Infection Control and Wound Care Flashcards
What are the risk factors for community acquired infections?
- Young age
- Contact sports
- Sharing towels or athletic gear
- Weakened immune system
- Crowded or unsanitary conditions
- Healthcare workers
What are the risk factors for hospital acquired infections?
- Current or recent hospitalization
- LTC facilities
- Invasive devices or procedures
- Recent antibiotic use
What are the most frequently missed spots of the hand in hand washing?
Back of the thumb, in between the fingers, tips of fingers
What is the most important factor for preventing the spread of infection?
hand washing
About how long should it take to wash your hands?
20 sec
What are the 3 ways infection can be transmitted? What is the most common?
Contact, Droplet, Airborne; contact
Condition spreads via direct or indirect person-to-person contact; most common cause of hospital acquired infections
Contact precautions
What are the standard caution precautions?
- Pt in private or cohort rooms
- Must wear gown and gloves
- Limit transport
- Patient-care equipment must be disinfected
What are some examples of diseases with contact precautions?
MRSA, VRE, C-diff, Hep A, Impetigo, Conjuntivitis
Condition spreads via large respiratory droplets generated by coughing sneezing, talking, etc.; droplets may land on mucous membrane of eyes, nose, or mouth, and may contaminate surfaces
Droplet precautions
What are some examples of diseases with droplet precautions?
Mumps, rubella, influenza, meningitis, pneumonia, and pertussis
What are the standard droplet precautions?
- Pt is isolated or with cohort
- Must wear gloves and mask (gown and eye protection may be needed)
- Hands should be decontaminated after removing gloves
- If pt is transported, pt must wear surgical mask
Condition spreads via small respiratory droplets generated by coughing, sneezing, talking, etc.; can remain suspended in the air for long periods of time and travel long distances
Airborne precautions
What are some examples of diseases with airborne precautions?
Measles, chickenpox, shingles, TB, SARS, smallpox
What are the standard airborne precautions?
- Pt is in private room with special air handling and ventilation systems (pts can be cohort if private room isn’t available)
- Healthcare workers must wear personal fit-tested respirators (N95 most common)
- If pt must be transported, pt must wear surgical mask
Diseases spread from person to person as a result of unprotected exposure to blood and other bodily fluids
Blood borne pathogens
What are some examples of blood borne pathogens? How can you protect yourself?
HIV/AIDS, Hep B, Hep C; standard precautions
What is medical asepsis? surgical asepsis?
Medical - universal precautions to limit contamination
Surgical - steps to eliminate contamination
About how big is the epidermis? the dermis?
½ mm; 2-4 mm
Outer epithelial layer; protective barrier; avascular; prevents dehydration of underlying tissues
Epidermis
Highly vascular; strong and elastic due to collagen and elastin; hair follicles; sebaceous glands; nerve endings; receptors for pain, touch, cold, heat
Dermis
What are blisters caused by?
Friction between the dermis and epidermis
Below the dermis; adipose tissue, connective tissue; provides insulation, support, cushioning; protects underlying tissues
Subcutaneous layers
What are the 3 wounds that describe depth of tissue involvement?
- Superficial wounds
- Partial-thickness wounds
- Full-thickness
What skin layer(s) are effected in superficial wounds?
Epidermis (1st degree burn)
What skin layer(s) are effected in partial-thickness wounds?
Epidermis and dermis
-blisters, second-degree burn, category II pressure ulcer, wagner grade 1 ulcer
What skin layer(s) are effected in full-thickness wounds?
Epidermis, dermis, subcutaneous tissue (and may extend into deeper tissue layers)
- 3rd degree burns, 4th degree burns, category III pressure ulcer, wagner grade 2-5 ulcer
Phase of wound healing that prepares wound for healing and cleans debris
Inflammatory
Phase of wound healing that rebuilds the damaged structures and provides strength to the wound; red, beefy, fragile tissue present
Proliferative
Phase of wound healing that modifies the immature scar to a mature scar
Maturation/ remodeling
How long does the inflammation stage last? Proliferation? Remodeling?
4-6 days; 4-24 days; 21 days-2 years
What are the cardinal signs of the inflammatory phase?
- Swelling
- Redness
- Warmth
- Pain
- Decreased function
What are the four events that take place in the proliferative phase?
- Angiogenesis (formation of new blood vessels)
- Granulation tissue formation (temporary lattice work of connective tissue that fills the void of the wound)
- Wound contraction (wound margin pull together)
- Epithelialization (cells work way across wound bed)
Method of wound closure where edges of the would come together
Primary
Method of wound closure where edges cannot approximate so skin has to fill in
Secondary
Method of wound closure where wound is left open and surgically closed later
Delayed primary (motorcycle accident)
Dead tissue that is dry, dark colored, and hard
Eschar
Dead tissue that is greenish/yellow in color and moist
Slough
Tissue around a wound
Periwound
Dryness to a wound (essentially a scab)
Dessication
Wound is too wet; usually drainage is causing wetness
Maceration
Description when wound is larger than it looks; wound is under the edge of opening
Undermining
Description when there are two openings to a wound, but the wound goes all the way from one opening to another; in abdominal wounds, dressing needs to fill wound so body can close it
Tunneling
Drainage that is dark yellow in color, more viscous (contains more protein) and normally occurs later on as wound progresses
Eudate
Drainage that is clear, thin, watery; made up of water salts and maybe a little protein
Transudate
What are the local factors that effect wound healing?
Circulation, sensation, mechanical stress
What are systemic factors that effect would healing?
Age, inadequate nutrition, comorbidities, medication, behavioral risk taking
Wound type that lacks adequate blood supply to the lower extremities
Arterial insufficiency
Wound type with inadequate return of blood from lower extremities
Venous insufficiency
Wound characterized by severe pain that increases with elevation; primarily located on distal toes, dorsal of foot, lat. malleolus, ant. leg; pale base, poor granulation, round/regular margins, little or no bleeding, and eschar; cool skin, decreased or absent pedal pulse
Arterial insufficiency
Wound characterized by mile to moderate pain that decreases with elevation; located medial lower leg, medial malleolus; red wound bed, good granulation, irregular margin, copious drainage; edema, normal to warm skin temp
Venous insufficiency
Where are pressure ulcers most likely to occur?
Bony prominences where you sit or lay
Debridement of just dead tissue
Selective (sharps, autolytic, enzymatic, biologic)
Debridement where there is risk of deriding good tissue as well as bad
Nonselective (mechanical, surgical)
