Infection Control and Wound Care

Question 1

What are the risk factors for community acquired infections?

Answer 1

1. Young age
2. Contact sports
3. Sharing towels or athletic gear
4. Weakened immune system
5. Crowded or unsanitary conditions
6. Healthcare workers

Question 2

What are the risk factors for hospital acquired infections?

Answer 2

1. Current or recent hospitalization
2. LTC facilities
3. Invasive devices or procedures
4. Recent antibiotic use

Question 3

What are the most frequently missed spots of the hand in hand washing?

Answer 3

Back of the thumb, in between the fingers, tips of fingers

Question 4

What is the most important factor for preventing the spread of infection?

Answer 4

hand washing

Question 5

About how long should it take to wash your hands?

Answer 5

20 sec

Question 6

What are the 3 ways infection can be transmitted? What is the most common?

Answer 6

Contact, Droplet, Airborne; contact

Question 7

Condition spreads via direct or indirect person-to-person contact; most common cause of hospital acquired infections

Answer 7

Contact precautions

Question 8

What are the standard caution precautions?

Answer 8

1. Pt in private or cohort rooms
2. Must wear gown and gloves
3. Limit transport
4. Patient-care equipment must be disinfected

Question 9

What are some examples of diseases with contact precautions?

Answer 9

MRSA, VRE, C-diff, Hep A, Impetigo, Conjuntivitis

Question 10

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

Answer 10

Droplet precautions

Question 11

What are some examples of diseases with droplet precautions?

Answer 11

Mumps, rubella, influenza, meningitis, pneumonia, and pertussis

Question 12

What are the standard droplet precautions?

Answer 12

1. Pt is isolated or with cohort
2. Must wear gloves and mask (gown and eye protection may be needed)
3. Hands should be decontaminated after removing gloves
4. If pt is transported, pt must wear surgical mask

Question 13

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

Answer 13

Airborne precautions

Question 14

What are some examples of diseases with airborne precautions?

Answer 14

Measles, chickenpox, shingles, TB, SARS, smallpox

Question 15

What are the standard airborne precautions?

Answer 15

1. Pt is in private room with special air handling and ventilation systems (pts can be cohort if private room isn’t available)
2. Healthcare workers must wear personal fit-tested respirators (N95 most common)
3. If pt must be transported, pt must wear surgical mask

Question 16

Diseases spread from person to person as a result of unprotected exposure to blood and other bodily fluids

Answer 16

Blood borne pathogens

Question 17

What are some examples of blood borne pathogens? How can you protect yourself?

Answer 17

HIV/AIDS, Hep B, Hep C; standard precautions

Question 18

What is medical asepsis? surgical asepsis?

Answer 18

Medical - universal precautions to limit contamination

Surgical - steps to eliminate contamination

Question 19

About how big is the epidermis? the dermis?

Answer 19

½ mm; 2-4 mm

Question 20

Outer epithelial layer; protective barrier; avascular; prevents dehydration of underlying tissues

Answer 20

Epidermis

Question 21

Highly vascular; strong and elastic due to collagen and elastin; hair follicles; sebaceous glands; nerve endings; receptors for pain, touch, cold, heat

Answer 21

Dermis

Question 22

What are blisters caused by?

Answer 22

Friction between the dermis and epidermis

Question 23

Below the dermis; adipose tissue, connective tissue; provides insulation, support, cushioning; protects underlying tissues

Answer 23

Subcutaneous layers

Question 24

What are the 3 wounds that describe depth of tissue involvement?

Answer 24

1. Superficial wounds
2. Partial-thickness wounds
3. Full-thickness

Question 25

What skin layer(s) are effected in superficial wounds?

Answer 25

Epidermis (1st degree burn)

Question 26

What skin layer(s) are effected in partial-thickness wounds?

Answer 26

Epidermis and dermis -blisters, second-degree burn, category II pressure ulcer, wagner grade 1 ulcer

Question 27

What skin layer(s) are effected in full-thickness wounds?

Answer 27

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

Question 28

Phase of wound healing that prepares wound for healing and cleans debris

Answer 28

Inflammatory

Question 29

Phase of wound healing that rebuilds the damaged structures and provides strength to the wound; red, beefy, fragile tissue present

Answer 29

Proliferative

Question 30

Phase of wound healing that modifies the immature scar to a mature scar

Answer 30

Maturation/ remodeling

Question 31

How long does the inflammation stage last? Proliferation? Remodeling?

Answer 31

4-6 days; 4-24 days; 21 days-2 years

Question 32

What are the cardinal signs of the inflammatory phase?

Answer 32

1. Swelling 2. Redness 3. Warmth 4. Pain 5. Decreased function

Question 33

What are the four events that take place in the proliferative phase?

Answer 33

1. Angiogenesis (formation of new blood vessels) 2. Granulation tissue formation (temporary lattice work of connective tissue that fills the void of the wound) 3. Wound contraction (wound margin pull together) 4. Epithelialization (cells work way across wound bed)

Question 34

Method of wound closure where edges of the would come together

Answer 34

Primary

Question 35

Method of wound closure where edges cannot approximate so skin has to fill in

Answer 35

Secondary

Question 36

Method of wound closure where wound is left open and surgically closed later

Answer 36

Delayed primary (motorcycle accident)

Question 37

Dead tissue that is dry, dark colored, and hard

Answer 37

Eschar

Question 38

Dead tissue that is greenish/yellow in color and moist

Answer 38

Slough

Question 39

Tissue around a wound

Answer 39

Periwound

Question 40

Dryness to a wound (essentially a scab)

Answer 40

Dessication

Question 41

Wound is too wet; usually drainage is causing wetness

Answer 41

Maceration

Question 42

Description when wound is larger than it looks; wound is under the edge of opening

Answer 42

Undermining

Question 43

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

Answer 43

Tunneling

Question 44

Drainage that is dark yellow in color, more viscous (contains more protein) and normally occurs later on as wound progresses

Answer 44

Eudate

Question 45

Drainage that is clear, thin, watery; made up of water salts and maybe a little protein

Answer 45

Transudate

Question 46

What are the local factors that effect wound healing?

Answer 46

Circulation, sensation, mechanical stress

Question 47

What are systemic factors that effect would healing?

Answer 47

Age, inadequate nutrition, comorbidities, medication, behavioral risk taking

Question 48

Wound type that lacks adequate blood supply to the lower extremities

Answer 48

Arterial insufficiency

Question 49

Wound type with inadequate return of blood from lower extremities

Answer 49

Venous insufficiency

Question 50

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

Answer 50

Arterial insufficiency

Question 51

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

Answer 51

Venous insufficiency

Question 52

Where are pressure ulcers most likely to occur?

Answer 52

Bony prominences where you sit or lay

Question 53

Debridement of just dead tissue

Answer 53

Selective (sharps, autolytic, enzymatic, biologic)

Question 54

Debridement where there is risk of deriding good tissue as well as bad

Answer 54

Nonselective (mechanical, surgical)