Infectious Disease- Exam 1 Flashcards
Name the 6 links in the chain of infection.
- Infectious Agent
- Reservoirs
- Portal of Exit
- Means of Transmission
- Portal of Entry
- Susceptible Host
Name the Infectious Agents in the chain of infection.
-Bacteria
-Fungi
-Viruses
-Rickettsiae
-Protozoa
How do you break the chain of infection at the Infectious Agent link?
Rapid accurate identification of organisms
What are examples of Reservoirs in the chain of infection?
-People
-Equipment
-Water
What are examples of ways to break the chain of infection at the Reservoir link?
-Employee health
-Environmental Sanitation
-Disinfection/sterilization
What are examples of Portal of Exit in the chain of infection?
-Excretions
-Secretions
-Skin
-Droplets
How can you break the chain of infection at the Portal of Exit link?
-Hand hygiene
-Control of excretions & secretions
-Trash & waste
What are the Means of Transmission in the chain of infection?
-Direct contact
-Ingestion
-Fomites
-Airborne
What are ways of breaking the chain of infection at the Means of Transmission link?
-Hand hygiene
-Sterilization
-Standard precautions
-Airflow control
-Food handling
-Isolation
What are examples of Portal of Entry in the chain of infection?
-Mucous membranes
-GI Tract
-GU Tract
-Respiratory tract
-Broken skin
What are ways to break the chain of infection at the Portal of Entry link?
-Aseptic technique
-Catheter care
-Wound care
What are examples of Susceptible Hosts in the chain of infection?
-Immunosuppression
-Diabetes
-Surgery
-Burns
-Elderly
What are ways to break the chain of infection at the Susceptible Host link?
-Treatment of underlying diseases
-Recognition of high-risk patients
What link in the chain of infection would E. coli be?
Infectious Agent
What link in the chain of infection would the GI Tract be?
Reservoir
What link in the chain of infection would the Anus be?
Portal of Exit
What link in the chain of infection would improper wiping (back to front) be?
Means of Transmission
What link would the Urethra be in the chain of infection?
Portal of Entry
What link would a woman be in the chain of infection?
Susceptible Host
Definition: Describes microorganisms present without host interference or interaction.
Colonization
What is an example of colonization?
S. aureus on the skin without any skin interruption or irritation
Definition: Indicates host interaction with the organism.
Break in skin allows organism to enter host.
Infection
(Not septic, localized area)
Definition: The infected host displays a decline in wellness caused by the infection.
Infectious disease
(Inside bloodstream)
List some Infection Control & Prevention organizations
-WHO
-CDC
-OSHA
-Local agencies (Health Department)
-Hospital & facility infection control specialists
Which type of patients do we use Standard Precautions for?
All patients
What type of patients do we use Transmission-based precautions for?
Patients with known infectious diseases spread by airborne, droplet, contact routes
List some Standard Precautions
-Hand hygiene
-Use of gloves & other barriers
-Proper handling of patient care equipment & linen
-Environmental control
-Prevention of injury from sharp devices & needles
-Patient placement
Name the 4 different categories of Transmission Based Precautions?
- Airborne Precautions
- Droplet Precautions
- Contact Precautions
- Enhanced Precautions
List some Airborne Precautions
-Negative pressure room
-N-95 Respirator
List some illnesses that fall into the category of Airborne Precautions
-TB
-Varicella
-Anthrax
What illnesses are Droplet Precautions used for?
-Influenza
-Meningococcus
-PNA (Pneumonia)
When do we use Droplet Precautions?
Used for organisms transmitted by close contact with respiratory or pharyngeal secretions
What additional PPE needs to be utilized for Droplet Precautions?
Wear a face mask
(Transmission is limited to close contact)
Door may remain open
What are Contact Precautions used for?
Used for organisms spread by skin-to-skin contact
Organisms are easily transmitted by contact between the health care worker and the patient
What barriers are used to prevent transmission of organisms with Contact Precautions?
Gown & Gloves (masks not needed)
What are examples of organisms that require Contact Precautions?
-Clostridium difficile
-Antibiotic-resistant organisms (VRE, MRSA, MDRO)
What must the nurse do when they leave a room with Contact Precautions?
Wash hands with soap and water for at least 20 seconds.
What should a nurse do when they leave a room with Droplet Precautions?
Wash hands with soap and water or use hand sanitizer
What PPE is needed for Enhanced Precautions?
-Goggles or face shield
-N-95 Mask
-Gown
-Gloves
What PPE should a nurse use for any patient when direct skin to skin contact is necessary?
Gloves
What does HA-MRSA stand for?
Healthcare Acquired Methicillin Resistant Staphylococcus Aureus
Examples of invasive procedures that can cause a HA-MRSA?
-PIV
-Incisions
-Surgeries
-Blood draws
-Indwellingcatheters
What does CA-MRSA stand for?
Community Acquired Methicillin Resistant Staphylococcus Aureus
What precautions are required for MRSA?
Contact Precautions
What precautions are required for COVID-19?
Enhanced or Airborne
What precautions are required for C. Diff?
Contact Precautions
What disinfectant will kill the spores of C. Diff?
Bleach containing disinfectants
What medication is the drug of choice for treatment of most MRSA infections?
Vancomycin
How are VRE (Vancomycin Resistant Enterococcus) treated?
Combinations of vancomycin, gentamicin, and/or linezolid
What laboratory test is performed to figure out what medication will work for an infection?
Culture & Sensitivity
What are the 5 recommendations in preventing CLABSI?
(Central Line Associated Blood Stream Infections)
- Optimal catheter site selection
- Hand hygiene- sterile technique for insertion
- Maximal barrier precaution (Tegaderm)
- Chlorhexidine skin anti-sepsis (daily)
- Daily review of line necessity (switch to PIV asap)
List some emerging infectious diseases
-Zika Virus
-West Nile Virus
-Ebola Virus
-Legionnaires Disease
-COVID
How can Zika virus be transmitted?
Through the bites of infected mosquitoes
Through sexual transmission
How is West Nile virus transmitted?
Through the bites of infected mosquitoes
How is Ebola transmitted?
Through direct contact with body fluid
Through infected wild animals
How is Legionnaires disease transmitted?
By the aerosolized route
How is COVID transmitted?
Through close contact by airborne transmission (airborne particles & droplets)
What are some examples of vaccinations used in the U.S.?
MMR
Varicella
Influenza
HPV
COVID
What are the most common infectious diseases in the United States?
Syphilis
Chlamydia Trachomatis
Neisseria Gonorrhea
Human Immunodeficiency Virus
What are sites of infection for STI’s?
Skin & mucosal lining of the urethra
Cervix
Vagina
Rectum
Oropharynx
What are routes of transmission of STI’s?
Sexual
Percutaneous
Perinatal
What are the 5 P’s when performing an assessment of STI’s?
Partners- are you active, sex of partner
Prevention of Pregnancy- birth control, future plans
Protection from STI’s- are you using protection, do you get tested
Practices- what kind of sex are you having
Past History of STI’s- diagnosed in the past & treatment used
What would a nurse look for when performing a physical examination (during assessment) for STI’s and what parts of the body do you examine?
Rashes
Lesions
Drainage
Inguinal Nodes
Genitalia
Rectum
Mouth
Throat
Woman assessed for abdominal & uterine tenderness
What are STI interventions?
-Education about STD’s & the spread & treatment of infection
-Reducing anxiety (encourage open discussion, provide factual info, involve partners, referral to a social worker)
-Increasing adherence (Pt. education in group or individual setting, referral to appropriate agencies)
What are potential complications of STI’s for woman?
-PID
-Ectopic pregnancies
-Transmission of infection to fetus if pregnant
-Infertility
What are potential complications of STI’s for men?
-Epididymitis
-Infertility
What are ways to reduce risk of infection to patients in home care?
-Assessment, reporting, and treatment of fever
-Care of equipment (disinfection & aseptic technique)
-Catheter care
-Home clean but not sterile, insect control
-Restriction of visitors if necessary
For home-based care measures, what does the nurse educate the patient and family of?
-Hand hygiene & aseptic technique
-Annual influenza vaccine, pneumonia 65+, COVID
-Recognition of mode of transmission
-Establishment of transmission-based precautions
What are ways to reduce the risk to the caregiver?
-Standard precautions (hand washing, PPE)
-Proper food storage
-Proper food preparation (proper storage, cook thoroughly)
What is the portal of entry of diarrheal diseases?
Oral Ingestion
What are examples of infectious agents in diarrheal diseases?
Bacterial- Campylobacter, Salmonella, Shigella, E. coli
Viral- Rotovirus, Calicivirus (Norovirus) LTC facilities & cruise ships
Parasitic- Giardia, Cryptosporidium
What history does a nurse need for infectious diarrhea?
-Recent Travel
-Use of Antibiotics
-Food Intake
-N/V/D- Dehydration
How does a nurse assess for hydration status in infectious diarrhea?
-Thirst
-Dry mucous membranes
-Weak pulse
-Loss of skin turgor
-Sunken eyes
-I&O
What are interventions for infectious diarrhea?
-Maintenance of fluid and electrolyte balance
-Increase knowledge about disease and risk of transmission
-Absence of complications
How is dehydration corrected?
-Oral rehydration is best
-IV rehydration in severe dehydration
What would a patient with mild dehydration exhibit?
Dry mucous membranes & increased thirst
What would a patient with moderate dehydration exhibit?
Sunken Eyes
Poor Skin Turgor
Increased Thirst
Dry Mucous Membranes
What would a patient with severe dehydration exhibit?
Signs of hypovolemic shock (rapid thready pulse, cyanosis, cold extremities, rapid breathing, lethargy, or coma)
IV replacement until hemodynamic & mental status return to normal then treat with oral solutions (Isotonic*, or sometimes Hypotonic)
