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BSNC 3000 > Module 6 - Infection > Flashcards

Module 6 - Infection Flashcards

1
Q

External Risk Factors

A

operating room (ventilation, sterilization)
contaminated equipment
improper hand hygiene

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2
Q

Procedural Risk Factors

A

infection at remote site not treated prior to surgery
inappropriate antimicrobial prophylaxis & skin prep (shaving vs. clipping)
improper technique (sterile field, foreign bodies)
contaminated hardware

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3
Q

Patient Risk Factors

A

immunocompromised

diabetes

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4
Q

5 W’s of infection

A 
wind - lungs/GIT
water - urinary
wings - limbs/hardware/tubes/lines/drains
wound - incision
wonder drugs - corticosteroids
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5
Q

Types of antibiotics

A

naturally derived

synthetically derived

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6
Q

Antibiotics

A

drugs that kill bacteria

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7
Q

Antimicrobials

A

any drug that targets microbes other than bacteria

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8
Q

Antibiotic MOA

A

bacteriostatic or bactericidal

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9
Q

Bacteriostatic

A

slows bacterial growth

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10
Q

Bactericidal

A

kills bacteria

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11
Q

Narrow spectrum abx

A

work on a subset of bacteria

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12
Q

Broad spectrum abx

A

work on a range of bacteria

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13
Q

Beta-lactam drugs (cell wall inhibitors)

A

penicillins
cephalosporins
carbapenams
monobactams

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14
Q

Other cell wall inhibitors

A

vancomycin

bacitracin

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15
Q

Mechanisms of microbial resistance

A

1) decreased penetration
2) increased enzymatic degradation/modification
3) alteration of target site
4) increased efflux (removal)

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16
Q

Lactam drugs mechanism of resistance

A

beta-lactamase breaks down the lactam ring

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17
Q

Multidrug resistance

A

bacteria develop molecular pumps to actively remove antibiotics out of cell

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18
Q

VRE mechanism of resistance

A

alter peptidoglycan synthesis so that antibiotic does not bind

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19
Q

MRSA mechanism of resistance

A

uses altered PBP so B-lactam can’t bind

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20
Q

Factors promoting bacterial resistance

A

1) fast evolution
2) bacteria can share DNA
3) antibiotic overuse –> increase abx resistant strains

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21
Q

Nursing antibiotic stewardship

A

1) reduce need for abx –> hygiene, vaccines, safe sex
2) validate infections before beginning abx treatment
3) use abx exactly as prescribed –> complete entire regiment
4) patient reassessment within 48 hrs

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22
Q

How long after abx should a pt be reassessed?

A

48 hrs

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23
Q

Most common bacteria causing UTI

A

Uropathogenic e. coli

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24
Q

Uncomplicated UTI risk factors

A

female gender
older age
younger age

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25
Q

Complicated UTI risk factors

A

indwelling catheters
immunosuppression
UTI abnormalities
abx exposure

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26
Q

Mechanisms of UTI infection

A

1) fecal bacteria (ascending)
2) sexual contact
3) contaminted diaphram/birth control
4) can occur from the blood

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27
Q

Recurrent UTI MOA

A

once uropathogenic enter the urethra they can colonize the epithelium –> recurrent infection

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28
Q

Estrogen & Immunity

A

estrogen promotes production of glycogen
lactobacilli digest glycogen –> lactic acid + bacteriocidal compounds
lactic acid = reduce urethral pH
bacteriocidal = kills bacteria

29
Q

UTI Risk Factors

A 
obstruction
reflux 
congenital abnormalities
female sex
menopause 
urinary retention/urinary stasis 
neurologic abnormalities
immunosuppression
catheterization / cystoscopy 
inflammation/abrasion of urethral mucosa
diabetes --> hyperglycemia
prostate disorders
30
Q

Factors causing urinary retention/stasis

A

diverticulitis
bladder tumors
contracture of bladder neck

31
Q

Urine collection steps

A

collect adequate amount 10-20 cc PRIOR to abx therapy
use a sterile container –> label
use aseptic technique –> clean catch, foley catheter
transport promptly to lab or fridge

32
Q

Direct analysis of pathogen

A

phenotype
genotype
serotype

33
Q

Indirect analysis of pathogen

A

serology –> look for specific antibodies made in response to infection

34
Q

Microscopic tests

A

gram stain

35
Q

Biochemical test

A

catalase enzyme

36
Q

Growth conditions

A

O2 requirement of bacteria

aerobic vs. anaerobic

37
Q

Elevated neutrophils

A

acute bacterial infection

38
Q

Elevated lymphocytes

A

viral infection

39
Q

Elevated eosinophils

A

allergic/parasitic infection

40
Q

Elevated basophils

A

food allergy

41
Q

Immature granulocytes

A

leukemia/lymphoma

42
Q

Lab tests for UTi

A

Urine dipstick
Microscopy
Culture & Sensitivity

43
Q

What does a urine dipstick measure

A

leukocyte esterase –> indicates WBC in urine

nitrites –> bacterial byproduct

44
Q

Pyuria

A

presence of WBC in urine

>5-10

45
Q

Hematuria

A

presence of blood in urine

46
Q

How long does a C&S take

A

2-3 days

47
Q

Systemic S/S of infection

A

fever
hypotension
fatigue

48
Q

UTI Classification

A

upper vs. lower
complicated vs. uncomplicated
acute, chronic, recurrent

49
Q

Upper UTI

A

kidneys

ureters

50
Q

Lower UTI

A

bladder

urethra

51
Q

Urinalysis components

A 
colour
specific gravity
pH
blood
protein
glucose
nitrite
leukocyte esterase
bacteria
WBC
52
Q

Antibiotic patient education

A 
take full dose, complete entire regimen
may need to take with food (GI upset)
may cause adverse fx 
follow prescription orders carefully
report any adverse fx to your doctor
53
Q

Common adverse fx of antibiotics

A 
nausea/vomiting
diarrhea
rash
urticaria
photophobia
fever
chills
54
Q

UTI Prevention

A 
increase fluids (2L daily)
void frequently (every 2-3 hrs)
proper hygiene (wipe front to back)
void after intercourse
drink cranberry/blueberry juice
55
Q

Immune defenses

A 
washout phenomenon
antibacterial enzymes
antibodies (IgA)
antiadherent fx of mucosal cells 
ureterovesicle junction (prevent reflux)
bladder mucin layer (water barrier)
prostate secretions 
normal bacterial flora of urethra
56
Q

Washout phenomenon

A

urine sweeps away bacteria in the urethral tract

57
Q

Urinary reflux

A

occurs when urine backflows from urethra –> bladder or bladder –> kidneys

58
Q

What causes urinary reflux?

A

sudden increase in intra-abdominal pressure
suddenly stopping urinary stream
common in children

59
Q

Routes of infection

A

ascending (most common)
thru bloodstream
fistula form intestine

60
Q

S/S of lower UTI

A 
pain
burning on urination
frequency
urgency
nocturia
incontinence
suprapubic/pelvic pain
hematuria
61
Q

S/S of upper UTI

A 
flank pain (costovertebral palpation)
chills
fever
N/V
headache 
malaise
painful urination
62
Q

S/S of UTI in Older Adults

A 
fatigue
delirium
sudden onset confusion
altered sensorium 
anorexia
new incontinence
hyperventilation
low grade fever
63
Q

Urine characteristics

A 
volume
color
concentration
cloudiness
odour
64
Q

Strategies to reduce CAUTI

A

aseptic technique
use smallest catheter possible
secure catheter w/ tape to prevent movement/irritation
inspect urine
daily perineal care
maintain closed system (foley catheter bag)

65
Q

Normal PVR

A

50-100 mL

66
Q

Types of urinary obstruction

A

functional

mechanical

67
Q

Mechanical urinary obstruction

A

renal/ureteral calculi
BPH
pregnancy
malformation of ureterovesical junction

68
Q

Functional urinary obstruction

A 
neurogenic bladder
decreased voiding
detrusor instability (anticholinergic drugs)
constipation

BSNC 3000 (11 decks)

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