Module 2: infection Med Surg readings

Question 1

PPT: clinical presentation of infection. how does it differ from inflammation

Answer 1

Redness
Swelling
Pain
Warmth
Exudate

On the slides inflammation does not have exudate

Question 2

are all infectious diseases communicable?

Answer 2

no.

Question 3

an infectious disease is…

Answer 3

any disease caused by the growth of pathogenic microbes in the body

Question 4

?components of chain of infection

Answer 4

1. causative organism
2. reservoir
3. mode of exit (portal of exit)
4. route of transmission
5. susceptible host
6. portal of entry

Question 5

infection definition

Answer 5

a condition in which the host interact physiologicaly and immunologically with a microorganism

Question 6

whats the primary source of info about bacterial infections?

Answer 6

lab reports

Question 7

clinical evidence of infection

Answer 7

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

Question 8

?when the host interacts immunologically with an organism but doesnt have symptoms do they have an infectious disease?

Answer 8

no. Infectious disease is the state in which the infected host displays a “decline in wellness” due to infection

Question 9

colonization=

Answer 9

microorganisms present without host interference or interaction

Question 10

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

Answer 10

the smear and the stain because they describe the mix of cells present at the anatomic site at the time of specimen collection

Question 11

3 components of microbiology report

Answer 11

the smear the stain
antimicrobial sensitivity
the culture and organism identification

Question 12

?when to wash hands instead of using ABHR

Answer 12

visibly soiled
after toilet
norovirus
C diff

Question 13

?Airborne precautions used for

Answer 13

• Chickenpox
• TB
• Measles

Question 14

?what type of organism do you use contact precautions for?

Answer 14

c. difficile

Question 15

?antibiotic resistant organisms examples

Answer 15

MRSE, 
VRE, 
C DIFF also 
extended spectrum beta lactamase 
carbapenemase producers

Question 16

?C difficile

Answer 16

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

Question 17

?MrSA

Answer 17

MRSA
o	Resistant to methicillin
o	Healthcare assoc and community assoc
o	Fear its becoming VRSA
treat w vanomycin or linezolid

Question 18

?VRE

Answer 18

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

Question 19

without running tests, what can you assess to gain info to determine if the pt has an infection?

Answer 19

health history and physical exam

Question 20

when taking health hx what type of questions do you ask to obtain information about possible infection? (17)

Answer 20

• 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

Question 21

?generalized signs of chronic infection may include

Answer 21

-significant weight loss or pallor asso w anemia of chronic diseases

Question 22

acute infection may manifest w

Answer 22

fever
chills
lymphadenopathy
rash

Question 23

potential complications from infection

Answer 23

septicemia, bacteremia, sepsis
septic shock
dehydration
abscess formation
endocarditis
infectious disease related cancers
infertility
congenital abnormalities

Question 24

nurses role in teaching about the infectious process

Answer 24

• 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

Question 25

how should you monitor fever?

Answer 25

graph it to see the trends, it gives clues to infection severity, and whether it responds to therapy

Question 26

?what should you be alert for in the vital signs of someone with septic shock
what other 4 things should you monitor

Answer 26

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

Question 27

? who should you teach endocarditis prevention to (inflammation of the endocardium)

Answer 27

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)

Question 28

when is it best to give antibiotics

Answer 28

as early as possible

Question 29

?sepsis=

Answer 29

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.

Question 30

?symptoms of sepsis

Answer 30

the patient typically develops fever, tachycardia, tachypnea, and leukocytosis.

Question 31

Procalcitonin=

how is it used?

Answer 31

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.

Question 32

diagnostics for inflammation

Answer 32

• c-reactive protein
• WBC differential
• WBC count

Question 33

diagnostics for infection

Answer 33

White blood cell count
Differential
C-Reactive Protein
Procalcitonin
Identification of an organism
Gram stain
Culture

Question 34

describe culture and sensitivity

Answer 34

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).

Question 35

WBC differential

Answer 35

Differential:Neutrophils
pyogenic infections

Eosinophils
allergic disorders & parasitic inf’ns

Basophils
parasitic inf’ns &
some allergic disorders

Lymphocytes
viral infections

Monocyte
severe infections (phagocytosis)

Question 36

PPT:WBC count

Answer 36

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

Question 37

neutrophils inc in

Answer 37

Neutrophils

pyogenic infections

Question 38

eosinophils inc in

Answer 38

Eosinophils

allergic disorders & parasitic inf’ns

Question 39

\Basophils inc in

Answer 39

Basophils
parasitic inf’ns &
some allergic disorders

Question 40

lymphocytes inc in

Answer 40

Lymphocytes

viral infections

Question 41

monocytes inc in

Answer 41

Monocyte
severe infections (phagocytosis)