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Integumentary > Infection Control > Flashcards

Infection Control Flashcards

1
Q

Defenses Against Infection

A 
Microflora
Acidic pH of skin
Immune cells
Inflammatory response
Complement system- release of proteins that  promote phagocytosis, the inflammatory response, and disruption of bacterial cell membranes
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2
Q

Microflora

A

A small number of bacteria and fungi normally reside in skin and digestive tract
Protect the body from pathogenic organisms

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3
Q

Contamination

A

presence of microbes on wound surface

normal

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4
Q

Colonization

A

presence of replicating microbes on wound surface

normal

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5
Q

Critical colonization

A

increasing wound bioburden reaches critical point and begins to adversely affect hos
abnormal
plateau or decline in wound status

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6
Q

Infection

A

replicating microbes invade viable body tissue
abnormal
decline in wound status

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7
Q

Wound healing =

A

(number of bacteria x bacterial virulent)+interaction between microbes/host resistance+ modifying factors

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8
Q

Modifying factors:

A

host’s overall health; presence of underlying pathologies, such as diabetes or peripheral vascular disease; steroid use; presence of nonviable tissue; and proper wound management

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9
Q

Adverse Effects of High Concentrations of Microbes

A

Compete with host cells for available oxygen and nutrients
Bacterial exotoxins may be cytotoxic
Bacterial endotoxins may activate host inflammatory processes
Wound infections delay and may prevent wound healing

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10
Q

Factors That Increase the Risk of Infection

A

Host characteristics

Local factors

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11
Q

Host characteristics:

A 
Break in skin integrity
Diabetes
Malnutrition
Obesity
Steroid use
Immuno-compromise
Increased age
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12
Q

Local factors

A

Ischemia
Necrotic tissue
Wound debris
Chronic wounds

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13
Q

Inflamed Rubor

A

Well-defined erythemal border

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14
Q

Infected Rubor:

A

Poorly defined erythemal border
Disproportionate amount of erythema
Possible proximally directed erythemal streaking

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15
Q

Inflamed Calor:

A

Localized increase in temperature

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16
Q

Infected Calor:

A

Large localized increase in temperature over wide area

May be febrile

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17
Q

Inflamed Tumor

A

Small amount of edema

Proportionate to wound

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18
Q

Infected Tumor:

A

Edema is disproportionate to wound size

Periwound may be indurated

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19
Q

Inflamed Dolor

A

Pain proportionate to wound size/extent

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20
Q

Infected Dolor:

A

Increased pain
New-onset pain
Pain disproportionate to wound size/extent

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21
Q

Inflamed Functio Laesa

A

Temporary decrease in function of affected area

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22
Q

Infected Functio Laesa

A 
Malaise
Tachycardia
Hypotension
Altered mental status
Altered function of affected area
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23
Q

Inflamed drainage:

A

Proportionate to
size/extent of wound
Thin consistency
Serous or serosanguinous

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24
Q

Infected drainage:

A

Disproportionate to size/extent of wound
Thick, purulent, creamy consistency
May be white, green, blue
May have distinctive odor

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25
Q

Inflamed decline in wound status:

A

Follows 3 phases of wound healing if treated appropriately

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26
Q

Infected decline in wound status:

A 
Plateau in healing
Granulation tissue:
Decreased amount
Friable
Cobblestone-like
Color change
27
Q

Who is at risk for a silent infection?

A

Patients who are immunocompromised or have inadequate perfusion

28
Q

Examples of silent infection:

A

Abscess

Patient with arterial insufficiency and gangrenous toe

29
Q

Biofilms:

A

Communities of microorganisms attached to wound surface encased in a glycocalyx
Protected against harsh environments, antiseptics, and antimicrobials
May increase bacterial virulence and resistance

30
Q

Where are biofilms found?

A

devitalized tissues, implanted devices, and within gastric mucosa

31
Q

Gold standard for diagnosing wound infection:

A

tissue biopsy

32
Q

Microbe ID Bacteria:

A 
Unicellular
Rigid cell wall
Lack nuclear membrane
Require external medium for growth
Reproduce by cellular division
33
Q

Most common skin and nail fungi

A

Tinea

Candida

34
Q

Patients with increased risk

for fungal infection:

A

On antibiotics
Have immune system diseases
Have diabetes
Have moist, occluded areas of skin

35
Q

Antimicrobial Agents

A

Destroy unicellular organisms

Used to treat infection or prophylactically

36
Q

Antibacterials

A

Bactericidal

Bacteriostatic

37
Q

Antifungals

A

Yeasts

Molds

38
Q

Types of antimicrobials

A 
penicillins
cephalosporins
erythromycins
amino glycosides
tetracycline
quinolones
sulfonamides
39
Q

Sensitive

A

Bacteria unable to grow in the presence of a certain antimicrobial

40
Q

Resistant

A

Bacteria that continue to multiply in the presence of a drug

May be natural or acquired

41
Q

Nosocomial

A 
Increased age
Diabetes
Immunosuppression
Malnutrition
Recent surgery
Immobility/debility
Large burns
Prior antimicrobial use
42
Q

Community Acquired

A

Prisons
Contact sports teams
Military
People with AIDS

43
Q

MRSA

A 
Can live hours to days on surfaces
Spread by:
Nosocomial: environmental contact
Community: person to person
Can cause cellulitis, osteomyelitis, abcess
Rx: mupirocin
44
Q

VRE

A

Commonly seen in surgical wounds and UTIs

Rx: ampicillin-amoxicillin

45
Q

Causes of Resistant Bacteria

A 
Misuse of antimicrobials in humans
Prescribed without infection present
50% deemed unnecessary
Wrong antimicrobial prescribed
Taken incorrectly
46
Q

Misuse of antimicrobials in animals

A

24.6 million pounds to livestock/yr in the U.S.
Build muscle faster
Banned in European Union

47
Q

Adverse reactions:

A

Mild skin reactions, hives
Difficulty breathing, anaphylactic shock
Photosensitivity, hearing loss, fever
Hepatitis, kidney damage

48
Q

Delayed sensitivity

A 
Neomycin
Gentamycin
Bacitracin
Lanolin-containing
Don’t use for prolonged periods
49
Q

Topical Antimicrobial Therapy

A 
Types
Ointments 
Creams
Solutions
Applied to wound surface 
Reapply every 8–24 hours
50
Q

Antimicrobial-Impregnated Dressings

A 
Silver, iodine
Broad-spectrum antimicrobials
Increase cost
Overuse may contribute to resistance
Must stay in contact with wound bed
Lack of scientific evidence
51
Q

Advantages of topical antimicrobial therapy:

A

Lower cost than systemic therapies
Reduce bacterial load
Effective in treating where circulation is compromised

52
Q

Disadvantages of topical antimicrobial therapy:

A

Higher cost than nonantimicrobial agents
Need for frequent applications
Sensitivity or allergic reaction
Potential for resistance

53
Q

Antiseptic Agents

A

Prevent infection by killing microorganisms
Proper uses
Surgical scrub, hand washing, cleansing intact skin

54
Q

Advantages of systemic antimicrobial therapy:

A

Reduce bacterial load
Easy to provide
Maybe better adherence

55
Q

Disadvantages of systemic antimicrobial therapy:

A 
Adverse reactions
More frequent/severe 
Resistance
Missed doses
Higher cost
56
Q

Prevent Infections in Open Wounds

A

Hand washing
Universal precautions/Standard precaution
Avoid strike-through drainage, control excessive moisture (medium for bacteria)
Reduce bioburden

57
Q

Clean technique

A

Reduce number of microorganisms present to decrease risk of transmission
Standard

58
Q

Sterile technique

A 
Only sterile equipment contacts patient’s wound
Used for:
Surgical debridement
Severe burns
Immunocompromised patients
59
Q

Clean

A

free of gross contamination

60
Q

Disinfect

A

to clean a surface with an antimicrobial

61
Q

Sterile

A

environment free of microbes

62
Q

Contamination

A

presence or anticipated presence of blood, wound fluid, or other potentially infectious waste

63
Q

Proper Wound Care Procedures

A

Sequence wound procedures to minimize contamination
If multiple wounds, treat most infected wound last and change gloves in between wounds
Remove gloves and wash hands upon completion
Thoroughly disinfect treatment area after procedures
Properly dispose of infectious waste and sharps
Check expiration dates
Open supplies just prior to use
Seal remaining supplies
Store meds according to JCAHO standards
Keep wounds covered except during examination and procedure
Change dressings if contaminated or ineffective

Integumentary (18 decks)

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