Infection

Question 1

An infection acquired while in the hospital is called

Answer 1

a nosocomial infection

Question 2

Factors that predispose individuals with open wounds to infection

Answer 2

• host characteristics

- local factors

Question 3

List host characteristics

Answer 3

• diabetes
• malnutrition
• obesity
• steroid usage
• immunocompromisation
• increased age

Question 4

List local factors

Answer 4

• ischemia
• presence of necrotic tissue or debris in wound
• chronic wounds

Question 5

Signs of infection

Answer 5

• Induration
• Fever - calor
• Erythema - rubor
• Edema - tumor
• Odor (even after irrigation)
• Infection vs. Inflammation
• Purulence
• Increased pain - dolor
• Friable tissue
• Change in color
• Increased glucose levels in pts with diabetes

Question 6

Bacterial bioburden - contamination

Answer 6

all wounds have non-replicating bacteria and does not impede healing

Question 7

Bacterial bioburden - colonization

Answer 7

increased number of bacteria replicating in wound without host reaction, does not impede healing

Question 8

Bacterial bioburden - critical colonization

Answer 8

bacteria is multiplying in wound with local signs causing delayed healing

Question 9

Bacterial bioburden - infection

Answer 9

10^4 or 10^5 organisms per gram of tissue causing a systemic response

Question 10

Other types of infection besides bacterial

Answer 10

• cellulitis
• lymphangitis
• sepsis
• osteomyelitis

Question 11

What is cellulitis?

Answer 11

• acute infection of dermis and subcutaneous tissue

- presents in stocking pattern sometimes

Question 12

What is lymphangitis?

Answer 12

• inflammation of lymphatic channels due to infection at distal channel
• streaking following lymph vessels

Question 13

What is sepsis?

Answer 13

body is overloaded with bacteria causing systemic inflammatory response and can lead to organ dysfunction

Question 14

What is osteomyelitis?

Answer 14

infection of the bone

Question 15

What is streaking?

Answer 15

. . .

Question 16

Fungi

Answer 16

• Tinea

- Candida

Question 17

What is Tinea? What does it affect?

Answer 17

• red, scaling patches with fissuring and itching

- nails/feet

Question 18

What is candida?

Answer 18

• red, papular skin rashes with burning, itching

- yeast-like

Question 19

Lab tests for infection

Answer 19

• sedimentation rate
• platelets
• WBC

Question 20

What culture technique identifies colonization, resistances, and sensitivities with 80% accuracy?

Answer 20

Levine Technique

Question 21

What is the big deal with the Levine Technique?

Answer 21

identifies colonization, resistances, and sensitivities with 80% accuracy

Question 22

Describe the Levine Technique

Answer 22

• cleanse wound thoroughly
• pat dry
• moisten swab with saline
• rotate swab over 1 cm viable tissue attempting to express wound fluid

Question 23

What should you do if a wound has not shown progress in 10-14 days?

Answer 23

reconsider the possibility of infection with diminished response

Question 24

Who is at greater risk of silent infections?

Answer 24

pts who are immunocompromised or have inadequate perfusion

Question 25

Examples of silent infections

Answer 25

- abscess - pt with arterial insufficiency - gangrenous toe

Question 26

If suspecting a silent infection, what should clinicians look for?

Answer 26

systemic signs of infection

Question 27

Define bacterial biofilm

Answer 27

structured community of bacteria cells enclosed in a self produced polymetric matrix and adherent to a living or inert surface

Question 28

Biofilms provide a ____________ mode of growth from _____________, _____________, and ______________.

Answer 28

protected mode; phagocytosis; antibodies; antibiotics

Question 29

What should you do if there is a biofilm?

Answer 29

- must be removed by effective debridement techniques | - once removed, prevent reformation by applying effective dressings, antibiotics, antimicrobials, or antiseptics

Question 30

Antimicrobial agent

Answer 30

destroys unicellular organisms

Question 31

Antibacterial agents

Answer 31

antimicrobials that are effective against bacteria

Question 32

2 types of antibacterial agents

Answer 32

- bactericidal | - bacteriostatic

Question 33

Bactericidal

Answer 33

resulting in bacterial death

Question 34

Bacteriostatic

Answer 34

inhibits bacterial growth

Question 35

Dressing techniques

Answer 35

- clean technique | - sterile technique

Question 36

Sterile technique

Answer 36

hold hands with palms facing your face so you can see them and know where they are (avoid bumping into anything or touching anything without thinking)

Question 37

Clean technique

Answer 37

wearing gloves, touch package of dressing, place dressing on pt