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U of R SCHOOL OF NURSING - 372 > NUR 372 CLASS 2 MEDICAL ASEPSIS > Flashcards

NUR 372 CLASS 2 MEDICAL ASEPSIS Flashcards

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1
Q

INFECTION

A
  • pathologic events that result from the invasion and multiplication of microorganisms in a host
  • bacterial, viral, fungal
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2
Q

COMMON BACTERIAL PATHOGENS

A
  • bacteria: single cell, independently living microorganisms

- examples: staph aureus/streptococcus: normal on skin; pseudomonas aeruginosa; enterococcus; e coli: GI, UTI in women

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3
Q

COMMON VIRAL PATHOGENS

A
  • living microorganisms

- ex: influenza (flu); chicken pox / shingles; HIV; norovirus (west nile; ebola)

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4
Q

COMMON PARASITE PATHOGENS

A
  • organisms that live on or in a host; get their food from or at the expense of its host.
  • ex: protozoa; helminths (worms); ectoparasites (flees, lice
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5
Q

COMMON FUNGI PATHOGENS

A
  • single cell organisms that include molds and yeasts

- ex: candidiasis; aspergillosis; dermatophytes; pneumocystis jiroveci

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6
Q

HEALTHCARE ASSOCIATED INFECTIONS

A
  • infections that people acquire while they are receiving treatment for another condition in healthcare settings
  • ex: inpatient hospitals
    ; ambulatory settings ; long-term care facilities
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7
Q

TYPES OF HAI’s

A
  • central line-associated bloodstream Infections (CLABSI)
  • catheter-associated urinary tract infection (CAUTI)
  • ventilator-associated
    pneumonia (VAP)
  • surgical site infection (SSI)
  • clostridium difficile gastrointestinal infection
  • methicillin-resistant staphylococcus aureaus (MRSA)
  • vancomycin resistant enterococcus (VRE)
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8
Q

DISINFECTION

A
  • chemical or physical processes used to reduce the numbers of potential pathogens on an object’s surface
  • ex: bleach, chlorhexidine, betadine, scrubbing hands with antibacterial gels
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9
Q

STERILIZATION

A
  • complete destruction of all microorganisms, including spores
  • ex: autoclave
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10
Q

BACTERICIDAL

A
  • chemical that kills microorganisms
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11
Q

BACTERIOSTATIC

A
  • chemical that prevents bacterial multiplication but does not kill the bacteria
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12
Q

MEDICAL ASEPSIS

A
  • practices aimed at reducing the number, growth or spread of microorganisms
  • ex: hand hygiene before/after patient contact (20 seconds, happy b-day 2x); use of PPE as indicated by disease process; no items on floor; do not shake sheets; clean least soiled first; moist items in plastic bags
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13
Q

SURGICAL ASEPSIS

A
  • measures aimed at eliminating all bacteria from an object
  • ex: skin preparation; surgical hand washing;
    sterile gloves & gowns;
    sterile field
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14
Q

5 MOMENTS OF HAND HYGIENE

A
  • before patient contact
  • before an aseptic task
  • after body fluid exposure risk
  • after patient contact
  • after contact with patient surroundings
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15
Q

CHAIN OF INFECTION

A
  • infectious agent: bacteria, fungi
  • source: blood, respiratory secretions
  • portal of exit: drainage
  • mode of transmission: dressing on bedside stand
  • portal of entry: how it gest into other person’s body, patient coughs and nurse inhales
  • susceptible Host
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16
Q

PERSONAL PROTECTIVE EQUIPMENT: GLOVES

A
  • contact with blood or body fluids, mucous membranes, or non-intact skin of all patients, and when touching contaminated items or surfaces
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17
Q

PERSONAL PROTECTIVE EQUIPMENT: MASK, EYE PROTECTION, FACE SHIELD

A
  • during patient activities that are likely to generate aerosols, splashes, sprays, etc. such as suctioning
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18
Q

PERSONAL PROTECTIVE EQUIPMENT: GOWNS

A
  • worn if splashing blood or contact of body fluids is likely to occur.
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19
Q

ORDER OF DONNING PPE

A
  • gown
  • mask
  • goggles or face shield
  • gloves
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20
Q

ORDER OF REMOVING PPE

A
  • gloves
  • goggles or face shield
  • gown
  • mask
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21
Q

TYPES OF PRECAUTIONS

A
  • standard/universal
  • contact
  • droplet
  • airborne
  • protective
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22
Q

STANDARD/UNIVERSAL PRECAUTION

A
  • PPE as needed to prevent contact with body fluids (gloves, possibly gown, mask and goggles if splashing is possible).
  • all patients
  • handle all blood and body fluids as if contaminated
  • hand hygiene before/after
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23
Q

TRANSMISSION-BASED PRECAUTIONS

A
  • used in addition to standard precautions for patients who are known or suspected to be infected or colonized with an infectious organism
  • ex: airborne precautions; droplet precautions; contact precautions; protective Isolation
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24
Q

AIRBORNE PRECAUTIONS

A
  • my - measles
  • stupid - SARS
  • chicken - chickepox
  • hez - herpes zoster
  • TB - TB
  • private room with negative pressure
  • door closed at all times
  • PPE: N95 respirator; surgical mask to patient if needing to leave room
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25
Q

DROPLET PRECAUTIONS

A
  • protects transmission of pathogens through close contact with mucous membranes or respiratory secretions
  • PPE: mask
  • streptococcal pharyngitis
  • pneumonia
  • scarlet fever
  • rubella
  • pertussis
  • mumps
  • mycoplasma pneumonia
  • meningococcal disease
  • pneumonic plague
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26
Q

DROPLET PRECAUTIONS NURSING INTERVENTIONS

A
  • private room preferred (same cohort of pts can room together).
  • door can be open since the risk area for transmission is 3-6 ft of direct contact with the pt.
  • mask is required to enter room for everyone including visitors.
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27
Q

CONTACT PRECAUTIONS

A
  • prevents transmission of infectious agents that are spread by direct/indirect contact with patient’s and their environment
  • used with: wound drainage, fecal drainage or other discharge that is suggestive of contamination and risk of transmission to others.
  • PPE: gloves, gown (mask and goggles may be needed depending on splash risk)
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28
Q

CONTACT PRECAUTIONS NURSING INTERVENTIONS

A
  • private room (may cohort pt’s with same infective process)
  • dedicated equipment for pt (thermometer, stethoscope, BP)
  • pt to leave room for special tests/procedure only
  • clean hands prior to and after entering room
  • gown and glove prior to entering room.
  • remove PPE before exiting room.
  • clean hands (use soap and water if C-diff) prior to exiting the room.
  • dispose of infectious dressings in non-porous bag (biohazard trash for blood/body fluids).
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29
Q

CONTACT PRECAUTIONS PNEUMONIC

A
  • M - Multidrug resistant organism
  • R - Respiratory infection - RSV
  • S - Skin infections
  • W - Wound infections
  • E - Enteric infections (c. diff)
  • E - Eye infections
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30
Q

PROTECTIVE PRECAUTIONS

A
  • used to protect patients who have increased risk to infections
  • ex: cancer/chemotherapy; immunocompromised; neutropenic
31
Q

PROTECTIVE PRECAUTIONS NURSING INTERVENTION

A
  • hand hygiene before entering and before leaving
  • private room
  • no persons with infections
  • no drive or live plants or flowers
  • no non-reelable fresh fruit or vegetables
  • PPE: mask, gloves, gown
32
Q

EXAMPLES OF CLEAN TASKS

A
  • administering medication
  • obtaining vital signs
  • assessing the patient
  • obtaining a medical history
  • feeding the patient
  • putting on clean bed linens
33
Q

EXAMPLES OF DIRTY TASKS

A
  • administering medication vaginally or rectally
  • caring for a wound
  • changing a wound dressing or I.V. site dressing
  • caring for a urinary catheter
  • performing suctioning
  • removing used or soiled bed linens
  • bathing the patient
    performing oral care
  • changing a depends or brief
  • obtaining body fluid specimens (urine, blood, sputum)
34
Q

HIV PRECAUTION

A
  • standard/universal
35
Q

HIV DURATION OF PRECAUTION

A
  • duration of illness
36
Q

HIV RESRVOIR

A
  • body fluids: blood, semen, vaginal secretions, breast milk, saliva, CSF
37
Q

HIV TESTING

A
  • positive result from ELISA

- confirm by positive results from western blot.

38
Q

HIV NURSING CONSIDERATIONS

A
  • hand hygiene, PPE if high potential contact with blood, secretions
  • assess risk factors
  • teach ways of prevention (condoms), not sharing IV needles
  • teach about medication compliance
  • monitor fluid intake/urinary output
  • daily weights to monitor weight-loss
  • monitor nutritional intake
  • monitor electrolytes
39
Q

HIV BLOOD SPILL DISINFECTION

A
  • 10% bleach solution after initial cleaning if you have a blood spill
40
Q

C. DIFF DEFINITION

A
  • bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon
  • most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications
41
Q

C. DIFF PRECAUTIONS

A
  • contact
42
Q

C. DIFF DURATION OF PRECAUTIONS

A
  • until there is one negative stool culture
43
Q

C. DIFF RESERVOIR

A
  • stool
44
Q

SIGNS/SYMPTOMS OF C. DIFF

A
  • liquid diarrhea
  • abdominal cramps
  • N/V
45
Q

TESTING FOR C. DIFF

A
  • stool culture

- need one negative culture before d/c precautions

46
Q

HEPATITIS DEFINITION

A
  • inflammation of liver cells
47
Q

HEPATITIS MAY RESULT IN….

A
  • chronic hepatitis
  • cirrhosis of the liver
  • liver cancer
  • liver failure
48
Q

HEPATITIS A RISK FACTORS

A
  • fecal oral route
  • ingestion of contaminated food or water
  • close personal contact with an infected individual
  • vaccination available
49
Q

HEPATITIS B RISK FACTORS

A
  • unprotected sex with infected individual
  • infants born to infected mothers
  • contact with infected blood
  • IV drug users
  • vaccination available
50
Q

HEPATITIS C RISK FACTORS

A
  • drug abuse
  • sexual contact
  • health care workers who get needle sticks
51
Q

HEPATITIS C PRECAUTIONS

A
  • standard unless high potential for splashing
52
Q

DURATON OF HEPATITIS C PRECAUTIONS

A
  • duration of illness
53
Q

RESERVOIR OF HEPATITIS C

A
  • blood and body fluids
54
Q

VIRAL MENINGITIS

A
  • most common form of meningitis
  • commonly resolves without treatment
  • risk factors for viral: acute illness such as mumps, measles, and herpes
55
Q

BACTERIAL MENINGITIS

A
  • contagious infection with high mortality rate
  • risk factors include bacterial infections (such as Streptococcus Pneumonia, Haemophilis influenza) upper respiratory infections (pneumonia, sinusitis, otitis media); immunosuppression; invasive procedures (skull fractures, penetrating head wound); overcrowded living conditions
  • vaccine available for high-risk (college)
  • maintain at least 3 feet distance when in same room as pt.
56
Q

MENINGITIS PRECAUTIONS

A
  • droplet
57
Q

DURATION OF MENINGITIS PRECAUTION

A
  • 24 hours of continuous tx
58
Q

RESERVOIR OF MENINGITIS

A
  • respiratory
59
Q

NURSING CONSIDERATIONS FOR MENINGITIS

A
  • report to infection control department
  • quiet room
  • little stimuli
  • decrease light
  • seizure precautions
60
Q

SIGNS/SYMPTOMS OF MENINGITIS

A
  • headache
  • nuchal rigidity
  • photophobia
  • fever
  • chills
  • N/V
  • altered LOC
  • tachycardia
  • Kernig’s sign (stiffness/pain in hamstrings)
  • Brudzinski’s sign (pain with neck flexion)
61
Q

DIAGNOSIS FOR MENINGITIS

A
  • spinal tap to collect CSF
  • high WBC
  • high protein
  • decreased glucose
62
Q

PRECAUTIONS FOR MRSA

A
  • standard/contact
63
Q

DURATION OF PRECAUTIONS FOR MRSA

A
  • duration of illness
64
Q

RESERVOIR OF MRSA

A
  • body fluids contaminated with MRSA
65
Q

NURSING CONSIDERATIONS FOR MRSA

A
  • no longer considered for contact precautions unless they have open wound with MRSA drainage
66
Q

PRECAUTIONS FOR VANCOMYCIN RESISTANCE ENTEROCOCCI

A
  • contact
67
Q

DURATION OF PRECAUTIONS FOR VRE

A
  • duration of illness
68
Q

RESERVOIR OF VRE

A
  • stool, body sites from which VRE is isolated
69
Q

TB PRECAUTIONS

A
  • airborne
70
Q

DURATION OF PRECAUTIONS FOR TB

A
  • 3 sputum smears are negative on consecutive days or TB is r/o
71
Q

RESERVOIR OF TB

A
  • respiratory
72
Q

NURSING CONSIDERATIONS FOR TB

A
  • N95 Mask
  • HEPA filter
  • pt wears surgical mask when transported outside negative flow room
73
Q

TESTING FOR TB

A
  • PPD annually
  • chest xray
  • induration > 5 mm
  • sputum positive for mycobacterium tuberculosis

U of R SCHOOL OF NURSING - 372 (12 decks)

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