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nur 112 > precaution > Flashcards

precaution Flashcards

1
Q

Routes of Transmission (4)

A
  • direct = directly touching

-indirect = contact with fomite (contaminated object)

  • droplet = from coughs, sneezing, talks, suctioning

-airborne = smaller particles

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2
Q

Precaution with Airborne:
who? ( 4)
room type?

wash hands?

gloves?

gown?

mask/goggles/shield?

A

measles , tuberculosis, chicken pox, SARS

negative pressure room with six air changes per hour vent to the outside or HEPA filter.

standard precautions

standard precautions

standard precautions. N 95 mask
- wears a regular mask during transportation

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3
Q

Precaution with Droplet:
who?(8)
room type?

wash hands?

gloves?

gown?

mask/goggles/shield?

A

Haemophilus influenza, Neisseria meningitides, streptococcus pneumonia , mycoplasma pneumonia, and viral infections ( mumps, nubella and flu)

respiratory isolation / yes private room or with pt with same disease/ door may be open

standard precautions

standard precautions

standard precautions

standard precautions/regular mask

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3
Q

Precaution with Standard:
who?
room type?
wash hands?
gloves?
gown?
mask/goggles/shield?

A

used with alll pts

private room only if pt is contaminated

at all times

before and after
anytime with body fluids

wear a gown when anticipation with fluids

wear when involved with fluids/ resususctaion mask/bag for CPR

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4
Q

Precaution with Contact:
who?
room type?( door closed yay or nay)
wash hands?
gloves?
gown?
mask/goggles/shield?

A

congenital rubella, MRSA, staph aures, C Diff, VRE herpes simplex, SARS, NEC Fasitits
- during transport impervious dressing

Contact/Enteric/ Drainage, Secretion/Blood and Body Fluids. Yes private room or with pt with same disease/ door could be open.

standard precautions

at all times

standard precautions
standard precautions

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5
Q

Dishes, cups etccc for all transmission :

A

Hot water and detergents.

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6
Q

MRSA
- mode of 🚗
- risk factors
- DX
- Tx
-nursing interventions
-control measure

A

direct and indirect

overuse of antibiotics, immunocomp, extended hospitalization, elderly, newborn, critically ill, debilitating, surgical wounds

culture and sensitivity

wound infection, pneumonia , sputum, iv cath sites, blood

Antibiotics

strict disinfection

contact precautions, cohorting pt surveillance culturing

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7
Q

C. Diff
- mode of 🚗
- risk factors
- DX
- Tx ( what meds 3)
-nursing interventions
-control measure( think about pts rooms if they share etc…)

A

direct + indirect

overuse of antibiotics, immunocomp, extended hospitalization, elderly, roommate, GI surgery, enemas, NG feeding + drainage. Multiple interventions

stool culture’

diarrhea

D/C antibiotics Give PO antibiotics
- vancomycin
- Flagyl
- Bactrian
-enema

handwashing. keep track of stools ( # n color). position q1-2. adm IVs and clear liquid, diet, no anti-peristaltic

contact precautions with private bathrooms. no linen on floor, no bedpans on bed, over bed tables or furniture

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8
Q

Vancomycin-resistant Enterococci
- mode of 🚗
- risk factors
- DX
- Tx
-nursing interventions
-control measure

A

direct or indirect (not coughing or sneezing)

-overuse of antibiotics, immunocomp, extended hospitalization, debilitating underlying Dx, intra-abdominal surgery , cardio thoracic surgery, IV’s Foley, ICU

culture n sensitivity

organisms found in GI tract and female genital tract

antibiotics

on readmisssin
- recognize
- isloate
private room, 3 neg culture
> 1 weeek apart = ok cohort

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9
Q

Nec. Fascitis(flesh eating)
- mode of 🚗
- risk factors
- DX
- Treatment
-nursing interventions
-control measure

A

direct
immunocomp, crtcially ill, debilitating - DM
- Obese
-atherosclerosis
-IV drug use

culture and sensitivity

pain out of proportion to wound, foul drainage .Flu like symtoms.2

debridement antibiotics analgesia ampuation

use skin pen q2hr, to mark size of area

contact precautions

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10
Q

Ebola
- mode of 🚗
- risk factors
- DX
- Tx
-nursing interventions
-control measure

A

direct

contact with infected animals, and humans. burial ceremonies

blood cultures

fever, fatigue, muscle pain, headache, sore throat, internal and external bleeding

supportive care

rehydration. Tx of specific symptoms, no proven treatments

contact precautions

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11
Q

Immune 🤺🤺🤺🤺🤺🤺responses serve three functions:

A

defense, homeostasis, and surveillance.

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12
Q

Artificial Passive Immunity

A

Protection from infection is achieved when a person receives serum from another person or animal that has already produced antibodies against the pathogen (e.g., serum for treatment of rabies or botulism).

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13
Q

The humoral immune response works

A

with the cellular immune response (involving T cells) to provide a comprehensive and coordinated defense against a wide range of pathogens.

Together, these responses contribute to the immune system’s ability to recognize, respond to, and remember specific threats, thereby protecting the body from infections.

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14
Q

Epidemiology –

Incidence –

Prevalence -

Epidemic -

Pandemic –

Bioterrorism

A

study of distribution and determinants of health conditions

health-related issues or problem that occur at a specific time

Prevalence – total number of people who have a specific health-related issue, problem, disease at a given time.

Epidemic – rise or increase of disease or condition in a community or area

Pandemic – epidemic which has geographical spread and affects countries around the world.

he intentional use of micro-organisms to bring about ill effects or death to humans, livestock, or crops

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15
Q

common allegry side effects

A

hives/rash/sob/ swollen/ gi condition

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16
Q

Culture and sensitivity

A

specify the organism and which antibiotic will inhibit growth
A tool to determine cause of infection
Analyze results in conjunction with the clinical assessment of the patient
Symptoms: fever, malaise, REED
Lab results: WBCs
Drainage: wounds, feces, saliva, urine, mucus/sputum

17
Q

Neutropenic Precautions

Restriction of visitors (no sick visitors)
Restriction of items (no fresh flowers, fruit, vegetables)

A

Benefits patients w/ immunosuppression:
Chemotherapy
Transplants
HIV/AIDS

Restriction of visitors (no sick visitors)
Restriction of items (no fresh flowers, fruit, vegetables)

18
Q

HAI common ( list the 3* hint 💩 n what mommy always tells me i catch)

CAUTI
CLABSI
SSI
VAP
MDRO

6

A

Pneumonia, Clostridium difficle,

Catheter-associated urinary tract infection
(central line-associated bloodstream infection),
(surgical site infections)
VENTALIR ASSOCIATED PNEUMONIA

19
Q

MDRO causes

6

A

-Admin ABT for viral infections
-Prescribing unnecessary ABT therapy
-Inappropriate drug regime to tx infection
Not using first line ABT instead using broad-spectrum ABT

Client skipping doses
-Client not taking full duration of therapy
-Client using saved ABT “in case I need it”

20
Q

MRSA Chain of Infection
(pathogen
reservior
transmisson
entry
exit
host)

A

Pathogen: Staphylococcus Aureus
Reservoir: colonized or infected patients, healthcare workers, or close contacts
Transmission: direct and indirect
to patient: contact with contaminated/colonized HCW hands or equipment;
to HCW: contact with infected body sites, secretions, equipment, environmental surfaces
Entry: non-intact skin, invasive procedures, surgery
Exit: wound drainage, sputum, blood
Host: elderly; immunocompromised; admitted patients-prolonged stays; prolonged use of antibiotics; exposure to other patients with MRSA

21
Q

Symptoms-MRSA

hintREEDAAA

A

Erythema
Fever
Induration (hardness of a skin area)
Elevated WBC
Purulent drainage
Positive culture = diagnosis

22
Q

Control & Treatment-MRSA

Nurse assignment
Infected:
Colonized: (think of nose)

A

Handwashing.Health teaching. Contact Precautions-private room or cohort
Gown and gloves (mask if in the lungs)
Dedicated equipment and limited transport
Nurse assignment

Infected: IV Vancomycin
Colonized: Mupirocin to nares

23
Q

Determined to be CA-MRSA if:

community MRSA

A

Outpatient setting OR positive MRSA culture WITHIN 48 hours of admission
NO hx permanent VAD(venous access device), foley catheters or other implantable medical devices
No medical history of:
MRSA infection or colonization
No history of hospital, nursing home, hospice, dialysis, or surgery within last year

24
Q

Spore forming bacterium release toxins into bowel that cause WBC and debris to accumulate in colon
May lead to sepsis(massive immune response to bacterial infection in the blood, life-threatening, organ injury/failure)
Infection preceded by:
GI surgery
Antibiotics
Enemas
NG feeding or suction

A
24
Q

Mutated Enterococci

Chain of Infection:
Pathogen:
Reservior
Transmisson
Entry
Exit

A

Pathogen: mutated Enterococci
Reservoir: infected wounds, skin, urine, stool, hands, environmental equipment, charts, bedrails, commodes, faucets, phones
Transmission: endogenous spread, direct and indirect contact
Entry – oral, non-intact skin
Exit- fecal or non-intact skin, drainage

24
Q

Symptoms C-diff

A

Low grade fever
Colitis (severe abdominal cramping)
Watery, foul-smelling green or yellow stools
Stools may become bloody with mucous
May have up to 30 stools per day
May cause fluid and electrolyte
imbalance and/or dehydration
Diagnosis=Positive stool culture

24
Q

Treatment & Control C-diff

A

DC IV antibiotics (often seen with clindamycin)
Tx with: Flagyl or Vancomycin
Contact Precautions-gloves & gown, private bath
Handwashing (soap and water, not hand gel)
Disinfecting with sporicidal
NO soiled linens on floor
NO bedpans on bedside furniture
USE barriers
Manage: skin breakdown, F&E imbalance, dehydration
Keep precautions in place until at least 3 days post last diarrhea or agency policy

25
Q

Vancomycin Resistant Enterococcus (VRE)

A

Enterococcus is a gram positive cocci normally found in the gut
Causes CAUTI, wound infection, sepsis, endocarditis
2nd leading pathogen for HAI
Mutated and resistant to most antibiotics
More virulent than MRSA, can remain viable on surfaces for weeks.

26
Q

Treatment & Control: VRE

explain culture test from where/ name antimicrobials

A

Private room
Infection: urinary tract, bloodstream, wounds, surgical sites
Dedicated equipment
Dedicated staff
Contact precautions – gloves & gown
Treat with antimicrobials – linezolid (Zyvox)
Must have 3 negative cultures one week apart from various parts of body (stool, wound, foley/urine)

27
Q

Chain of Infection: VISA/VRSA

A

Pathogen: antibiotic resistant Staph. Aureus
Reservoir: infected patients
Transmission: direct contact with infected patient or contaminated equipment or dressings
Entry: non-intact skin, invasive procedures, surgery
Exit: wound drainage, sputum, blood
Host: patients with underlying health conditions such as kidney disease or diabetes, previous infections with MRSA, invasive lines, recent hospitalizations, recent exposure to vancomycin and other antimicrobial agents

28
Q

Necrotizing Fasciitis

Pathogen

A

Pathogen: Beta hemolytic streptococcus bacterial infection-Group A streptococcus
Also known as “flesh eating disease”
73% mortality, poor prognosis
Transmission: direct contact
Cause by: bacterial invasion/local tissue damage, insect bite, surgical procedures, IV drug abuser, trauma, surgery, recent scratch or cuts
Severe necrosis of skin, fascia, and SQ tissue

29
Q

Critical Symptoms-(N.F.)

A

Usually within 4-5 days
Septic shock:
Renal failure
DIC (Disseminated Intravascular Coagulation)
Respiratory failure
Decreased BP
Cardiovascular collapse
Unconsciousness
All due to toxins being released into the body and causing septic shock and multi-organ system failure

30
Q

Treatment-Necrotizing Fasciitis

A

Early recognition is key (subjective data)
Early: debridement of site
Late: amputation
IV Antibiotics & antimicrobials: ampicillin, clindamycin, metronidazole, imipenem
Contact Precautions – gloves, gown, goggles
Supportive care (emotional)

31
Q

Ebola Virus Disease (EVD)

A

Pathogen: Zaire ebolavirus
Transmission: direct contact blood or body fluids (urine, saliva, sweat, feces, vomit, breast milk, semen) indirect contact with objects(needles/syringes) contaminated.
Enters body via broken skin or mucous membranes in eyes, nose or mouth.

32
Q

Covid 19

A

Pathogen: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
RNA virus that has “spikes” on surface
Transmission: Multiple ways – droplets from cough, sneeze, talking, airborne inhaled into the lungs

33
Q

COVID- TESTING

A

Airborne – gloves, gown, N95 mask and goggles
*RT-PCR diagnostic test.
Rapid antigen test – not as reliable
Antibody tests identify recent or prior Covid 19 infection
Treatment: isolate, rest, hydrate, acetaminophen (fever), vit C, vit D, Zinc,
Hospitalization, oxygen, intubation

COVID Antiviral – remdesivir (IV therapy), Paxlovid (po med for high-risk clients, BID x5 days)
Monoclonal antibodies – laboratory-made molecules = substitute antibodies
Corticosteroids – dexamethasone
mRNA vaccine – do not contain live virus, COVID-19 Vaccine, Bivalent

34
Q

COVID TESTING

COVID Antiviral –
Monoclonal antibodies –

Corticosteroids –*Hint adernal *
mRNA vaccine –

A

remdesivir(iv), paxlovid

laborty made molecules= subsititue antibodies

dexamthasone

do not contain live virus, COVID-19, BIVALENT

35
Q

Postacute COVID-19 syndrome

A

Long lasting symptoms
Loss of taste and smell
Dyspnea
Heart problems
Fatigue
Cognitive changes

36
Q

respiratory isolation aka

what precautiopn

A

droplet precaution

37
Q

HAI is acquired at least ____ after admission

A

12 hrs

nur 112 (23 decks)

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