Lesson 1 - Asepsis and Infection Control Flashcards
(the collective vegetation in a
given area) in one part of the
body, yet produce infection in
another
Resident flora
This bacteria is a normal
inhabitant of the large intestine
but a common cause of infection
of the urinary tract.
Escherichia coli
Common Resident Microorganisms in the skin?
- Staphylococcus epidermis
- Staphylococcus aureus
- Propionibacterium acnes
- corynebacterium xerosis
- Pityrosporum ovale
Coomon Resident Microorganisms in the Nasal passages?
- Staphylococcus aureus
- Staphylococcus epidermis
Coomon Resident Microorganisms in the Oropharynx / mouth?
- Staphylococcus pnemonae
- Lactobacillus
- Staphylococcus mutans
- Bacteroides
- Actinomyces
A detectable alteration in
normal tissue function,
however, is called _____.
Disease
_____ is the growth of
microorganisms in body tissue
where they are not usually
found, such a microorganism is
called an _____.
Infection
- Infectious agent
If the microorganism produces
no clinical evidence of disease,
the infection is called
_____
asymptomatic / subclinical
Common resident microorganisms in intestine?
- Bacteroides
- Fusobacterium,
- Eubacterium Lactobacillus
- Streptococcus Enterobacteriaceae,
- Shigella
- Escherichia coli
Common resident microorganisms in urethral orifice?
Staphylococcus epidermis
Common resident microorganisms in lower urethra?
Proteus
Common resident microorganisms in vagina?
- Lactobacillus
- Bacteroides
- Clostridium
- Candida Albicans
the ability of the
microorganism to produce
disease, the severity of the
diseases they produce and
their degree of
communicability
Virulence
the ability
to produce disease; thus, a
pathogen is a
microorganism that causes
disease
Pathogenicity
a condition resulting from an
infectious agent that is
transmitted to an individual
by direct or indirect contact
or as an airborne infection
Communicable disease
causes disease only in a
susceptible individual.
oppurtunistic pathogen
The freedom from
disease-causing
microorganisms and to decrease the
possibility of transferring
microorganisms from one
place to another, an
aseptic technique is used
Asepsis
What are the 2 types of Asepsis?
Medical asepsis
Surgical asepsis
includes all practices intended to
confine a specific microorganism
to a specific area, limiting the
number, growth, and
transmission of microorganisms.
Medical asepsis
In medical asepsis, objects are
referred to as _____, which
means the absence of almost all
microorganisms, or _____ (soiled,
contaminated), which means
likely to have microorganisms,
some of which may be capable
of causing infection.
- clean
- dirty
Refers to those practices
that keep an area or object
free of all microorganisms;
it includes practices that
destroy all microorganisms
and spores (microscopic
dormant structures formed
by some pathogens that are
very hardy and often survive
common cleaning
techniques)
Surgical asepsis / Sterile technique
This occurs when chemicals released into the b loodstream to fight an infection trigger inflammatory responses throughout the body
Sepsis
Four Major Categories of Microorganisms:
- Fungi
- Bacteria
- Algae
- Protozoa
Types of infection:
- local infection
- systemic infection
- Bacteremia
- Septicemia
- Chronic infection
- Acute infection
- nosocomial infection
limited to the specific part of
the body where the
microorganisms remain
Local infection
the microorganisms spread
and damage different parts of
the body, the infection
Sytemic infection
When a culture of the individual’s
blood reveals microorganisms
Bacteremia
bacteremia results in systemic
infection
Septicemia
may occur slowly, over a very long
period, and may last months or years
Chronic infection
Generally, appear suddenly or last a
short time
Acute infection
classified as infections that
originate in the hospital
Nosocomial infections
The microorganisms that
cause nosocomial infections
can originate from the clients
themselves ( _____) or from the hospital
environment and hospital
personnel ( _____)
endogenous source
exogenous sources
When there is an improper catherization what bacteria is present?
Escherichia coli
When there is an Contamination of closed drainage system, what bacteria is present?
Enterococcus species
When there is an Inadequate hand hygiene in urinary tract, what bacteria is present?
Pseudomonas aeruginosa
When there is an Inadequate hand hygiene and Improper dressing change technique, what bacteria is present?
- Staphylococcus aureus
- Enterococcus species
- Pseudomonas aeruginosa
When there is an Inadequate hand hygiene in bloodstream, what bacteria is present?
Coagulase
When there is an Improper intravenous fluid, tubing and site care technique, what bacteria is present?
- Staphylococcus aureus
- Enterococcus species
When there is an Inadequate hand hygiene in pneumonia, what bacteria is present?
Staphylococcus aureus
When there is an Improper suctioning technique, what bacteria is present?
- Pseudomonas aeruginosa
- Enterobacter species
Chain of reaction:
- Agent
- Reservior
- portal of exit
- mode of transmission
- portal of entrance
- susceptible host
2 types of transmission:
- direct transmission
- indirect transmission
involves the immediate and direct
transfer of microorganisms from
individual to individual through
touching, biting, kissing, or sexual
intercourse
direct transmission
_____ is also a form of
direct transmission but can occur
only if the source and the host are
within 1 m (3 ft) of each other.
Droplet spread
- 1m (3ft)
Sneezing, coughing, spitting,
singing, or talking can project
droplet spray into the conjunctiva or
onto the mucous membranes of the
eye, nose, or mouth of another
individual.
Must Read:
3 types of indirect transmission
- Vehicle-borne transmission
- Vector-borne transmission
- Airborne transmission
A _____ is any substance that serves as an intermediate means to transport and introduce an infectious agent into a susceptible host through a suitable portal of entry.
Vehicle
_____ (inanimate materials or objects), such
as handkerchiefs, toys, soiled clothes, cooking
or eating utensils, and surgical instruments or
dressings, can act as vehicles.
Fomites
A type of transmission where a vehicle is any substance that serves as an
intermediate means to transport and introduce
an infectious agent into a susceptible host
through a suitable portal of entry
Vehicle - borne transmission
A type of transmission where a vector is an animal or flying or
crawling insect that serves as an
intermediate means of
transporting the infectious agent.
Vector - borne transmission
A _____ is an animal or flying or
crawling insect that serves as an
intermediate means of
transporting the infectious agent.
Vector
_____, the residue of
evaporated droplets emitted by an
infected host such as someone with
tuberculosis, can remain in the air for
long periods.
Droplet nuclei
may involve
droplets or dust. Droplet nuclei, the residue of
evaporated droplets emitted by an
infected host such as someone with
tuberculosis, can remain in the air for
long periods. Dust particles containing the
infectious agent
Airborne transmission
Body area reservoirs for Microorganisms:
- Respiratory tract
- Urinary tracts
- Reproductive tract
- Blood
- Tissue
Intact skin and mucous membranes are the body’s first line of defense against
microorganisms. Normal secretions make the skin slightly
acidic; acidity also inhibits bacterial growth
Anatomic and physiological barriers
The dryness of the skin also is a deterrent to
bacteria. Bacteria are most plentiful in moist areas of
the body, such as the perineum and axillae
Anatomic and phyiological barriers
As entering air follows the
tortuous route of the passage, it comes in contact
with moist mucous membranes and cilia. These trap
microorganisms, dust, and foreign materials.
Nasal Passages
The _____ have alveolar macrophages (large phagocytes).
Lungs
______ are cells that ingest microorganisms,
dead cells, and foreign particles.
Phagocytes
The _____ regularly sheds mucosal epithelium
to rid the mouth of colonizers. The flow of saliva and
its partial buffering action help prevent infections.
Oral cavity
_____ contains microbial inhibitors, such as lactoferrin, lysozyme, and secretory IgA.
Saliva
The _____ is protected from infection by tears, which
continually wash microorganisms away and contain
inhibiting lysozyme
Eye
The _____ also has defenses against infection. The high
acidity of the stomach normally prevents microbial growth.
Gastrointestinal tract
The resident flora of the _____ helps prevent the
establishment of disease-producing microorganisms.
Large intestine
The _____ also has natural defenses against infection.
When a girl reaches puberty, lactobacilli ferment sugars
in the vaginal secretions, creating a vaginal pH of 3.5 to
4.5. This low pH inhibits the growth of many diseaseproducing microorganisms.
Vagina
The entrance to the ______ normally harbors many
microorganisms. Urine flushes out bacteria
urethra
______ is a local and
nonspecific defensive response of the
tissues to an injurious or infectious
agent
Inflammation
Five signs of inflammation:
- Pain
- Swelling
- Redness
- Heat
- Impaired function of the part
2 types of nonspecific defenses?
- Anatomical and physiologic barriers
- Inflammatory response
Injurious agents can be categorized as:
- Physical agents
- Chemical agents
- mircoorganisms
_____ include mechanical objects causing
trauma to tissues, excessive heat or cold, and
radiation.
Physical agents
______ include external irritants (e.g.,
strong acids, alkalis, poisons, and irritating gases)
and internal irritants (substances manufactured
within the body such as excessive hydrochloric acid
in the stomach).
Chemical agents
_____ include the broad groups of
bacteria, viruses, fungi, and parasites.
Microorganisms
A series of dynamic events is commonly referred to as
the three stages of the inflammatory response:
1st stage: vascular and cellular response
2nd stage: exudate production
3rd stage: reparative production
______ is produced, consisting
of fluid that escaped from the
blood vessels, dead phagocytic
cells, and dead tissue cells and
products that they release.
Exudate
The plasma protein _____
(which is converted to fibrin when
it is released into the tissues),
_____ (released by
injured tissue cells), and platelets
together form an interlacing
network to wall off the area and
prevent spread of the injurious
agent.
- fibrinogen
- thromboplastin
This involves the repair of injured
tissues by regeneration or
replacement with fibrous
tissue (scar) formation.
Reparative phase
_____ is the
replacement of destroyed
tissue cells by cells that are
identical or similar in
structure and function.
Regenaration
An _____ is a substance that
induces a state of sensitivity or
immune responsiveness (immunity). If the proteins originate in an
individual’s own body, the antigen is
called an _____
antigen
autoantigen
The immune response has 2
components:
- Antibody Mediated Defenses
- Cell Mediated Defenses
______ of the body involve
the immune system. An antigen is a substance that
induces a state of sensitivity or
immune responsiveness (immunity). If the proteins originate in an
individual’s own body, the antigen is
called an autoantigen.
Specific defenses
_____ (or circulating) immunity
because these defenses reside ultimately
in the B lymphocytes and are mediated
by antibodies produced by B cells.
Humoral
_____, also called
immunoglobulins, are part of the
body’s plasma proteins.
Antibodies
The ______ defend primarily against the extracellular
phases of bacterial and viral infections.
antibody-mediated responses
2 Major Types of Immunity
Active immunity
Passive immunity
A type of immunity where, The B cell may produce antibody molecules of
five classes of immunoglobulins designated by letters and usually written as IgM, IgG, IgA, IgD, and IgE.
Active immunity
A type of immunity where , the host receives natural
(e.g., from a nursing mother) or artificial (e.g.,
from an injection of immune serum) antibodies
produced by another source
Passive immunity
The ______, or cellular
immunity, occur through the T-cell system. On
exposure to an antigen, the lymphoid tissues
release large numbers of activated T cells into
the lymph system.
cell-mediated defenses
These T cells pass into the general circulation.
There are three main groups of T cells
- Helper T cells, which help in the functions of the immune system;
- Cytotoxic T cells, which attack and kill
microorganisms and sometimes the
body’s own cells; and - Suppressor T cells, which can suppress the functions of the helper T cells and the
cytotoxic T cells.
Factors Increasing Susceptibility to Infection:
- Age
- Heredity
- Level of stress
- nutritional status
- current medical therapy
- pre - existing disease process
Newborns and older adults
have reduced defenses
against infection.
Age
Influences the development of infection in that some individuals have a genetic
susceptibility to certain infections.
Heredity
Stressors elevate blood cortisol. Prolonged elevation of blood cortisol decreases inflammatory responses, depletes energy stores, leads to exhaustion, and decreases resistance to infection
Level of stress
Resistance to infection
depends on adequate
nutritional status
Nutritional status
Predispose a client to infection. Ex.
Radiation treatments for cancer destroy
not only the cancerous cells but also
normal cells making them vulnerable to
infection
Current medical therapy
Certain medications increase susceptibility to
infection. Ex. Anticancer medications may
depress bone marrow function resulting in inadequate production of white blood cells
Pre -exisiting disease process
The degree to which a client is at risk of developing an infection. Any client complaints suggesting the presence of an infection.
Nursing history
To identify clients at risk, the nurse
- reviews the client’s chart
- collect data regarding the factors influencing the development of infection like:
- existing disease process
- history of recurrent infections
- current medications
- therapeutic measures
- current emotional stressors
- nutritional status
- history of immunizations
Signs of systemic infection include the following:
- Fever
- Increased pulse and respiratory
rate if the fever is high - Malaise and loss of energy
- Anorexia and, in some situations,
nausea and vomiting - Enlargement and tenderness of
lymph nodes that drain the area of
infection
Types of exudate, this exudates indicate the damage of _____
- Serous
- Serosanguineous
- Sanguineous
- Purulent
Capillaries
Clear, thin, and watery fluid
Serous
Thin, watery, w/ light or pink hue
Serousanguineous
Bright red, fresh blood
Sanguineous
Thick, opaque, and odorous, build up from infection
Purulent
In laboratory data, Elevated leukocyte (white blood cell [WBC]) count (______ > mL3 ).
4500 to 11,000>mL3 is normal
Diagnosing, actual and potential problems:
- Risk for infection
- altered comfort
- ineffective coping
Patients with infections are at risk of complications. This diagnosis emphasizes the potential for
infection and the need for preventive measures.
Risk for infection
Infections often lead to discomfort and pain.
This diagnosis focuses on comfort measures and symptom
management.
Altered comfort
Dealing with an infection can be emotionally challenging. This diagnosis addresses the patient’s coping abilities.
ineffective coping
Major goals of planning:
- Maintain or restore defenses
- Avoid the spread of infectious
organisms - Reduce or alleviate problems
associated with the infection
A common skill which xxplain the proper technique for changing the dressing and disposing of
the soiled one. Reinforce the need to place contaminated dressings and
other disposable items containing body fluids in moisture-proof plastic
bags.
wound care
the use of antiseptics (agents that inhibit the growth of
some microorganisms) and disinfectants (agents that
destroy pathogens other than spores) and by sterilization.
Disinfecting and sterilization
the use of ______ (agents that inhibit the growth of
some microorganisms) and ______ (agents that
destroy pathogens other than spores) and by sterilization.
antiseptics
disinfectants
An ______ is a chemical preparation used on skin or
tissue.
antiseptic
A ______ is a chemical preparation, such as phenol or
iodine compounds, used on inanimate objects
disinfectant
______ destroys bacteria
Bactericidal preparation
______ prevents
the growth and
reproduction of
some bacteria.
Bacteriostatic preparation
_______ is a process that destroys all microorganisms, including spores and viruses.
Sterilization
Four commonly used methods of sterilization:
moist heat
gas
boiling water
radiation.
To sterilize with moist heat (such as
with an autoclave), steam under
pressure is used because it attains
temperatures higher than the boiling
point
Moist heat
Ethylene oxide destroys
microorganisms by interfering
with their metabolic processes.
It is also effective against
spores.
Its advantages are good penetration
and effectiveness for heat-sensitive
items.
Its major disadvantage is its
toxicity to humans.
Gas
This is the most practical and
inexpensive method for sterilizing
in the home.
The main disadvantage is that spores
and some viruses are not killed by
this method.
Boiling a minimum of 15 minutes is
advised for disinfection of
articles in the home.
Boiling
Both ionizing (such as alpha, beta, and xrays) and nonionizing (ultraviolet light)
radiation are used for disinfection
and sterilization. used effectively in
industry to sterilize foods, drugs, and other
items that are sensitive to heat.
Its main advantage is that it is effective for
items difficult to sterilize; its chief
disadvantage is that the equipment is very
expensive.
Radiation
are used in any situations involving blood; all body
fluids, excretions, and secretions except sweat;
nonintact skin; and mucous membranes (whether or not
blood is present or visible).
Standard / Universal precaution
Standard precaution includes:
- Hand hygiene;
- use of personal protective equipment
(PPE), which includes gloves, gowns,
eyewear, and masks; - safe injection practices;
- safe handling of potentially
contaminated equipment or surfaces in
the client environment; and - respiratory hygiene or cough etiquette
that calls for covering the mouth and
nose when sneezing or coughing,
proper disposal of tissues, and
separating potentially infected
individuals from others by at least 1 m
(3 ft) or having them wear a surgical
mask.
Used in addition to standard precautions for
clients with known or suspected infections that
are spread in one of three ways:
Transmission-based precautions
TRANSMISSION-BASED
PRECAUTIONS are by?
- by airborne
- By droplet transmission,
- by contact
The three types of transmission-based
precautions may be used alone or in
combination but always in addition to SP
- Airborne precautions
- droplet precautions
- contact precautions
Wear an ______ when entering the room of a
client who is known to have or suspected of having primary
tuberculosis. See the Practice Guidelines on using a
respirator mask.
N95 respirator mask
refers to measures designed to
prevent the spread of infections or
potentially infectious microorganisms to
health personnel, clients, and visitors.
Isolation
Category-specific isolation precautions use seven categories:
- strict isolation
- contact isolation
- respiratory isolation
- tuberculosis isolation
- enteric precautions, drainage and secretions precautions
- blood and body fluid precautions.
use seven categories: strict isolation, contact isolation, respiratory
isolation, tuberculosis isolation, enteric precautions, drainage and
secretions precautions, and blood and body fluid precautions.
Category-specific isolations
provide precautions for specific diseases. These precautions delineate
use of private rooms with special ventilation, having the client share a
room with other clients infected with the same organism, and gowning to
prevent gross soilage of clothes for specific infectious diseases.
Disease-specific isolation precautions
An object is sterile only when it is free of all microorganisms, it is practiced in operating rooms and special diagnostic areas.
Sterile technique
It is also used for many procedures in general care areas (such as when
administering injections, changing wound dressings, performing urinary catheterizations, and administering intravenous therapy).
Sterile technique
All objects used in a
sterile field must be
_____
sterile
Always check a package containing a sterile
object for :
- intactness
- dryness
- expiration date.
Always keep sterile gloved hands in sight
and ______; touch only
objects that are sterile.
above waist level
During a surgical hand wash, hold the hands ______ to
prevent contaminants from the forearms from reaching the hands.
higher than the elbows
______ represent biohazardous material. This is one of the main reasons that biohazard waste is referred to red bag waste. This is any medical waste that has been contaminated with blood or other potentially infectious materials.
- Blood and blood products
- Body fluids contaminated with - blood
- Sharps waste
- Personal protective equipment (PPE) that came into contact with blood or other potentially infectious materials
Red bins
______ are for trace amounts of chemotherapy waste. This can be any medical waste that came into contact with chemotherapeutic agents. clearly labeled as “CHEMO WASTE.”
- PPE that came into contract with chemotherapeutic agents
- IV bags or tubing used in the administration of chemotherapy drugs
- Sharps waste involved in chemo treatment
Yellow bins
_______ are for non hazardous pharmaceutical waste. This is any prescription or over the counter drug that goes unused. It is a good idea to use a sequestration device which prevents unauthorized access to pharmaceutical waste.
Pills
Injectables
Antibiotics
Blue bins
______ represent hazardous waste. Hazardous waste is any waste with the following characteristics: ignitability, corrosivity, reactivity, or toxicity.
Hazardous pharmaceuticals
Certain cleaning solvents
Radioactive waste
Black bins
