mi 116 unit 3 Flashcards
what are micoorganisms?
grow in or on a host organism and cause diseases known as infections
what is an infection ?
establishment and growth of a microorganism on or in a host
what go pathogens produce ?
high temperature, nausea, vomiting or shock
what are the four types of pathogens?
bacteria, virus, fungi and protozoa
bacteria
single celled organisms that grow in a colony
can be cocci, spheres, bacilli, rods or spiral shaped
strept throat, pneumonia, and food poisoning
virus
cannot live outside a living cell and depends on host cell
can lay dormant at times
rhinovirus, warts
fungi
much larger then bacteria
yeast and molds
athletes foot, ringworm, tinea nigra
medically important fungi are dimorphic
protozoa
larger then bacteria
live on or in other organisms and have motile functionality
can ingest foot particles
pinworms, tapeworms, malaria
STEPS to require a break through the host
encounter-entry-spread-multiplication-damage-outcome
what are the four factors involved with the spread of infection ?
a host, an infectious microorganism, a mode of transportation and a reservoir
if broken, the infection will cease at any point
where do microorganism thrive?
warm temperatures, darkness and moist areas
exogenously
from outside the body (can be direct or indirect)
endogenously
from inside the body (flora transported to a different area)
exogenously (indirect)
vector (vehicle) or a fomite (mechanical or biological)
exogenously (direct)
host to host
can be hand holding, coughing or sexual contact
vector
usually an arthropod
needs a microorganism to enter and exit the body
tick or insect
fomite
inanimate object that has been in contact with an infectious organism
food, water, latex gloves, etc
reservoir
site where an infectious organism can remain alive and from which transmission can occur
can be people, animals, insects or inanimate objects like food or dust
CHAIN of infection
infectious agents- reservoir- portals of exit-modes of transmission- portals of entry- susceptible host
HAIs
healthcare associated infections
-infections people acquire while they are receiving treatment in healthcare setting for another condition
-UTIs, surgical sit infection, pneumonia
nosocomial infection
hospital acquired infection
-5% of hospital patients acquire an additional condition while in the hospital
iatrogenic
infection that is a result of interventions with a physician
communicable diseases
HIV, HBV, flu, chicken pox, malaria, tuberculosis, polio
HIV
blood borne pathogen
infects the CD4 and T cells in the human host
hepatitis B
HBV, causes illness that primarily affects the liver
transmits through needle, penetrating injury and inmate contact
MDRO
multi-drug resistant organism
C-DIFF!!!
MRSA, VRE, ESBLs,PRSP, MDR
MRSA
methicillin resistant staphylococcus aureus
a lot of the times comes from open skin
comes from contact with infected objects or surfaces
VRE
part of the normal flora in the GI
capable of causes disease when it affects blood, urine, or wounds
large groups and resistant to a lot of drugs
resistant to normal hand washing
C-Diff
clostridium diffcile
bowel disease
spore forming bacterium that releases toxins into the bowel, resistant to disinfectants, easy to spread and frequent in the hospital
tuberculosis (TB)
recurrent, chronic disease caused by the spore-forming Mycobacterium, tuberculosis
mostly infects the lungs, communicable disease and treatable disease
how do you prevent disease transmission
wash your hands, get immunizations, get boosters, follow post exposure protocols
standard precautions
handwashing, gloves, PPE, Needle capping and biospills
all patients are potentially infectious
whats the most effective way to preventing infection spread?
handwashing
when should you use gloves?
any time a procedure or contact may include body fluids, blood, secretions, excretions, mucous membranes, non intact skin and contaminated items
sequence for donning PPE
gown first, mask, goggles then gloves
sequence for doffing PPE
gloves, goggles, gown, mask
transmission based precautions
airbone, droplet, contact
airborne
required N95 mask
pathogenic organisms that remain suspended in the air for long periods on aerosol droplets or dust
patients places in negative pressure isolation room
what types of conditions require a N95 mask (airbone)
TB, chickenpox, and measles
droplet
must be 3ft within a patient wearing a surgical mask
-infected with pathogenic organisms
contact
what types of conditions are droplet
rubella, mumps, flu, and adenovirus
contact
-need gloves, gown and possible face shield and bouffant
-a patient infected with a virulent pathogen that spreads by direct contact with the patient or by indirect contact w/ a contaminated object
what conditions are considered contact
staphylococcus aureus, hepatitis A, impetigo, varicella, and varicella zoster
gloves and gown rules
never leave outside patient room with “dirty gown” and “dirty gloves”
environmental precautions
bleached is used
must by soap and water for hand hygiene
compromised/ immunosuppressed
AKA neutropenic and protective precautions
-patient who is at increased risk for infection against contact with potential pathogens
we have to wear PPE
aseptic technique
can be used in all clinical settings
most of the time this is used in surgery and insertion of IV, catheters and drains
medical asepsis
performing a removal or destruction of material
surgical aspesis
used to prevent contamination of microbes and endospores before during and after surgery using sterile technique
sterilization
to control microorganisms we must have autocave steam under pressure, dry heat, gas and chemicals
disinfection
as many microorganisms as possible are removed from surfaces by chemical or physical means (boiling not always effective)
what procedures require sterile technique
angiography, arthrograms, hysterosalpinograms, x-ray in the oR and myelograms
sterile field
do not reach across a sterile field, must be more than one inch border, use sterile drape
OR zones
zone 1unrestricted, may enter in street clothes
zone 2- semi-restricted , only person I scrubs and hair and shoes covered may enter
zone 3-restricted, like zone 2 + mask
sterile gowning
only sleeves and front of gown down to waist are considered sterile
what is sterile during a sterile procedure
anything blue
patient, table and other furniture covered with sterile drapes, personnel wearing sterile attire
dressing changes
must be ordered by a physician, wear gown if wound in patient, wash hands before beginning, ensure privacy, remove adherence tape from dressing, remove dressing with triceps or gloves hands, wrap dressing and places in plastic bag
skin preparation
circle motions, inside to out
urinary catheters
insertion of a tube the bladder using aseptic technique
foley and straight
used to empty bladder, relieve retention, irrigate the bladder
foley
has a balloon which is filled with sterile water to hold the catherter in place
straight
no balloon and used for short term/quick drainage
non aspetic techniques
Ng tubes, male urinals, bedpans, enemas, colostomies
barium enema
have patient in Sims position, lubricate enema tip, instruct patient to exhale, insert to umbilicus
enema tip
non sterile
endotracheal tubes
always associated with intubation
used for inadequate breathing, inadequate arterial oxygenation, severe airway obstruction, shock, parenchymal diseases that impair gas exchange, etc
placement
distal tip of the tube should be 1-2 inches above the tracheal bifurcation, usually done through mouth or nose, cuff inflated with air and placed at mid trachea; pediatric tube does not have cuff
complications with tube placement
most common misplacement is intubation of the right main bronchus; wider than left main bronchus and straighter than left main bronchus; tube may not be placed far enough; erosion of tracheal mucosa due to cuff trauma
chest tubes
used to drain the intrapleural space and the mediastrunum (air and fluid)
how lungs work
negative pressure is needed to explain the lungs and when liquid or air is in the pleural cavity, the lungs cannot expand
nasogastric/ nasointestinal
patients cannot drink or eat with this
used to administration of medication, gastric decompression and removal of flatus and fluids from the stomach
levin
single lumen is one line
most commonly used
when is suction needed
excessive vomiting and unable to change position on their own; gurgling sounds
suctioning in an emergency
suctioning is not in our scope of practice
tracheostomies
used when theres an obstruction and we have to enter through a different way
complications of central venous lines
one third of CVC lines places incorrectly
central line inserted on the right side should never corss the midline,left side needs to cross the midline and distal tip should not go bas SVC
tissue drains
drain every 24 hours unless filled before hand
ileostomy
surgical opening in the small intestine for colitis
colostomy
surgical opening in the large intestine for various disorders
ureteroilstomy
section at the end of the small bowl that is surgically removed and relocated as a passageway for urine to pass form the kidneys
