Infection Flashcards
describe the difference between localized, disseminated, and systemic infections
A localized infection is limited to a small area.
A disseminated infection has spread to areas of the body beyond the initial site of infection.
Systemic infections have spread extensively throughout the body, often via the blood.
what is the difference between bacteria and viruses?
Bacteria cause disease in 2 ways: by entering the body and growing inside human cells (e.g., TB) or by secreting toxins that damage cells (e.g., Staphylococcus aureus).
Viruses, unlike bacteria, do not have a cellular structure. They are simple infectious particles that consist of a small amount of genetic material (either ribonucleic acid [RNA] or deoxyribonucleic acid [DNA]) and a protein envelope
describe the difference between nonspecific and specific defenses
NONSPECIFIC DEFENSES: anatomic physiological barriers, as well as the inflammatory response
SPECIFIC DEFENSES: involve the immune system
______ and _______ are the first line of defense
intact skin and mucous membranes
a patient’s susceptibility to infection is affected by ______
age and heredity
which population groups have a reduced defense against infections?
newborns and older adults
why do newborns have a reduced defense against infection?
newborns have an Immature immune systems
Protected by immunoglobulins received from mother for only first 2 or 3 months
Infants begin to synthesize their own immunoglobulin between 1–3 months of age
why do older adults have a reduced defense against infection
Immune responses become weak-Have reduced defenses & physiological changes
○ Cardiovascular changes: decrease in cardiac output and decrease in tissue perfusion will delay the inflammatory response and healing ○ Respiratory system changes: decreased mucociliary response, decreased elastic recoil, they also have that diminished cough reflex, which leads to decreased clearance of respiratory secretions ○ Genitourinary changes: loss of muscle tone, reduced bladder contractility, altered bladder reflexes, prosthetic hypertrophy in men, which can lead to reduced bladder capacity and incomplete emptying ○ Gastrointestinal changes: impaired swallow reflex, decreased gastric acidity, a delaying gastric emptying, and have that increase risk for aspiration ○ Skin, subcutaneous tissue changes: decreased cushioning, as well as decreased sensation leads to that increase for risk of injury and ulceration which can become infected ○ Immune changes: decreased phagocytosis that reduced inflammatory response, and then slowed or impaired healing processes, which does lead to reduced immunity
infection assessments
- History – What questions will you ask?
○ What are your symptoms? Have you had an injury? Have you been exposed to anything? Have you had any recent infections? Have you been diagnosed with cancer? Have you had any recent surgeries? What medications are you currently taking? Have you traveled anywhere recently? - Examination
○ Assess for:
Chills Fever Swelling Malaise Redness or drainage in a wound Pain Respiratory assessment if applicable
assessing patients for infection is vital to:
- Treating clients
- Preventing spread of infection
assessing patients is especially importnat for clients at risk of infection such as those with: SELECT ALL THAT APPLY
A. IV lines
B. Indwelling catheters
C. Surgical wounds
all of the above
diagnostic test for infections
*CBC with elevated WBC differential count
- increased neutrophils are seen with bacterial infection
- increased basophils and eosinophils are not seen in a viral or a bacterial infection
*culture and sensitivity
- identifies pathogen
- can be done on blood, sputum, urine, throat, culture, spinal fluid etc.
- serological testing
- to determine if a virus is present or if the body has antibodies against a pathogen
- radiological examination of the chest, abdomen or urinary system
- assess for organ abnormalities that indicate inflammatory response to tissue
- ultrasonic examination
- echo or renal US to evaluate organ function
infection treatments for bacteria, viruses, and fungus
- Antibiotics – Several classes – recall pharm. Attack and kill the bacteria
- Antivirals – Kill viruses or suppress replication
- Antifungals – Kill fungal organisms.
what are some ways nurses can prevent infection?
- Proper handwashing
- Getting immunizations: CDC Immunization schedule
- Taking precautions when handling potentially contaminated materials
- Standard precautions (“universal precautions”)
- Preventing airborne droplets from spreading
- Limited antibiotic use (especially broad-spectrum antibiotics)
UTIs can be classified into ______& ____ infections
upper and lower
Upper UTIs include
renal parenchyma, pelvis, and ureters
- typically cause fever, chills and flank pain
lower UTIs include
bladder or urethra
- no systemic manifestations
what is the difference between uncomplicated UTI and complicated UTI
*uncomplicated
- Urinary tract is normal
- usually involve just bladder
*complicated
- coexisting obstruction, stones, or catheters
- abnormal GU tract
- antibiotic resistance
- recurrent infection
What are some risk factors for UTIs?
- foreign bodies - catheters (CAUTIs) or cystoscopy
*anatomic - fistula or congenital defect
*frequently delaying urination
*poor hygiene
*obesity
*aging
*diabetes
*HIV infection
*renal impairment
*urinary retention - constipation
*menopause
*multiple sex partners
*use of spermicidal agents
*pregnancy
and more!
what are some signs and symptoms of lower UTI’s
- dysuria: painful or difficult urination
- hesitancy
- intermittency
*postvoid dribbling
*urinary retention or incomplete emptying - incontinence
*nocturia - nocturia enuresis: adults - loss of urine during sleep
- urgency
- urinary frequency
UTI symptoms in older adults
- abdominal discomfort
- cognitive impairment
- unlikely to have a fever
UTI diagnostic studies
- dipstick urinalysis
- identify the presence of nitrates, WBCs
*urine for culture and sensitivity - clean catch sample preferred
- specimen by catheterization or suprapubic needle aspiration more accurate
- determine bacteria susceptibility to antibiotics
- identify the presence of nitrates, WBCs
how can UTIs be prevented?
- helping to identify at-risk patients
- promoting good urinary health
- cranberry juice or tablets
- proper catheter insertion
Nursing considerations for patients with UTIs
- good fluid intake
*avoid bladder irritants such as caffeine - heat to the lower back may help
*taking the full course of antibiotics
which meds can be used for complicated UTIs?
ciprofloxacin, levofloxacin
which meds can be used for uncomplicated UTIs?
TMP/sulfa (Bactrim), nitrofurantoin, ampicillin, amoxicillin
which kind of antibiotics can be given to patients with repeat UTIs?
prophylactic antibiotics
RESPIRATORY SYNCYTIAL VIRUS (RSV) is more common in which population?
kids
- peak is at 6 months. most have been infected by age 3 at least once
RSV is the major cause of ________
bronchiolitis
what are the initial symptoms of RSV?
- rhinorrhea
- cough
- otitis
- conjuctivitis
- pharyngitis
- wheezes
what are later signs of RSV?
- increased wheezing, cough
- air hunger
- tachypnea
- retractions
- cyanosis
*crackles
*decreased breath sounds
RSV diagnostic studies
- History
- Physical examination
- nasal swab
- chest X-ray
RSV treatment symptomatic and supportive care
○ Hydration–IV fluids if unable to take PO, nutritional support
○ Oxygen
○ Frequent respiratory assessments
only severe lower respiratory tract infection should be treated with _______
ribavirin
*oral and inhaled ribavirin appear to be well tolerated
RSV infections tend to resolve within ________, even in severe cases that require hospitalization
1-2 weeks
when is Palivizumab (synagis) given?
not a vaccine - given monthly during RSV season
what is the criteria for Palivizumab (synagis)
○ Criteria for getting Synagis. Infants in their first year of life
- Born before 29 weeks
- Have chronic lung disease of prematurity (born < 32 weeks) and needed oxygen for at least 28 days after birth
Certain heart defects
What is RSV?
a enterovirus that can cause a common cold
Cystitis is an infection of the:
A. Kidneys
B. Ureters
C. Bladder
D. Urethra
C. bladder
Which of the following about Respiratory Syncytial Virus is true?
A. RSV only occurs in immunocompromised children.
B. Nearly all children who develop RSV have to be hospitalized.
C. The only cure for RSV is the vaccine palivizumab.
D. RSV is a major cause of bronchiolitis.
D. RSV is a major cause of bronchiolitis
Nearly all children get RSV. Most don’t have to be hospitalized. Palivizumab is an expensive monoclonal antibody given to select children within specific criteria
A client with a suspected infection has a CBC with WBC differential count drawn. Results show that the client has elevated levels of eosinophils and basophils. Themost likelysource of the client’s infection is?
A. Parasite
B. Bacteria
C. Virus
D. Fungus
A. parasite
