Nurse Notes Flashcards
clean gloves vs sterile gloves
Clean gloves - standard precautions
Sterile gloves-gets rid of microorganisms and spores that contaminate
chain of infection
infectious agent: pathogen
reservoir: source for pathogen growth
portal of exit: from the reservoir
mode of transmission: can be inanimate object or something living on hand/part of body
portal of entry: to a host
host
(all in one circle)
what is a reservoir?
-a place where microorganisms survive, multiply, and await transfer to a susceptible host
-Microorganisms require nourishment
-most organisms require water or moisture for survival
-can only live in certain temperature ranges
-thrive in dark environments
-pH
-food, water, oxygen, temperature, pH , light
portal of exit
After microorganisms find a site to grow and multiply, they need to find a portal of exit if they are to enter another host and cause disease. Portals of exit include sites such as blood, skin and mucous membranes, respiratory tract, genitourinary (GU) tract, gastrointestinal (GI) tract, and transplacental (mother to fetus)
modes of transmission
Contact
Direct
Indirect
Droplet
Airborne
Vehicles
Vector
modes of transmission: direct vs indirect
Direct: Person-to-person (fecal, oral) physical contact between source and susceptible host. A health care provider’s hands become contaminated by touching germs present on a patient, medical equipment, or high-touch surfaces, and the health care worker then carries the germs on his or her hands and spreads to a susceptible person.
Indirect : Personal contact of susceptible host with contaminated inanimate object (e.g., needles or sharp objects, soiled linen, dressings, environment)
droplet. vs airborne: mode of transmission
Droplet: An infected person coughs or sneezes, creating droplets that carry germs short distances (within approximately 6 feet). These germs can land on a susceptible person’s eyes, nose, or mouth and can cause infection (e.g., pertussis or meningitis).
Airborne: Organisms are carried in droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing. Germs are aerosolized by medical equipment or by dust from a construction zone (e.g., nontuberculous mycobacteria or Aspergillus).
vehicles vs vector: mode of transmission
Vehicles: Contaminated items. For example, sharp injuries can lead to infections (e.g., HIV, HBV, HCV) when bloodborne pathogens enter a person through a skin puncture by a used needle or sharp instrument.
* Water
* Drugs, solutions
* Blood
* Food (improperly handled, stored, or cooked; fresh or thawed meats)
Vector: External mechanical transfer (flies). Internal transmission such as parasitic conditions between vector and host such as:
* Mosquito
* Louse
* Flea
* Tick
portal of entry
Organisms enter the body through the same routes they use for exiting. For example, during venipuncture when a needle pierces a patient’s skin, organisms enter the body if proper skin preparation is not performed first. Factors such as a depressed immune system that reduce body defenses enhance the chances of pathogens entering the body.
susceptible host
Susceptibility to an infectious agent depends on an individual’s degree of resistance to pathogens. Although everyone is constantly in contact with large numbers of microorganisms, an infection does not develop until an individual becomes susceptible to the strength and numbers of the microorganisms.
course of infection by stage
incubation period: appearance of first symptoms, 1 to 2 days for common cold
prodromal stage: more specific symptoms, tingling of herpes before lesions appear
illness stage: signs and symptoms to a type of infection
convalescence: symptoms start to disappear
local vs systemic infection
localized: pain, tenderness, warmth and redness at the wound site
systemic: infection that affects the entire body instead of a single organ and can become fatal if undetected or untreated
natural defense mechanisms
skin: intact multilayered surface, shedding of outer layer of skin cells, sebum
mouth: intact multilayered mucosa, saliva
eyes: tearing and blinking
Respiratory tracts: cilia lining upper airway, coated by mucus
urinary tract: flushing action of urine flow, intact multilayered epithelium
gastrointestinal tract: acidity. of gastric secretions, rapid contraction and release in small intestine
vagina: normal flora, low pH
why do older adults have a higher risk for infection?
Older adults are less capable of producing lymphocytes to combat challenges to the immune system. When antibodies are produced, the duration of their response is shorter, and fewer cells are produced
-ALL PATIENTS BEING ADMITTED TO HOSPITAL ARE CONSIDERED…
-when should skin assessment be completed?
-ALL PATIENTS BEING ADMITTED TO HOSPITAL ARE CONSIDERED A FALL RISK UNTIL EVALUATED.
SKIN ASSESSMENT MUST BE COMPLETED WITHIN 4-24 HOURS; ANY PRESSURE INJURY THAT IS NOT DOCUMENTED/ACKNOWLEDGED ON ADMISSION (WITHIN 24 HOURS) IS DEEMED THE RESPONSIBILITY/FAULT OF THE HOSPITAL`
Joint Commission 2020 Hospital National Patient Safety Goals
Identify patients correctly.
* Improve staff communication.
* Use medicines safely.
* Use alarms safely.
* Prevent infection.
* Identify patient safety risks.
* Prevent mistakes in surgery.
environmental safety
-Basic Human Needs:
Oxygen
Nutrition
Temperature
-Physical Hazards:
Motor Vehicle Accidents
Poison
Falls*
Fire: PASS
* P ull the pin to unlock handle,
* A im low at the base of the fire,
* S queeze the handles,
* S weep the unit from side to side
Disasters
transmission of pathogens
A pathogen is any microorganism capable of an illness.
When a patient acquires an infection in a health care setting, it is called a nosocomial infection or health care–acquired infection (HAI).
Immunizations
Moors Scale vs Braden Scale
-Moors Scale measures the risk of fall for a patient. The higher the score, the more risk of a fall
-Braden Scale measures the risk of Predicting Pressure Ulcer Risk
factors influencing patient safety
-Developmental Stages and Risks
-Risk Factors for Violence
-Individual Risk Factors:
Lifestyle
Impaired Mobility
Sensory or Communication Impairment
Economic Resources
Lack of Safety Awareness
hospitals will not receive additional payment for cases in which one of the selected conditions was not present on admission…
-Pressure injury Stages 3 or 4
-Falls and trauma (fracture, dislocation, intracranial injury, crushing injury, burn, electric shock)
-Catheter-associated urinary tract infections
-Vascular catheter-associated infections
types of restraints
what are nurse responsible for?
-A physical restraint is any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move arms, legs, body, or head freely.
-Chemical restraints are medications such as anxiolytics and sedatives used to manage a patient’s behavior and are not a standard treatment for a patient’s condition.
-alarm devices
-Nurses are responsible for making ongoing assessments of patients who are restrained. After a restraint is applied, monitor a patient closely (i.e., every 15 minutes for a violent patient and every 2 hours for a nonviolent patient)
RACE
used in case fire
R—Rescue and remove all patients in immediate danger.
A—Activate the alarm. Always do this before attempting to extinguish even a minor fire.
C—Confine the fire by closing doors and windows and turning off oxygen and electrical equipment.
E—Extinguish the fire with an appropriate extinguisher.
what are complementary therapies?
therapies used together with conventional treatment recommended by a person’s health care provider.
When nonpharmacologic therapies such as exercise, chiropractic, and herb supplements are used in place of conventional pharmacologic or other medical procedures, they are considered alternative therapies
Complementary medicine is used in addition to standard treatments.
Alternative medicine is used instead of standard treatments
PASSIVE RELAXATION VS ACTIVE PROGRESSIVE RELAXATION
-ACUPUNCTURE
-MEDITATION
-IMAGERY
-Herbal medicines are not approved for use as drugs and are not regulated by the FDA.
-passive:mental relief
-progressive: mental relief through physical relief
