Skills Test 3 Flashcards
Sanguineous
Large amounts of red blood cells
Full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to but not through underlying fascia
Stage III
Renewal of tissues
Regeneration
Risk factors for pressure ulcers
Friction and sheering Immobility Inadequate nutrition Incontinence Decreased mental status Diminished sensation Excessive body heat Advanced age Chronic medical conditions
Full thickness skin or tissue loss depth unknown
Unstageable
Tissue surfaces have been approximated (closed) and there is minimal or no tissue loss
Primary intention healing
Non blanch able erythema signaling potential ulceration
Stage I
Secondary intention healing
Pressure ulcer
Repair time is longer
Scarring is greater
Susceptibility to infection is greater
Wound left open 3-5 days to allow edema or infection to resolve then closed with sutures or staples
Tertiary intention
Most commonly used dressing on a wound. Permits air to circulate
Gauze
Begins immediately after injury and lasts 3-6 days
Inflammatory phase
Results from vasoconstriction of the larger blood vessels in the affected area
Hemostasis
Cell migration
Leukocytes ( specifically neutrophils) move into the interstitial space
Phagocytosis
Macrophages engulf microorganisms and cellular debris
Serous fluid
Serum
Ex- closed surgical incision or liquid glue on a laceration
Primary intention healing
Pressure ulcers are due to what
Localized ischemia
Complications of wound healing
Hemorrhage
Infection
Dehiscence
Evisceration
Factors affecting wound healing
Developmental consideration
Nutrition
Lifestyle
Medications
Preventing pressure ulcers
Provide nutrition
Maintain skin hygiene
Avoid skin trauma
Provide supporting devices
Strip of cloth used to wrap some part of the body
Bandage
Elasticized bandages
Provide pressure to the area
Binders
Type of bandage designed for a specific body part
Purulent
Pus
Partial thickness skin loss involving epidermis and possibly the dermis
Stage II
Full thickness skin loss with tissue necrosis or damage to muscle,bone or supporting structures.
Stage IV
Maturation phase
About day 21 and can extend 1-2 years
Wound is remodeled and contracted
Scar becomes stronger but the repaired area is never as strong as the original tissue
Sitz bath
Used to soak a patients perineal or rectal area
Teds
Used to facilitate venous return from the lower extremities
Prevent venous stasis and DVT
Reduce peripheral edema
Sutures
Thread used to see body tissues together
Pulmonary embolism
Clot formed elsewhere that travelled to the lung
Control severe bleeding by
Applying direct pressure over the wound
Elevating the involved extremity
Prevent infection in a wound by
Cleaning or flushing abrasions or lacerations with normal saline
Cover the wound with a clean dressing
Control swelling of a wound by
Applying ice over the wound and surrounding tissues
Signs of shock In a patient
Rapid thready pulse
Cold clammy skin
Pallor
Lowered blood pressure
Size of needle and syringe needed to irrigate a wound
18-19 gauge
30-60mL
Heat
Vasodilation Increases capillary permeability Increase cellular metabolism Increases inflammation Sedative effect
Most common type of contaminant of blood cultures
Epidermis
Specimen should never be refrigerated
Blood culture
Serious disease characterized by chills, fever, prostration, and the presence of bacteria or their toxins in the bloodstream
Septicemia
Signs of septic shock/septicemia
Reduced mental alertness Confusion Rapid breathing Chills Fever Warm, flushed skin
Presence of bacteria in the bloodstream
Bacteremia
Causes septicemia
Kidneys lung and hear fail with septic shock
Endotoxins
To diagnose bacteria or septicemia
3 blood cultures should be collected in a 24 hour period
Consist of injury to the skin or underlying tissue. Usually a bony prominence
Pressure ulcers
Poisonous proteins secreted by a variety of pathogens
Exotoxins
Hardened painless chance develops about 3 weeks after exposure
Open lesion containing treponema pallidum
Primary syphilis
Blood is sterile until it becomes contained with bacteria
bacteremia
What affects the central nervous system
Neurotoxins
Any indigenous microbiota in the specimen may
Overgrow inhibit or kill pathogens
Period during which the disease is most easily transmitted
Period of illness
Neurotoxins are produced by what
Clostridium tetani and clostridium botulinum
CNS, cardiovascular and other symptoms occur 5-20 years after exposure
Tertiary syphilis
Vast numbers live in or in the human body
Indigenous micro flora
Enterotoxins affect
Gastrointestinal tract
Failure to refrigerate urine within 30 min
Will cause an inflated colony count which could lead to an incorrect diagnosis or a UTI
Time that elapsed between arrival of the pathogen and the onset of symptoms
Incubation period
No symptoms
Last for weeks to years
Sometimes continues throughout life
Latent syphilis
Day 3-4 to about day 21
Collagen, granulation tissue and eschar
Proliferative phase
Organized layer of glycocalx, firmly attached to the outer surface of a bacterial cell wall, thAt protects the bacteria from being phagocytized by phagocytic white blood cells
Capsule
Considered to be virulence factors because they serve an antiphagocytic function
Bacterial capsules
Interferons
Interfere with viral replication
Increase host resistance
Are protein molecules released by host cells to nonspecifically inhibit the spread of viral infections
Leukocytosis
Count that is higher than normal
Occurs as a normal protective response to physiologic stressors, such as infection, anesthesia, surgery and toxins
Time during which the patient recovers
Convalescent period
Chance curls inward and a rash develops about 4-6 weeks after exposure
Rash resolves within 12 months
Secondary syphilis
Leukopenia
Count that is lower than normal
Never normal
When low person is at risk for life threatening infections
Can be caused by radiation, anaphylactic shock, autoimmune disease or chemo
Infectious diseases that go from being symptomatic to asymptomatic and then later go back to symtomatic.
Latent infections
May remain inactive for a long period of time before becoming active
Latent infections
Toxin
Obvious virulence factor
Molecule on the surface of a pathogen that is able to recognize and bind to particular receptor on a host cell
Adhesion
Rickettsia and chlamydia
Gram negative bacteria
Toxin of s. Aureus causes the epidermal layer of the skin to slough away, leading to a diseases known as scaled skin syndrome
Exfoliative toxin
Produced by some strains of s. Pyogenes causing scarlet fever
Eryhrogenic toxin
Destroy white blood cells
Leudocidins
Which of the following virulence factors enable bacteria to attach to tissues?
Pili
What dies when exposed to air and therefore must be protected from oxygen during transport to the CML
Obligate anaerobes
Loss of adhesions become
A virulent
Neurotoxins are produced by
Clostridium botulinum and clostridium tetani
Which of the following pathogens produce enterotoxins
Bacillus cereus and certain serotypes of eschericha coli
C diff and c perfringens
Salmonella spp and shigella spp
All of the above
All of the above
A bloodstream infection with BLANK could result in the release of endotoxin into the bloodstream.
Neisseria gonorrhoeae or E. coli
Communicable diseases are most easily transmitted during the
Period of illness
Enterotoxins affect the cells in the
Gastrointestinal tract
Which of the following bacteria is least likely to be the cause of septic shock
Mycoplasma pneumoniae
Which of the following produces both a cytotoxin and an enterotoxin
C. Difficile
Which of the following virulence factors enables bacteria to avoid phagocytosis by white blood cells
Capsule
Which of the following can cause toxic shock syndrome
S. Aureus and s. Pyogenes
Assuming that a CCMS urine was processed in the CML which of the following colony counts are indicative of a UTI?
A. 10,000 CFU/mL
B. 100,000 CFU/mL
C. >100,000 CFU/mL
Both b and c
Both b and c
Which of the following statements about blood is false
Bacteremia and septicemia are synonyms
Which of the following statements about CSF specimens is false
They should always be refrigerated
All clinical specimens submitted to the CML must be
Properly and carefully collected
Properly labeled
Properly transported to the laboratory
All of the above
All of the above
Which of the following is not one of the three parts of a urine culture
Performing a microscopic observation of the urine specimen
Which of the following matches is false
Tease mount.. Bacteriology section
Which of the following sections is least likely to be found in the CML of a small hospital
Virology section
In the mycology section of the CML moulds are identified by
A. Biochemical test results
B. Macroscopic observations
C. Microscopic observations
D. A combination of b and c
D. A combination of b and c
Exoenzymes secretion
Necrotizing enzymes Coagulase Kinases Hyaluronidase Collagenase Hemolysins
Which of the following is not one of the four major day to day responsibilities of the CML
Process environmental samples
Time during which the patient experiences the typical symptoms associated with that particular disease
Period of illness
Time during which the body gradually returns to normal as the patients immune response or medical treatment vanquish the pathogens
Decline
Who is primarily responsible for the quality of specimens submitted to the CML
Person who collects the specimen
Time during which the patient feels “out of sorts” “ coming down with something” but is not yet experiencing actual symptoms of the disease
Prodromal period
Cold
Vasoconstriction Decreases capillary permeability Decreases cellular metabolism Slows bacterial growth Decreases inflammation Local anesthetic effect
Produced by gram negative bacteria as a part of their cell wall structure. Can cause serious adverse physiologic effects such as fever and shock
Endotoxins
