Infections Flashcards
Categories of infections
local and systemic (spread by blood)
Causes of infections
- Bacteria
- Viruses
- Fungi
- Protozoa
Bacteria causes diseases in two ways
- Enter body and grow inside cells.
2. Secrete endotoxins that damage cells:
Endotoxins
- Exotoxinsareprotein released during bacterial growth
- part of the cell wall of gram (–) bacteria
- released with bacterial lysis activates inflammatory response and produce fever (pyrogenic)
acquired immunodeficiency syndrome (AIDS)
End-stage of chronic HIV infection; a syndrome involving a defect in cell-mediated immunity that has a long incubation period and is manifested by various opportunistic infections and cancers.
acute retroviral syndrome
Symptoms accompanying the development of HIV-specific antibodies (seroconversion), including a flulike syndrome of fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, or a diffuse rash, or some combination.
Bacteria
One-celled microorganisms that are found virtually everywhere on earth and are involved in fermentation, putrefaction, infectious diseases, and nitrogen fixation.
emerging infectious disease
A disease of infectious origin that newly appears in a population, or whose incidence in humans has increased within the recent past or threatens to increase in the near future, including those infections that appear in new geographic areas or increase abruptly.
Fungi
Organisms similar to plants, but lacking in chlorophyll; pathogenic fungi cause infections that are usually localized, but may become disseminated in an immunocompromised individual.
human immunodeficiency virus (HIV)
A retrovirus that causes HIV infection and acquired immunodeficiency syndrome (AIDS).
opportunistic disease
Infections and cancers that occur in immunosuppressed patients that can lead to disability, disease, and death.
oral hairy leukoplakia
An Epstein-Barr virus infection that causes painless, white, raised lesions on the lateral aspect of the tongue.
protozoa
Single-cell, animal-like microorganisms that normally live in soil and bodies of water, but can cause infection when introduced into the human body.
retrovirus
A virus that replicates in a “backward” manner, going from RNA (ribonucleic acid) to DNA (deoxyribonucleic acid).
reverse transcriptase
An enzyme made by HIV and other retroviruses, that helps the virus replicate back from RNA to DNA.
viral load
The number of HIV particles in the blood.
viremia
Large amounts of virus in the blood.
virus
Infectious agents consisting of either RNA or DNA and a protein envelope; can reproduce only in the cells of a living organism
window period
Time period of two months after infection, during which an infected individual will not test positive for HIV antibodies
Bacteria Morphology Shapes
Coccus Bacillus Coccobacillus Spirochete Spirillium Vibrio
Gram-positive organism
- Stain purple
- Much thicker cell walls
- Thicker outer cells capsule
Gram-negative organism
- Stain red
- Cell wall structure is more complex
- Usually harder to treat because antibiotics have a more difficult time penetrating the cell wall
What is the most common infection in humans?
Viral
Obligate parasite
a parasitic organism that cannot complete its life-cycle without exploiting a suitable host. If an obligate parasite cannot obtain a host it will fail to reproduce. A virus is an example of this.
How do viruses bypass the body’s defense mechanisms?
By developing intracellularly
• They hide in cells, away from inflammatory and immune responses
When does the immune response develop in a viral infection?
- This immune response resolves the infection
* Therefore viral infection is often self-limiting or resolves without medications
Mycosis
any disease caused by a fungus
Can fungi be part of the normal flora?
yes
What complications can disease states or antibiotic therapy cause in regards to fungal infections?
Disease states or antibiotic therapy can upset this balance causing fungal overgrowth and ‘opportunistic infection’(e.g.-Candida albicans-causes oral candidiasis [thrush], esophageal candidiasis, intestinal vaginitis)
What do pathogenic fungi cause?
infections that are usually localized to a small area (e.g.. -Athlete’s foot and ringworm)
How does a fungi infection become systemic?
In an immunocompromised person (e.g.. –cancer, AIDs) fungi can becomes disseminated (systemic infection)
Four categories of protozoa
- Amebas
- Ciliates
- Flagellates
- Sporozoa
Examples of protozoa infection
Amebic dysentery, giardiasis
Emerging Infections
- Disease of infectious origin that newly appears in a population
- infections that appear in new geographic areas
- Infections increase abruptly
Examples of emerging infections
- SARS
- West Nile Virus
- HIV
- Avian influenza
- Ebola
- Lyme Disease
Causes and contributing factors of emerging infections
Animals vectors, Antibiotic resistance, Climate change, Natural disasters, Global travel, and population density
Animal Vectors and emerging infections
severe acute respiratory syndrome (SARS) and the West Nile virus
Antibiotic Resistance and emerging infections
have emerged as a result of a previously treatable organism developing resistance due to inappropriate use of antibiotics
Climate Change and emerging infections
increased vegetation in some regions that leads to increases in rodent numbers and hantavirus; expanded range of insect populations including disease-carrying mosquitoes
Natural Disasters and emerging infections
such as earthquakes and breakdown on sanitation infrastructure and access to clean drinking water are associated with the spread of water-borne diseases such as cholera
Re-Emerging Infection
- Infections once thought under control
- Vaccines and proper medications have led to the near eradication of some infections
- Re-emergence caused by numerous factors including more global travel, less uptake of vaccinations, drugs resistance
Examples of re-emerging infection
- Tuberculosis
* Pertussis
Type of Resistant organisms
AROs: Antibiotic Resistant Organisms(aka ‘super bugs’)
MDROs: Multidrug Resistant Organisms
Resistant organisms
- Bacteria whose growth and reproduction is unaffected by particular antibiotics
- Bacteria adapt -mutation and acquisition of new DNA
- Bacteria resist antibiotics by producing enzymes that destroy or inactive drugs
MRSA: Methicillin-Resistant Staphylococcus Aureus
- Hospital or community acquired
- Spreads via contact
- Organism can remains viable on surfaces for days
Those at risk for MRSA
- Immunosuppressed persons
- Invasive devices
- Breaks in skin barrier
VRE: Vancomycin-Resistant Enterococci
- Hardier than MRSA
- Spread via contact
- Can remain viable for weeks on environmental surfaces
BSL: Extended Spectrum Beta-Lactamases
- Enzymes produced by bacteria that cause resistance to cephalosporins –the most widely used antibiotic in hospital
- Spread via contact
- Usually lives in urine
ARO Prevention
- Appropriate antibiotic use
- Take antibiotics as prescribed and finish entire prescription
- Do not request antibiotics for viruses (colds and flus)
- Do not use antibiotics as a prevention strategy
- Frequent hand washing
Health Care Associated Infections (HAIs)
AKA nosocomial infection
- Acquired due to exposure in the health care setting
* Caused by any bacteria –most common: e.coli, staph aureus, c.difficile
Those at risk for Health Care Associated Infections (HAIs)
- Surgical patients
* Immunocompromised
Health Care Associated Infection (HAI) Prevention
- Universal precautions
- Hyper-vigilant hand hygiene!
- Infection control precautions
- PPE
- Appropriate isolation precautions
Incubation period
- Time between entrance of pathogen and first symptoms
- Examples:
* Mumps incubate in 18 days
* Chicken pox incubate in 2 to 3 weeks
Prodromal Stage
- Time from onset of nonspecific findings (such as fatigue, malaise) to more specific findings.
- The pathogen is multiplying.
- The host is most contagious.
Illness Stage
- When a client exhibits the specific findings of a disease
* Examples: The parotid gland swelling of mumps; The sore throat of a cold
Convalescence
when the acute findings begin to disappear
Localized infection clinical manifestations
- Pain
- Redness
- Swelling
- Heat
- Exudate
Systemic infection clinical manifestation
- Fever
- Chills
- Diaphoresis
- Fatigue
- Loss of appetite
- Leukocytosis
- Exudate
Common Infections in Older Adults:
- Pneumonia
- UTIs
- Skin infections
- TB
Presentation of infection in older adults
- Cognitive and behavioural changes will often present before changes in lab values
- FEVER is not a reliable indication of infection!
Infection physical assessment
- Clinical manifestations vary depending on the pathogen
- Majority of symptoms are related to the inflammatory and immune responses
- Non-specific, vague, constitutional symptoms: fatigue, malaise, weakness, decreased concentration
- Generalized aches, loss of appetite
Monitoring for infection
MONITOR VITAL SIGNS
• Fever, chills, –how does this impact other vital signs?MONITOR LAB WORK
• Specimen collection: blood cultures, urine, sputum, fecal specimens (obtain blood cultures and specimens as appropriate prior to giving antibiotics)
• Monitor CBC values
Nursing Diagnosis in infection
Activity intolerance 2 ̊ loss of function Body image –disturbed 2 ̊ wound, scar}Body temperature –impaired Comfort –impaired}Coping –ineffective Fatigue Fluid volume -deficient Knowledge deficit Hopelessness Infection –risk for Health maintenance –ineffective, impaired Mobility –impaired Nausea Nutrition –less than body requirements Pain –acute/chronic Tissue integrity –impaired Self-care deficit Skin integrity -impaired
