Module 2: infection Med Surg readings Flashcards
PPT: clinical presentation of infection. how does it differ from inflammation
Redness Swelling Pain Warmth Exudate
On the slides inflammation does not have exudate
are all infectious diseases communicable?
no.
an infectious disease is…
any disease caused by the growth of pathogenic microbes in the body
?components of chain of infection
- causative organism
- reservoir
- mode of exit (portal of exit)
- route of transmission
- susceptible host
- portal of entry
infection definition
a condition in which the host interact physiologicaly and immunologically with a microorganism
whats the primary source of info about bacterial infections?
lab reports
clinical evidence of infection
redness, heat, pain and lab evidence of WBCs on the wound specimen smear.
Infection is recognized by the host reaction as well as the lab evidence
?when the host interacts immunologically with an organism but doesnt have symptoms do they have an infectious disease?
no. Infectious disease is the state in which the infected host displays a “decline in wellness” due to infection
colonization=
microorganisms present without host interference or interaction
as markers for the likelihood of infection what markers generally provide the most helpful information and why?? not lab tests but part of microbiology report
the smear and the stain because they describe the mix of cells present at the anatomic site at the time of specimen collection
3 components of microbiology report
the smear the stain
antimicrobial sensitivity
the culture and organism identification
?when to wash hands instead of using ABHR
visibly soiled
after toilet
norovirus
C diff
?Airborne precautions used for
- Chickenpox
- TB
- Measles
?what type of organism do you use contact precautions for?
c. difficile
?antibiotic resistant organisms examples
MRSE, VRE, C DIFF also extended spectrum beta lactamase carbapenemase producers
?C difficile
C difficile
o Spore forming bacterium-freq cause of HA diarrhea.
o Usually preceded by antibiotic use that disrupts the usual intestinal flora
o Spread fecal-oral
o Treat w vancomycin often. Or new fecal transplants
?MrSA
MRSA o Resistant to methicillin o Healthcare assoc and community assoc o Fear its becoming VRSA treat w vanomycin or linezolid
?VRE
VRE
o Gram positive bacteria that live in the GI tract and commonly found in env
o May be colonized but not have symptoms considered infected once symptoms present
o Tx with penicillin formulation
without running tests, what can you assess to gain info to determine if the pt has an infection?
health history and physical exam
when taking health hx what type of questions do you ask to obtain information about possible infection? (17)
- vaccinations
- occupation
- hobbies
- travelling
- sex hx
- substance use hx
- insects/animals/farms
- past hx of infectious disease
- fever
- cough
- TB? tests exposure etc
- pain
- edema
- dirrhea, vomiting, abdominal pain
- rash
- exposure to others
- meds-antibiotics-corticosteroids, immunosuppressants-chemo
?generalized signs of chronic infection may include
-significant weight loss or pallor asso w anemia of chronic diseases
acute infection may manifest w
fever
chills
lymphadenopathy
rash
potential complications from infection
septicemia, bacteremia, sepsis septic shock dehydration abscess formation endocarditis infectious disease related cancers infertility congenital abnormalities
nurses role in teaching about the infectious process
- encourage immunizations to parents, immunocompromised, older adults over 65, disabled or chronically ill, those in nursing homes
- may be duty to report cases of infection to public health agencies
- get vaccinated
- teach to take accurate fever measurements
- educate about prevention
how should you monitor fever?
graph it to see the trends, it gives clues to infection severity, and whether it responds to therapy
?what should you be alert for in the vital signs of someone with septic shock
what other 4 things should you monitor
fever, tachycardia, tachypnea, evidence of dec perfusion or dysfunction of vital organs in the form of 1-change in mental status 2. hypoxemia (ABG) 3. elevated lactate levels 4. urine output less than 30ml/hr
? who should you teach endocarditis prevention to (inflammation of the endocardium)
pts with: -valvular disease -congenital heart disease -intracardiac prosthesis -previous endocarditis (these people are at risk of seeding of the cardiac valves during procedures that can cause bacteremia)
when is it best to give antibiotics
as early as possible
?sepsis=
Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body.
?symptoms of sepsis
the patient typically develops fever, tachycardia, tachypnea, and leukocytosis.
Procalcitonin=
how is it used?
Procalcitonin (PCT) is a peptide precursor of the hormone calcitonin.Procalcitonin (PCT) is a highly specific marker for the diagnosis of clinically relevant bacterial infections and sepsis. It doesnt elevate significantly with viral infections. If elevated more than 2 nanograms/ml it should be sepsis.
diagnostics for inflammation
- c-reactive protein
- WBC differential
- WBC count
diagnostics for infection
White blood cell count Differential C-Reactive Protein Procalcitonin Identification of an organism Gram stain Culture
describe culture and sensitivity
Culture and Sensitivity. A culture is done to find out what kind of organism (usually bacteria) is causing an illness or infection by looking at size, shape, and color using gram stain and microscope. Culturing can also enable a bacterial count to be made, which can assist in deciding whether a wound is colonised or infected.
A sensitivity test checks to see what kind of medicine, such as an antibiotic, will work best to treat the illness or infection. If the organism grows up to a disc it is resistant to that antibiotic; if there is a clear zone around the disc it is susceptible. This can confirm a patient is on the correct treatment or not and can further help with identification e.g. methicillin-resistant Staphylococcus aureus (MRSA).
WBC differential
Differential:Neutrophils
pyogenic infections
Eosinophils
allergic disorders & parasitic inf’ns
Basophils
parasitic inf’ns &
some allergic disorders
Lymphocytes
viral infections
Monocyte severe infections (phagocytosis)
PPT:WBC count
Complete count is both diagnostic and prognostic. It will be elevated in infection, inflammation, tissue necrosis, and (leukemic neoplasia). If very decreased indicates bone marrow failure.
Lifespan of WBC is 13-20 days
Destroyed by lymphatic system, excreted in feces
neutrophils inc in
Neutrophils
pyogenic infections
eosinophils inc in
Eosinophils
allergic disorders & parasitic inf’ns
\Basophils inc in
Basophils
parasitic inf’ns &
some allergic disorders
lymphocytes inc in
Lymphocytes
viral infections
monocytes inc in
Monocyte severe infections (phagocytosis)
