Set 5 Flashcards
Infections originating in the hospital
Nosocomial (ex: MRSA)
Infection coming from a procedure or intervention
Iatrogenic (ex: catheter associated urinary tract infection [CAUTI])
What is the most important step in the prevention of nosocomial infections?
Proper hand hygiene
When should hand hygiene with soap and water be performed?
- before eating
- after using the restroom
- when hands are visibly soiled
- when caring for patients with infectious diarrhea
Order for donning PPE
Gown, mask, eyewear, gloves
Order for doffing PPE (hint: dirtiest to cleanest)
Gloves, eyewear, gown, mask
Standard precautions consists of
Hand hygiene and clean gloves
Examples of infections that require contact precautions
C.Diff, MRSA, VRE, RSV, lice, scabies
Contact precautions consist of
Hand hygiene, clean gloves, gown
T or F: A nurse caring for a patient with C.Diff MUST perform hand hygiene with soap and water
True
Droplet precautions consist of
Hand hygiene, gown, gloves, surgical mask (if within 3 feet of patient)
Examples of infections that require droplet precautions
Influenza, pertussis, group A strep, mumps, diphtheria, rubella, bacterial meningitis
Examples of infections that require airborne precautions
Tuberculosis, varicella (chickenpox), measles
Airborne precautions consists of
Private room with negative air pressure, gown, gloves, N95 respirator
T or F: if a patient with tuberculosis has to leave their room, they must wear an N95 mask
False! They must wear a SURGICAL mask
What patients might be placed on protective isolation?
Immunocompromised, neutropenia, radiation
Protective isolation consists of
Private room with positive pressure airflow (pumps in fresh, clean air), dedicated equipment, no live plants, visitors screened for illness/no visitors
Patient education for protective isolation
Avoid crowded areas, avoid contact with people known to be sick, do not share personal items, avoid raw foods (baby carrots), ensure meat is cooked thoroughly, avoid live plants and gardening
Indications for sterile field
Sterile procedures such as central line, PICC line, straight catheter, indwelling catheter, tracheostomy care, surgical procedures
Sterile field best practices
- NEVER turn back to sterile field
- do NOT drop hands below waist
- do NOT reach over sterile field with anything that is not sterile
- do NOT talk, cough, or sneeze over field
- make sure everything being put on field is intact
How much of the sterile field is considered non-sterile
1 in border
Sterile field nursing consideration
Any moisture on the field means the field has been contaminated and is no longer sterile
How should the sterile field package be positioned prior to opening?
The package should be positioned so that the topmost flap will open AWAY from your body
When giving a bed bath, the nurse should wash the _________ first without soap to decontaminate that area of the skin without bringing in bacteria and causing infection
Eyes
Order for conducting a bed bath
Face, chest, arms, abdomen, legs, feet, and back
What is the last area a nurse should wash when giving a bed bath?
The perineum and rectum
Nursing considerations for washing perineum
- change water before washing perineum
- wipe from front to back on patient with vulva
Bed-making best practices
- raise bed to waist height to prevent injury
- do NOT shake linen
- soiled linens immediately placed in soiled linen bag
Providing oral care for a patient who is unconscious
Angle their head 45 degrees and turn them to the side to prevent aspiration; make sure suction is readily available
Seizure precautions
- pad side rails of bed
- ensure that oxygen, suction, and vital signs equipment are readily available
Actions to take for patients having a seizure
- lower patient to floor (if standing)
- turn patient on side
- loosen restrictive clothing
- move anything that may be in the way out of the way (PRIORITY! Protect patient from harm)
- do NOT restrain patients or put anything in their mouths
- note when the seizure started and stopped
Post-seizure nursing care
Reorient patient, keep the patient calm and reassure them, record vitals, perform brief neurological exam
