infection control and isolation Flashcards
Explain the elements of the chain of infection and the body’s defenses.
the infectious agent (pathogen), reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host;
Describe the manifestations of an inflammatory response, local and systemic infections, and related diagnostic tests.
An inflammatory response manifests locally with redness, swelling, heat, pain, and loss of function at the site of injury or infection, while systemic manifestations include fever, elevated white blood cell count, increased heart rate, and elevated acute phase proteins like C-reactive protein (CRP) in the blood
Relate principles of medical and surgical asepsis and their application to client care.
Medical and surgical asepsis are both important for preventing the spread of microorganisms and keeping patients safe
Differentiate between standard precautions and various types of isolation precautions.
- Standard precautions are a set of basic infection control practices applied to all patients, regardless of their diagnosis, to prevent the transmission of infectious diseases through contact with bodily fluids, while
- isolation precautions are specific measures used for patients with known or suspected infections that require additional protection beyond standard precautions, categorized into contact, droplet, and airborne precautions based on the mode of transmission of the pathogen involved
identify the nursing interventions that can protect against infection
hand hygiene, respiratory hygiene, PPE, sterilization, transmission-based precautions, aseptic technique, environmental hygiene
Which of the following factors are examples of reservoirs in the chain of infection?
health care workers, equipment, clients, furniture
steps of inflammatory response
bacteria invade an open wound
histamine, kinins and prostaglandins arrive at the site
plasma from the blood enters the site
phagocytosis occurs
pus develops
A nurse is performing hand hygiene after caring for a client who has Clostridium difficile. Which of the following hand hygiene methods should the nurse use?
soap and water
A nurse is wearing gloves while caring for a client. In which of the following situations should the nurse obtain a new pair of gloves?
after changing a dressing on the client and before documenting findings on a computer
A nurse is assisting with teaching a newly licensed nurse about needlestick injuries. Which of the following instructions should the nurse include?
reporting needlestick injuries to the nursing supervisor
A nurse is caring for a client who has acquired an infection from a visitor. The client is an example of which of the following links in the chain of infection?
susceptible host
A nurse is assisting in providing an in-service about infectious agents to a group of nurses. The nurse should include in the teaching that tuberculosis is transmitted by which of the following modes of transmission?
airborne
A nurse is assisting with teaching a newly licensed nurse about laboratory tests that can indicate generalized inflammation. The nurse should include which of the following laboratory tests?
c-reactive protein
A nurse is caring for a client who is on contact precautions. Which of the following actions should the nurse take?
place the client in a private room
A nurse is assisting with teaching a newly licensed nurse about surgical asepsis. Which of the following statements should the nurse make?
remove nail polish on your fingernails if it is chipped
A nurse is assisting with teaching a newly licensed nurse about infection control. The nurse should include in the teaching that which of the following types of precautions requires the use of an N95 mask?
airborne
A nurse is assisting with implementing an infection control bundle for clients at risk for catheter-associated urinary tract infections (CAUTIs). Which of the following interventions should the nurse include in the bundle?
try to use alternatives before inserting indwelling urinary catheters
A nurse is supervising a newly licensed nurse perform hand hygiene. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?
turns off the faucet with a towel
A nurse is planning to admit a client who has respiratory syncytial virus. Which of the following precautions should the nurse plan to implement?
droplet
A nurse is caring for a client who states, “I am feeling so much better. My fever is gone, and I have a good appetite.” The nurse should identify the client is likely in which of the following stages of infection?
convalescence
A nurse is assisting with teaching a newly licensed nurse about infectious agents. The nurse should include in the teaching that pertussis is transmitted by which of the following modes of transmission?
droplet
A nurse is assisting with teaching about personal protective equipment with a newly licensed nurse. Which of the following instructions should the nurse include?
gloves should be removed from the inside out
A nurse is assisting with teaching a newly licensed nurse about hand hygiene for surgical asepsis. Which of the following instructions should the nurse include?
apply chlorhexidine and ethanol to the hands
A nurse is assisting with teaching a newly licensed nurse about airborne infection isolation rooms (AIIR). Which of the following information should the nurse include?
the door to the AIIR should remain closed
A nurse is setting up a sterile field to perform a dressing change on a client. Which of the following actions should the nurse take?
open the first flap on the sterile package away from their body
A nurse is caring for a client who has influenza. The client asks how they acquired the infectious agent. The nurse should inform the client that influenza is transmitted by which of the following modes?
droplet
A nurse is assisting with teaching a group of nurses on processes that can trigger an inflammatory response in the body. The nurse should include that which of the following is an infectious trigger?
bacteria
A nurse is caring for a client who acquired an infection after touching a faucet that an infected person had touched. Which of the following links in the chain of infection does the faucet represent?
reservoir
A nurse in a clinic is caring for a client who reports generalized aches and fever for the past 12 hr. The nurse suspects the client has acquired an infection. Which of the following stages of infection is the client likely experiencing?
prodromal
A nurse is assisting with teaching a newly licensed nurse about removing personal protective equipment (PPE). Which of the following items should the nurse instruct to remove first?
gloves
A nurse is admitting a client who has vancomycin-resistant enterococcus (VRE) of the urine. The nurse should place the client on which of the following precautions?
contact
A nurse is performing a throat culture on a client. Which of the following actions should the nurse take?
swab the back of the client’s pharyngeal wall
the sequence of necessary pieces for an infection to occur:
the chain of infection
infectious agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
types of infectious agents
bacteria
fungi
virus
parasite
prion (degenerative in brain)
flora
animate reservoirs
people
animals
bugs
inanimate reservoirs
plants
medicine
medical equipment
food
feces
portal of exit
a portal of exit is a way the infectious agent can leave the reservoir
- any body orifice: eyes, ears, nose, mouth, skin/open wounds
contact: mode of transmission
occurs when microorganisms move from an infected person to another person
droplet: mode of transmission
occurs when airborne droplets from the respiratory tract of a client travel through the air and into the mucosa of a host
colonizations
being able to pass on or have something without knowing, may be more likely to test for something you don’t want to test positive for
what is is common to be colonized for in the ICU
MRSA
airborne: mode of transmission
occurs when small particulates move into the airspace of another person
susceptible host
- a susceptible host is required for the infectious agent to take hold and become a reservoir for infection
- not everyone who is exposed to an infectious agent gets sick
direct contact transmission
transmission occurs when microorganisms are directly moved from the infected person to another person without having a contaminated object or person between the two
examples of direct contact transmission
Herpes simplex virus (HSV)
scabies
hepatitis
indirect contact transmission
transmission occurs when microorganisms are moved from the infected person to another person with a contaminated object or person between the two
examples of indirect contact transmission
healthcare workers hands
shared equipment
improperly sterilized surgical equipment
nonspecific immunity
- Nonspecific immunity refers to neutrophils and macrophages and
their work as phagocytes. - Phagocytes eat and destroy microorganisms, thereby helping to
protect the body from harm. - Both neutrophils and macrophages are released during the
inflammatory response.
what is everyone born with
everyone is born with generalized immunity
specific immunity
- Specific immunity refers to the work of antibodies (also called
immunoglobulins) and
lymphocytes. - Antibodies bind to infectious agents and call to the white blood cells and complement to destroy them.
the inflammatory response steps
- pattern receptors on the cell surfaces recognize harmful stimuli
- inflammatory pathways are activated
- inflammatory markers are released
- inflammatory cells are recruited
infectious causes of inflammatory responses
viruses
bacteria
other microorganisms
noninfectious causes of inflammatory responses
physical
chemical
biological
psychological
the stages of infection
- Incubation: An infection enters host and begins to multiply.
- Prodromal: The client begins having symptoms.
- Acute illness: Manifestations of the
specific infectious disease process are obvious and may become severe. - Decline: Manifestations begin to wane as the degree of infectious disease decreases.
- Convalescence: The client returns to a normal or a “new normal” state of
health.
local infections
- confined to one area of the body
- can be treated with topical and oral antibiotics
systemic infections
- start as local infections
- spread to the bloodstream to infect the entire body
hand hygiene
- Hand hygiene is a broad term to cover any type of cleansing of the hands.
hand hygiene can be done using:
- Soap and water
- Alcohol-based hand sanitizers
- Antiseptic handwash or hand rub
- Surgical hand antisepsis.
medical asepsis
(clean technique) is a term used to define the elimination of and the absence of disease-causing microorganisms
standard precautions
- Standard precautions is a term used to describe the infection prevention
practices applied to all clients, whether they are known to have an infectious agent or not.
standard precautions are used to protect self and others from:
blood
bodily secretions
body fluids
excretions (all except sweat)
nonintact skin
mucous membranes
PPE (personal protective equipment)
- It is the nurse’s responsibility to
know what type(s) of Personal Protective Equipment (PPE) is
needed to care for clients and to don and doff PPE appropriately.
Health Care Associated Infections (HAIs): the four main types
Central Line-associated Bloodstream Infections (CLABSIs)
* Catheter-associated Urinary Tract Infections (CAUTIs)
* Surgical Site Infections (SSIs)
* Ventilator-assisted Pneumonia (VAPs)
who is responsible for maintaining asepsis when accessing patient-invasive devices
the nurse
when not properly followed what happens to the client
the risk of infection will increase
