Hazards, Precautions, Etc.

Question 1

How many hospitalized patients in the US acquire 1 or more healthcare associated infections?

Answer 1

5-10% or 2 million people a year

Question 2

What does HAI stand for?

Answer 2

healthcare-associated infections

Question 3

What are the 4 most prevalent infections?

Answer 3

Urinary tract infections (catheter associated 35%)
Surgical site infections (20%, but 1/3 of the costs)
Bloodstream infections (15%)
Pneumonia (15% and usually ventilator-associated. accounts for 25% of mortality)

Question 4

What organization makes the rules for ensuring workers have safe working environment?

Answer 4

National Institute for Occupational Safety and Health (NIOSH)

Question 5

What organization enforces the rules and standards set forth?

Answer 5

Occupational Safety and Health Administration (OSHA)

Question 6

What is methylmethacrylate?

Answer 6

Glue used in ortho rooms that can cause respiratory and genitourinary problems

Question 7

What anesthetic vapor was known to cause/increase likelihood of Hepatitis and therefore is no longer used?

Answer 7

Halothane

Question 8

What patient population is automatically treated as having a latex allergy?

Answer 8

Spina bifida (congenital birth defect)

Question 9

What does PPE stand for?

Answer 9

Proper precautions equipment

Question 10

You should stand at least _____ ft away from radiation to be safe for a 1 time zap IE. chest x-ray in PACU

Answer 10

6

Question 11

Name the 4 risks associated with lasers?

Answer 11

Thermal burns
Eye injury
Electrical hazard
Fire/Explosions

Question 12

What should healthcare personnel always wear in room with lasers?

Answer 12

Proper eye protection and high-efficiency laser mask

Question 13

What percent of error in anesthesia management is attributed to fatigue?

Answer 13

64% by far the highest

Question 14

For transmission of infection to occur, what must be present/required

Answer 14

Source
Stabile pathogen
Adequate numbers
Infectivity of agent
Appropriate vector
Portal of entry

Question 15

What respiratory infections can be transmitted by aerosolization (coughing sneezing airborne)

Answer 15

Influenza
Measles
TB

Question 16

What respiratory infections can be transmitted by self inoculation (direct)

Answer 16

Rhinovirus

Respiratory syncital virus (RSV)

Question 17

This disease leads to 36 K deaths a year, is very easily transmitted, and pt should be isolated bc disease is shed for 5 days

Answer 17

INFLUENZA

Question 18

T OR F: If a patient has measles, mumps, or rubella, they can still have surgery?

Answer 18

FALSE–no surgery for these patients

Question 19

All about rubeola:

Answer 19

aka measles
Transmitted aerosol
Carries fever and 3 c’s: cough, coryza,and conjunctivitis

Question 20

All about rubella:

Answer 20

aka german measles
most adults immune
Can cause birth defects and miscarriages in 1st trimester

Question 21

All about mumps:

Answer 21

transmitted by airborne droplets
swelling of salivary and parotid glands
most often seen in children 5-9 YO

Question 22

All about respiratory syncytial virus (RSV):

Answer 22

most severe cause of lower respiratory disease in children
transmitted by self-inoculation–Infected children can shed virus for 7 days
viable on skin for 6 hours
can have recurrent asthma for 6 months

Question 23

What is the common cold called?

Answer 23

Rhinovirus

Question 24

What are the 3 types of Herpes virus?

Answer 24

Varicella-zoster (VZV)
HSV 1 & 2
Cytomegalovirus (CMV)

Question 25

All about VZV:

Answer 25

aka chicken pox and shingles transmitted to immuno-compromised patients communicability 1-2 days before pt will show symptoms and lasts 5-6 days

Question 26

All about herpes simplex type 1:

Answer 26

severe oral lesions and pt has fever transmitted by self-inoculation can lead to encephalitis

Question 27

All about cytomegalovirus (CMV):

Answer 27

usually in childhood transmitted by direct contact can spread to fetus during pregnancy

Question 28

Which is the "bad guy" of hepatitis?

Answer 28

Hep C | transmitted by blood/body fluids

Question 29

All about Hepatitis B:

Answer 29

seroconversion up to 30% can develop cirrhosis and ESLD HBV primary prevention strategy

Question 30

All about hep C:

Answer 30

leading cause of chronic liver disease | seroconversion 1.8%

Question 31

What is seroconversion?

Answer 31

Exposure to a disease that will turn into an active disease in the exposed

Question 32

All about Human immunodeficiency virus (HIV):

Answer 32

seroconversion 0.3% increased risk with blood, deep injury, needle sticks is terminal illness, death within 2 months

Question 33

All about Tuberculosis (TB)

Answer 33

``` transmitted through airborne particles Protection: N95 mask detected with skin PPD test Elective surgeries should be postponed until pt no longer infectious non-elective performed at end of day ```

Question 34

Is urine considered to be sterile?

Answer 34

YES

Question 35

Fluids that can be considered infectious?

Answer 35

Blood, bloody fluids CSF fluid Amniotic/pleural/pericardial fluids Peritoneal/ synovial fluids

Question 36

What is the single most important action in prevention of the spread of infection?

Answer 36

Hand washing

Question 37

What is the recommended minimal amount of time to scrub hands?

Answer 37

15 seconds

Question 38

If spraying or splashing of fluids is anticipated during surgery, what should be worn?

Answer 38

Mask, eye protection, gowns

Question 39

What goes in the blue contamination bags?

Answer 39

soiled linens

Question 40

Needles or other sharps go in what bin?

Answer 40

RED

Question 41

The reusable gowns go in which container?

Answer 41

green

Question 42

For all airborne precautions, you should wear what PPD(device)/PPE(equipment)?

Answer 42

N-95 mask | Do not have contact with mumps,measles, or rubella unless immune

Question 43

What procedure is done to a person who tested positive on a PPD?

Answer 43

Chest x-ray (CXR)

Question 44

T OR F: All patients are treated as if they have a communicable blood and/or body fluid infection?

Answer 44

TRUE

Question 45

Define cleaning

Answer 45

removal of foreign material

Question 46

Define antiseptic

Answer 46

chemical germicide for use on living tissue | iodine, chlorohexadine

Question 47

Define disinfectant

Answer 47

chemical germicide for use on non-living items | bleach

Question 48

Define sterile:

Answer 48

completely free of all microorganisms

Question 49

Define sterilization

Answer 49

process that results in probability of microorganism survival on an item is <1:1000000

Question 50

What are the disinfection levels?

Answer 50

High level- kills fungi, viruses, and vegetative bacteria (no endospores) Intermediate-level: kills fungi, large viruses, and bacteria (no endospores) low-level : kills fungi, some viruses and bacteria (exception TB endospores)

Question 51

T or F: Any item which comes in contact with mucous membranes but does not penetrate body surface must be washed and cleaned with high-level disinfectant

Answer 51

TRUE | laryngoscopes, bronchoscopes

Question 52

Define simple cleaning:

Answer 52

soap and water

Question 53

Define antiseptic cleaning:

Answer 53

substance that has antimicrobial activity and that can be applied to living tissue

Question 54

Define steam sterilization:

Answer 54

autoclaving: kills everything b/c of pressure and temperature 15 min @ 121*C 10 min @ 126*C 3.5 min @ 134*C confirmed by indicator strip on inside of tray

Question 55

What is the most widely used of the chlorine disinfectants and used on tables, floors, and equipment?

Answer 55

Chlorine (hypochlorite)

Question 56

What food allergies are also associated with latex allergy?

Answer 56

avocado, kiwi, banana, chestnuts, stone fruit

Question 57

What past medical history can be associated with latex allergy?

Answer 57

hay fever rhinitis asthma eczema

Question 58

When do you want to schedule surgeries for patients who have latex allergy?

Answer 58

First cases of the day

Question 59

Betadine allergy patients can also be allergic to?

Answer 59

Shellfish

Question 60

Which vein carries the lowest risk of catheter related infections?

Answer 60

subclavian

Question 61

Describe the best prevention for IV catheter related infections:

Answer 61

Single lumen full body wraps when placing catheter transparent, semi-permeable dressings