Infection Flashcards
Drinking contaminate water is a risk factor for which type of infection?
Hepatits A
Female gender is a risk factor for which type of infection?
Pyelonephritis
Which of the following is NOT a risk factor for developing cirrhosis?
a. ) Hep A
b. ) Excessive alcohol intake
c. ) Autoimmune
d. ) Acetaminophen overuse
Hep A - bc its acute
Chronic hep turns into cirrhosis
What type of transmission precautions decrease the risk of C Diff infection?
Contact enteric precautions
Which of the following is NOT a risk factor for pyelonephritis
a. ) Recent antibiotics use
b. ) Blood stream infection
c. ) Previous UTI
d. ) Vesicoureteral reflux
A - recent antibiotic use
Which of the following is the greatest risk factors for developing Hep D?
a. ) IV drug use
b. ) Exposure to virus during birth
c. ) Contaminated food and water
d. ) Hep B
D- Hep B
Hep D only occurs with Hep B
Which of the following is NOT a risk factor or developing C Diff.?
a. ) Previous C Diff
b. ) Broad spectrum antibiotics
c. ) Hospitalization
d. ) Droplet precautions
D- droplet precautions
Labs that help identify infection
CBC
Culture and sensitivity
ESR
Lactic acid
ESR
Measure of how inflamed a person’s body is
Pt has general infection. With temp of 102.3. What should the nurse make sure they have on their food tray?
Protein - protein is needed to make antibodies
Sepsis
Uncontrolled inflammatory response triggered by severe infection
During Sepsis, why is the D-dimer, PT, and PTT all elevated?
The immune response damages the vessels cause vasodilation of all vessels, capillary leak > abnormal clotting > DIC*
During Sepsis, the body has little perfusion and goes to anerobic metabolism. What is the result from this mechanism?
Lactic acid is a by product of anerobic metabolism. Which is not getting excreted = lactic acid build up
Lactic acid build up leads to
Metabolic acidosis
Pt with recent abdominal surgery. Pt. VS: BP 90/50, HR 140, Temp. 101.6, RR, 28. What does the nurse suspect?
Sepsis
Pt with recent abdominal surgery. Pt. VS: BP 90/50, HR 140, Temp. 101.6, RR, 28. Nurse intervenes. Gives fluid bolus and O2. Does not change VS. What med can the nurse give to bring up BP?
Vasopressor - Epi or Norepi
Normal Lactic Acid
0.5 - 2.2
Early Signs of Sepsis
High Temp High HR Low BP Low O2 Increase Lactic Acid High BS**
Priority intervention for pt. with early signs of sepsis
Antibiotics and fluid bolus
First action for pt. with early signs of sepsis
Blood culture
Normal D-Dimer
< 250
Normal BUN
7 - 20
Normal Cr
0.7 - 1.4
Normal WBC
4,500 - 11,000
Complications of C. Diff
Dehydration
Worsening colitis
Toxic Megacolon***
Death
Most concerning manifestation of C. Diff
3 or more unformed stools in 24 hr. or less
Antibiotics use to Tx C. Diff.
Metronidazole
Vancomycin
ORAL!
Diagnosis tool for C. Diff.
Stool test + symptoms
What diet would a pt. with C. Diff need?
Clear liquid diet
Pt. has recently recovered form C. Diff. What can the pt. eat?
Slowly advance diet from clear liquids to regular diet
Pt. with C. Diff has a positive blood occult stool test. What would the nurse be concerned about?
H and H levels
Need for blood transfusion
Px of C. Diff.
Probiotics
Vesicoureteral reflux
Major risk factor for Pyelonephritis
Congenital disorder - needs Surgical correction
What is a strict assessment the nurse should trend for pt. with Pyelonephritis?
I and Os
VS - monitor for Sepsis
Symptoms of Pyelonephritis
Flank, back, abdomen pain Dysuria/Oliguria Fever Chills N/V
What is a major indicator of kidney failure?
< 30 mL of urine an hour
Call HCP
Pt is taking Phenazopyridine (Pyridium) for pain from bladder spasms from Pyelonephritis. The nurse notes the urine is orange. What is the nurse’s next action?
Nothing this is a normal SE
Hepatitis
Inflammation of the liver
Cirrhosis
Failure of the liver
Fuliminant
Sudden/rapid onset of hepatitis
Which types of Hepatitis are treated with vaccines?
Hep A and B
Hep A transmission mode
Fecal-oral route
Hep B transmission mode
Needle sticks Sex Blood transfusion Dialysis Maternal-fetal Open cuts
Tx of Hep B
Vaccine Immunoglobulin Therapy (usually for babies)
Hep C transmission mode
Blood to blood transmission
IV drug users or tattoos
What type Hepatitis is the most common reason for a pt. to get a liver transplant?
Hep C
Hep D only occurs in people with __ __
Hep D only occurs in people with Hep B
Hep E resembles Hep ___
Hep E resembles Hep A
Hep F and G are similar to Hep ___
Hep F and G are similar to Hep C
Common meds that can cause Toxic Hepatitis
Acetaminophen
“Statin” - Hyperlipidemics
Alcohol
Some antibiotics and anesthetics
Biggest risk factor for Autoimmune Hepatits
Young women
Hepatorenal Syndrome
Rapid kidney and liver failure b/c very low perfusion
Hepatic Diet
Small frequent meals
Moderate protein
Low fat
Vitamin supplement for Hepatitis pt.?
Folic acid
Thiamine
Multivitamin
Foods High in Thiamine
Whole grains Fish Beef Pork Steak
Wht is the most common cause of Cirrhosis
Hep C
Gold Standard for confirming liver scarring?
Liver biopsy
Most dangerous complication of Cirrhosis
Portal Hypertension
Very Late stages of Cirrhosis
Esophageal varices Splenomegaly DIC Glucose intolerance Palmer erythema Testicular atrophy Gynecomastia Encephalopathy/asterixis
Other symptoms of Cirrhosis
Ascites Hepatomegaly Jaundice "Full" feeling Clay stools Amber urine
Encephalopathy is caused by an elevated of what lab?
Ammonia
Too much protein = ___
Ammonia build up during cirrhosis
Why would a pt with Cirrhosis have low H and H
B/c liver maintain cycle of making RBCs
The nurse is admin Lactulose what lab can the nurse expect to drop after admin?
Ammonia levels
What vitamins need to be supplemented in a pt. with cirrhosis?
Fat soluble vitamins
A, D, E, K
Why should the nurse use caution when administering a diuretic to a cirrhosis pt.?
Don’t want to drop Na+ too low
What intervention can stop the bleeding from esophageal varices
Sengstaken-Blakemore Tube
