Medical Asepsis/Routine Precautions Flashcards
explain infection and chain of infection
=>microorganism =>reservoir => portal of exit =>
route of transmission => portal of entry to host => susceptibility of host =>
and around and around and around
what is the most important procedure to break the chain of infection?
Hand Hygene
What microorganisms are considered infectious agents?
Bacteria, Virus, Parasites, Fungus
The potential for microorganisms to cause disease depends upon:
the health and condition of patient, age, immune status, heredity, level of stress, smoking, nutrition
explain when resident skin micro-organisms can be pathogenic
an imbalance between microorganisms and defenses.
highly virulent, microbial load is greater than available defences
compromised defence mechanisms (skin fissures, aids etc)
why do you dry your hands from fingers to wrists
keeps your hands cleanest - as you move up your arms microorganisms get on the towel
What is a reservoir and what is the most common reservoir?
a reservoir is the place where a microorganism resides.
the most common is human
other are plants, animals, or general environment
example of Aerobic organism
staphylococcus species (bacteria)
examples of Anaerobic organism
Clostridium tetani - causes tetnus
modes of transmission for microorganisms
direct, indirect, droplet, airborne, vehicle borne
resident vs. transient microorganisms
resident: normally resides on the skin
transient: attatches to the skin when there is direct contact with another person
nosocomial or exogenous infection
source is outside the host and results from a healthcare setting
disinfection
elimination of all pathogens except bacterial spores
contamination
process by which an object becomes unclean or contaminated
sterilization
procedure that completely eliminates ALL microorganisms
Asepsis
the absence of pathogenic organisms
How do you protect a susceptible host against infection
maintain integrity of skin and moist mucous membrane in nasal passages oral hygene high acidity of stomach resident flora of large intestine urine flow thorugh uretha low PH of the vagina ensure a balanced diet educate importance of immunizations
Ways to reduce transmission of infection
change dressings and bandages
skin and oral health
disposing of damp, soiled linens appropriately
disposing of fecal matter and urine appropriately
cover and cap all fluid containers
empty suction and drainage bottles
clinical signs of infection
inflammation & redness swelling pain purulent exudate (pus) fever elevated leukocyte count (WBC)
specific body defenses against infection
active autoimmunity - antibbodies produced in response to antigens
passive autoimmunity - antibodies produced by another source and transfered to host
causes of endogenous infections
resident flora becomes altered and leads to overgrowth
examples of airborn infections
PPE required
tuberculosis, measles, varicella, rubeola
hepa filter mask, gown, gloves, hairnet, googles
NEGATIVE PRESSURE room/private room
door closed at all times
examples of droplet infections
PPE required
Meningitis, pertussis, diphtheria, influenza, pneumonia
Mask within 1m of client, handwashing
Private room or with same infection clients
door closed unless farther than 1m from bed
examples of contact infections
PPE required
MRSA, VRE, Scabies, Impetigo, C. Difficile
gown and gloves when in contact with infected area or equipment or giving direct personal care
Single room/open door
only share with clients with same infection
define active immunity pg 959
host produces its own antibodies in response to natural antigens or artificial antigens
what are the additional PPE & precautions in infection control for airborne
airborne: place the client in a private room with negative airpressure. 6-9 air changes/hr. keep door closed. place with another client who has same pathogen. wear an N95 respirator for tuberculosis. non-immune persons should not enter the room of a client who has rubella or varicella.
place a mask on client if having to move outside of room. perform hand hygiene after removing respirator
additional PPE & precautions for droplet
place client in private room or with another person suffering from same pathogen. wear a mask, eye protection within 1-2 m of client. place surgical mask on client if they have to move outside or foorm
Hand hygiene after removal of PPE
additional PPE & contact precautions
private room or same pathogen as other person
wear gloves if touching infectious material. remove them and dispose prior to leaving the room. preform hand hygiene. Wear gown and remove prior to leaving the room. Limit movement of client outside of room. dedicate the use of noncritical care equipment to a single client. clean before using on another client.
Alcohol-bases hand rub (ABHR)
kills microorganisms on the hand and more effective than soap and water in reducing hand contamination. REmoves transient microorganisms but not resident flora. Eventually you will need to use soap and water
Antibodies or immunoglobulins
part of the body’s plasma proteins. b lymphocytes are activated when they recognize an antigen. They differentiate into plasma cells which secrete antibodies that bind to antigens to neutralize the virus or toxin or they opsonization (coate) bacterial cells to make them more attractive to leukocytes.
antiseptic
is a chemical preparation used on skin or tissue to cleanse it to reduce the number of microorganisms.
antiseptic technique
is the clean technique where clean denotes the removal of most but not all microorganisms
cicatrix
a scar left after healing
cytokenisis
the release of chemical mediators into the bloodstream in response to leukocytosis and the presence of a pathogen.
exudate production
the second stage of the inflammatory response after cytokenisis. exudate is pus filled with white blood cells.
A patient is a chronic carrier of an infection. to prevent the spread of the infection to other patients or health care providers, the nurse emphasizes interventions that do which of the following:
a. eliminate the reservoir
b. block the portal of exit from the reservoir
c. block the portal of entry into the host
d. decrease the susceptibility of the hoast
b. block the portal of exit from the reservoir
The most effective nursing action for controlling the spread of infection includes which of the following?
a. Performing hand hygiene before and after client contact
b. Wearing gloves and masks for all client care
c. Implementing isolation precautions
d. Administering broad-spectrum prophylactic antibiotics
a. Performing hand hygiene before and after client contact
In caring for a patient on contact precautions for a draining infected foot ulcer, the nurse should perform which of the following?
a. Wear a mask during dressing changes.
b. Provide disposable meal trays and silverware.
c. follow routine practices in all interactions with the patient.
d. Use aseptic technique for all direct contact with the patient.
c. Follow routine practices in all interactions with the patient
When caring for a single patient during one shift, it is appropriate for the nurse to reuse which of the following PPE?
a. goggles
b. Gown
c. Surgical Mask
d. clean gloves
a. Goggles
While donning sterile gloves (open method), the cuff of the first glove rolls under itself about .5 cm. Which is the BEST action for the nurse?
a. Remove the gloves and start over with a new pair.
b. Wait until the second glove is in place and unroll the cuff with the other sterile hand.
c. ask a colleague to assist by unrolling the cuff.
d. Leave the cuff rolled under
d. Leave the cuff rolled under
Which of the following statements by a 69 year old client with no major health problems requires further teaching?
a.
I need to make sure that I get my flu shot at least every two years?
b.
I don’t think I need to get vaccinated agains Hep A unless I plan on doing some travelling to risky areas
c. I had one dose of vaccine against pneumonia when I turn 65 so I think I am fine with that.
d. I had chickenpox when I was a child so I don’t think I need that new vaccine.
a. I need to make sure I get my flu shot at least every two years
The nurse has taught a client and family general infection prevention strategies. Which of the following statement by the client indicated effective learning has occurred?
a. We will use antimicrobial soap and hot water to wash our hands at least three times per day
b. We must wash or peel all raw fruits and vegetables before eating
c. A wound or sore is not infected unless we see it draining pus
d. We should not share toothbrushes but it is OK to share towels and washcloths.
b. We must wash or peel all raw fruits and vegetables before eating
Which of the following areas are considered sterile on a person in the operating room? Assume that all articles were sterile when applied.
a. teh chest area of the surgeon’s sterile gown
b. the back area of the surgeon’s sterile gown
c. the sterile face mask on the surgeon’s face
d. the full arm of the surgeon’s gown
a. the chest area of the surgeon’s sterile gown.
The nurse determines that a field remains sterile if which of the following conditions exist?
a. the tips of wet forceps are held upward when held in un-gloved hands
the field was set up 1 hour before the procedure
c. sterile items are kept at least 5 cm from the edge of the field
d. The nurse reaches over the field rather than around the edges.
c. sterile items are kept at least 5 cm from the edge of the field.
sue and Mary are coworkers who have desks beside each other and share a telephone. Sue comes to work with a cold. She is tired, has a low-grade fever, and is sneezing frequently. What can sue do to minimize the risk that Mary will develop the same respiratory infection?
a. She should stay a minimum of 0.5 m away from Mary
b. she should take an antipyretic agent to lower her fever
c. She should sneeze into a tissue or her sleeve
d. she should not come to work if the symptoms do not subside within 2 days.
c. She should sneeze into a tissue or her sleeve.
type of airborne infections, facts
Tuberculosis, Measles, Varicella (chicken pox), Rubeola
Airborne travels 9 feelt
Can be transmitted on uniform
type of droplet infections & facts
Meningitis, Pertussis, Diptheria, Influenza, Pneumonia
Viruses suspended in air for short time through coughing, sneezing or talking
types of contact infections & facts
MRSA, VRE, Scabies, Impetigo, c. Difficile
MRSA Mircroorganisms live 20 minutes on objects
VRE - up to 9 months
Room will be double cleaned upon discharge.
