify the public health department of incidences of communicable diseases
- consult with all departments to investigate unusual events or clusters
- monitor antibiotic resistant organisms`
What are some clinical situations in which a nurse would use surgical asepsis?
- during procedures that require intentional perforation of the patient’s skin
- when the skin’s integrity is broken
- during procedures that involve insertion of catheters
What are the 7 principles of surgical asepsis?
- a sterile object remains sterile only when touched by another sterile object
- place only sterile objects on a sterile field
- a sterile object or field out of the range of vision or an object held below a person’s waist is contaminated
- a sterile object or field becomes contaminated by prolonged exposure to air
- when a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated by capillary action
- because fluid flows in the direction of gravity, a sterile object becomes contaminated if gravity causes a contaminated liquid to flow over the object’s surface
- edges of a sterile field or container are considered to be contaminated
List in order the steps for performing a sterile procedure:
- assemble all equipment
- don caps, masks, and eye wear
- open sterile packages
- open sterile items on a flat surface
- open a sterile item while holding it
- prepare a sterile field
- pour sterile solutions
- surgical scrub
- apply sterile gloves
- don a sterile gown
The expected outcome is the absence of signs and symptoms of infection. List some ways the nurse can monitor the patient. (evaluation)
- monitor patients postoperatively, including surgical sites, invasive sites, the respiratory tract, and the urinary tract
- examine all invasive and surgical sites for swelling, erythema (redness of the skin), or purulent drainage
- monitor breath sounds
- review laboratory results
Which of the following is not an element in the development or chain of infection?
- means of transmission
- infectious agent or pathogen
- formation of immunoglobulin
- reservoir for pathogen growth
Infection occurs in a cycle that depends on the presence of certain elements.
The severity of a patient’s illness depends on all of the following except:
- incubation period
- extent of infection
- susceptibility of the host
- pathogenicity of the microorganisms
1.
The incubation period is the interval between the entrance of the pathogen into the body and appearance of first symptoms.
Which of the following best describes an iatrogenic infection?
- It results from a diagnostic or therapeutic procedure.
- It results from an extended infection of the urinary tract
- It involves an incubation period of 3 to 4 weeks before it can be detected.
- It occurs when patients are infected with their own organisms as a result of immunodeficiency.
4.
The nurse sets up a nonbarrier sterile field on the patient’s over bed table. In which of the following instances is the field contaminated?
- sterile saline solution is spilled on the field
- the nurse, who has a cold, wears a double mask
- sterile objects are kept within a 1 inch border of the field
- the nurse keeps the top of the table above his or her waist
If moisture leaks though a sterile package’s protective covering, organisms can travel to the sterile object.
When a patient on respiratory isolation must be transported to another part of the hospital, the nurse:
- places a mask on the patient before leaving the room
- obtains a health care provider’s order to prohibit the patient from being transported
- instructs the patient to cover his or her mouth and nose with a tissue when coughing or sneezing
- advises other health team members to wear masks and gowns when coming in contact with the patient
1.
Patients who are transported outside of their rooms need to wear surgical masks to protect other patients and personnel.
What is the rationale for ppe gloves?
*prevent the transmission of pathogens by direct or indirect contact
If an infectious disease can be transmitted directly from one person to another, it is a:
*communicable disease
What is the most likely means of transmitting infection between patients?
*contact with a health care worker’s hands
What is the interval when a patient progresses from nonspecific signs to manifesting signs and symptoms specific to a type of infection?
*prodromal (a distinct period or phase) stage
What is the most effective way to break the chain of infection?
*hand hygiene
A family member is providing care to a loved one who has an infected leg wound. What would you instruct the family member to do after providing care and handling contaminated equipment or organic material?
- perform hand hygiene after care and/or handling contaminated equipment or material
A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. What is the best intervention?
*explain the reasons for isolation procedures and provide meaningful stimulation
Why would the nurse where a gown?
*blood or body fluids may get on the nurse’s clothing from a task that he or she plans to perform
The nurse has redressed a patient’s wound and now plans to administer a medication to the patient. What is the correct infection control procedure?
*remove gloves and perform hand hygiene before administering the medication
When a nurse is performing surgical hand asepsis, the nurse must keep hands:
*above elbows
What are the correct steps for removal of ppe after leaving an isolation room?
- remove gloves
- remove eye wear or goggles
- untie waist and neck strings of gown. allow gown to fall from shoulders, remove gown, rolling it onto itself without touching the contaminated sides
- untie top, then bottom mask strings and remove from face
- perform hand hygiene
A patient has an indwelling urinary catheter. Why does indwelling urinary catheter present a risk for urinary tract infection?
*it obstructs the normal flushing action of the urine flow
Your ungloved hands come in contact with the drainage from your patient’s wound. What is the correct method to clean your hands?
*wash them with soap and water
A patient’s surgical wound has become swollen, red, and tender. You note that the patient has a new fever and leukocytosis (wbc above the normal count). What is the best immediate intervention?
*notify the health care provider and support the patient’s fluid and nutritional needs
What does infection control do?
- provides measures that reduce or eliminate sources and transmission of infection
- protects patients and health care providers from diseases
While preparing to do a sterile dressing change, a nurse accidentally sneezes over the sterile field that is on the over the bed table. Which principle of surgical asepsis is violated?
*a sterile field becomes contaminated by prolonged exposure to air
How do you break the chain of infection?
- hand washing
* sanitation
What should you watch patients for signs of in isolation?
- loneliness
- explain the purpose for isolation to pt and family
- practice cultural
Where are health care associated infections (HAIs) acquired?
*health care settings
