NUR 118 - Lect. #1 Body Defense / Infect. Process Flashcards

1
Q

NUR 118 - Define Infection

A

Invasion of pathogens in the body

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2
Q

NUR 118 - Factors that increase risk of infection

A
  • Age
  • Stress
  • Poor diet
  • Medications (steroids)
  • immune deficiency disease (cancer)
  • Travel
  • Substance abuse
  • Skin breakdown
  • Invasive surgeries
  • Living/work environment
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3
Q

NUR 118 - Factors that decrease risk of infection/Support host defenses

A

Proper nutrition, hygiene, rest (reduce stress), exercise, immunization,

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4
Q

NUR 118 - What are Healthcare Associated Infections (HAIs) vs Nosocomial infections?

A

HAIs - Infections that patients contract in any healthcare setting
Nosocomial - Hospital acquired infection
- Ex: Urinary catheters, not removed or poorly managed; CENTRAL LINES - IMPROPER MANAGEMENT THAT LEADS TO A BLOODSTREAM INFECTION

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5
Q

NUR 118 - Name and define the six links in order

A

1) Infectious Agent - the source; pathogens
2) Reservoir - Where pathogens live and multiply
3) Portal of EXIT - How the pathogen “exits”; ex: Coughing, sneezing, IV lines
- skin to skin, skin to surface, blood
4) Mode of Transmission - Contact, direct (airborne, droplet contact), or indirect (w/ a fomite: contaminated equipment, vectors, water)
5) Portal of Entry - Normal body openings: Eyes, mouth, vagina, nose
Abnormal body openings: Wounds, scrapes, IVs, incisions
6) Susceptible Host - Person with inadequate defense; ex: elderly, young, immunocompromised

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6
Q

NUR 118 - Name and define the stages of infection in order

A
  • Incubation – Time of infection/entry
  • Prodromal – Vague signs & symptoms
  • Illness – Obvious signs & symptoms; can end in death if not treated
  • (Pathogenic) Decline – Number of pathogens decline; signs & symptoms
  • Convalescence – Tissue repair; return to health; # of microorganisms reach zero
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7
Q

NUR 118 - Classifications of Infections - Location

A

Local – Occurs in a specific region of the body
- location determines signs & symptoms
Ex: skin, bladder, lung

Systemic – When pathogens invade the blood or lymph and spread through the body
- Starts as a local infection
Sepsis – Systemic infection spread via blood
–> Blood poisoning, tissue damage, shock, death

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8
Q

NUR 118 - Classification of Infection by Duration

A

Acute - Rapid onset of short duration
Ex: common cold

Chronic: slow development, long duration
Ex: Hepatitis B and C, long COVID

Latent – Infection present with NO discernible symptoms
Ex: HIV/AIDS, Tuberculosis, shingles

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9
Q

What is the function of the Primary (Immune) Body Defenses?
List examples

A

Function: Prevent organisms from entering body
- Normal Flora
- Skin (intact, healthy = prevents pathogen entry)
- Eyes: Lysozymes in tears
- Mouth: Lysozymes in saliva
- GastroIntestinal (GI): Acidity, bile, vomiting
- GenitoUrinary (GU): Mucus membrane, vaginal acidity & lysozymes in urine

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10
Q

What are Endogenous vs Exogenous infections?

A

Endogenous - ​Infection caused from inside the patient, when the patient’s normal flora is altered
Exogenous - Infection caused from a source outside the patient

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11
Q

What is the function of Secondary Body Defense?
List examples

A

Function: Protective biochemical processes that fight pathogen that enter, chemically activated when pathogens get past primary

Phagocytosis - Special WBC attack&kill pathogens (WBC count > 10,000; normal count 4,500-10,000)

Complement Cascade - Chemicals attack pathogen, histamine released = triggers inflammation

Inflammation - Histamine released from damaged cells, blood vessels dilate (assess: redness, warm to touch, edema, pain)

Fever - Rise in core body temp = increases metabolism, inhibits pathogens

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12
Q

What is the function of Tertiary body defense?
List examples

A

Function: Body builds immune memory

Natural active - after becoming ill with infection; body makes its own antibodies to protect from pathogens

Natural Passive - Antibodies from someone else/one body to another; ex: placenta, breast milk

Artificial active - Immune response from artificial exposure from vaccines; Body makes antibodies to block illness development

Artificial Passive - Serum/injection from another person or animal with antibodies; ex: rabies, botulism

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13
Q

What is Medical Asepsis?

A

“Clean Technique”
Practices & Procedures that REDUCE number of microorganisms to decrease spread of infection
- Microorganisms exist everywhere except sterile objects
Best method = handwashing

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14
Q

What is Surgical Asepsis?

A

“Sterile Technique”
Practices/Procedures to eliminate ALL microorganisms & spores
Sterilization of equipment required

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15
Q

What are the principles of surgical asepsis?

A
  1. Sterile object remains sterile only when touched by another sterile object
  2. Only sterile objects can be placed on sterile field
  3. Sterile object/field out of range of vision, held above head or below waist is contaminated
  4. Sterile object/field is contaminated from prolonged exposure to air
  5. When sterile surface/field comes in contact with wet, contaminated surface, the sterile object/field is contaminated by capillary action
  6. Fluid flows in the direction of gravity
  7. Edges of sterile field/container are contaminated. 1 inch around sterile field.
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16
Q

What is standard precauations?

A
  • What applies to every patient in all settings
  • Utilize PPE (Personal protective equipment)
  • Assume all blood, body fluids, secretions, opens skin & mucus membranes may contain pathogens
  • Respiratory hygiene + cough etiquette
  • Gloves for contact with fluids/opening
  • Gown and goggles for splashing
17
Q

Define Contact precautions: Patient placement/transport, PPE, diseases

A

Placement/transport: Private room/cohort, limit patient transport
PPE: gloves and gown
Diseases:
Clostridium Difficile (C-Diff)
Methicillin resistant staphylococcus aureus (MRSA)
Vancomycin Resistant Enterococcus (VRE)
Extended Spectrum beta-lactamase (ESBL)

18
Q

Define droplet precautions: Particle size, pt placement/transport, PPE, Diseases

A
  • Larger/heavier particles, >5 microns, travels 3-6 feet
    Patient placement/transport: Private room/cohort, wear surgical mask on transport
    PPE: surgical mask
    Diseases: IMMMPS
    Influenza (flu)
    Mumps
    Meningitis
    (German) Measles
    Pertussis (whooping cough)
    Streptococcus (Strep throat)
19
Q

Define airborne precautions: Particle, pt placement/transport, PPE, diseases

A
  • Small aerosolized particles, travel over 6 feet
    PPE: Fitted N95 respirator mask
    Placement/Transport: Private, negative air pressure room, 6-12 gas exchanges per hour; only transport pt if necessary, pt wear surgical mask
    Diseases: MTV-C-SARS
    Measles (Rubeola)
    Tuberculosis
    Varicella (Chicken Pox OR Herpes Zoster = Shingles)
    COVID
    SARS
20
Q

Why and how is protective isolation used?

A

Why: For immunocompromised pts to protect from organisms
How:
-No fresh fruits/veggies, plants/flowers, standing water
-PPE for staff/visitors: hand hygiene, gloves, gowns, mask
-Patient specific equipment or clean equipment

21
Q

How do nurses contribute to asepsis?

A

-Hand hygiene
-Standard precautions
-Implement Transmission/isolation precautions (contact, droplet, airborne, reverse)
- Proper PPE
-Medical/surgical asepsis principles

22
Q

Nursing interventions that promote wellness and support host defenses
(Think general, easy interventions)

A

Hand hygiene
Med + Surg Asepsis
Precautions and PPE
Monitor VS q4h (every 4 hours)
Reduce stress
Maintain skin integrity - Turn/position q2h, keep dry

23
Q

Nursing Assesment ADPIE: A

A
  • Take a history & perform physical assessment

History: information r/t (related to) risk for infection, exposure to pathogens, interact with sick person, travel outside country, unprotected sex, current meds
- Source can be: patient, family, medical record

Physical assessment:
General appearance - Fatigue, chills, well nourished
Skin - Turgor (elasticity), intact/breaks, signs of local infections
Palpation - Swollen lymph nodes, skin (dry/moist & hot/cold)
V/S - Temp >100.4, Heart rate >100
Labs - WBC > 10,000 , culture (urine, blood, throat, wound), ESR (Erythrocyte sedimentation rate) - detects inflammation

24
Q

What stage of infection occurs from the time of infection to possible symptoms & can infect others?

A

Incubation

25
Q

A duration classification of infection that develops slowly and can last for weeks, months to years?

A

Chronic

26
Q

Nurse is assessing a client for a systemic response to an inflammatory process. For which response should the nurse monitor the client?

A

Fever
Leukocytosis (Increased WBC count)