Unit 10

Question 1

Define and describe the concept of infection as it applies to nursing practice.

Answer 1

Parasitic or protozoal infection
Fungal infections
Bacterial infections
Viral infections

Question 2

Notice risk factors that place individuals at risk for infection.

Answer 2

Age (young and old)
Uninsured
Residents of geographic areas where an infection is prevalent
Decreased immune system secondary to disease
Compromised skin integrity

Question 3

Recognize when an individual has an infection.

Answer 3

Fever is 100.4
Local infections
WBC differential (left shift)

Question 4

What is left shift?

Answer 4

Bacterial infection which shows an increased # of immature neutrophils
Bands > 6
Neutro >62
Lump <25
WBC > 10

Question 5

Describe the signs and symptoms of seasonal influenza.

Answer 5

Severe headache and muscle aches
Chills
Fatigue
Severe diarrhea and cough
Fever Hypoxia

Question 6

Discuss the health promotion and maintenance and nursing interventions of a client with influenza.

Answer 6

MAINTAIN DROPLET AND CONTACT PRECAUTIONS
Provide saline gargles
Monitor for hydration status (I/Os)
Administer fluid therapy as prescribed
Monitor respiratory status

Question 7

What allergy should you check before giving the flu vaccine?

Answer 7

Eggs

Question 8

Review the causes of antibiotic resistance.

Answer 8

Not finishing antibiotics
Taking too many antibiotics without a need to.

Question 9

What are superbugs?

Answer 9

Organism of bacteria that mutates to resist antibiotics

Question 10

Cues of infection (antibiotic resistance)

Answer 10

Nausea
Fever
Chills

Question 11

Interventions for infection (antibiotic resistance)

Answer 11

Contact precautions
Get labs and cultures
HAND HYGIENE
EDUCATION OF PATIENT FOR HAND HYGIENE AND TAKING ABX AS PRESCRIBED AND FULLY

Question 12

Discuss MRSA (methicillin-resistant Staphylococcus aureus) and VRE (vancomycin-resistant enterococci), including prevention and treatment.

Answer 12

Put on contact precautions
Linezolid is the ABX for VRE
MRSA: grows in warm, hairy places; strongly resistant to antibiotics
VRE: resides in bowels and leads to infection when spreads outside of bowels

Question 13

Discuss the best way to prevent infections in the hospitalized client.

Answer 13

HAND HYGIENE

Question 14

Describe the pathophysiology of sepsis

Answer 14

A systemic response to infection secondary to the release of cytokines

Question 15

Describe the pathophysiology of septic shock.

Answer 15

Poor global perfusion of the major organs manifested by either HYPOTENSION that is unresponsive to fluid or a serum lactate >4mmol/L

Question 16

What is severe sepsis?

Answer 16

Results in one or more organ dysfunctions (decreased output, respiratory distress)
MODS (Multi-organ dysfunction) – septic shock with organ dysfunction and no coming back

Question 17

What is SIRS?

Answer 17

Systemic inflammatory response syndrome (response to inflammation)

Question 18

Review conditions predisposing to sepsis and septic shock.

Answer 18

Malnutrition
Immunosuppression
Large, open wounds
GI ischemia
Cancer
Age (>65 or <1)
Alcoholism
Chronic diseases (kidney failure, DM)
Hepatitis, HIV/AIDS

Question 19

Recognize cues of sepsis.

Answer 19

Low BP and CO
Tachycardia
Excessive blood clotting = DIC
Warm skin which switches to cool and clammy + cyanotic
RR increases
Low urine output
Increase of creatinine levels (Normal 0.6-1.2)

Question 20

Describe the interventions for sepsis and septic shock (including the hour-1 bundle)

Answer 20

Oxygen if poor perfusion/gas exchange
Draw blood cultures and serum lactate (>2 is out of range)
Give ABX
Give fluid bolus 30mL/kg of NS for low BP or after fluid boluses to maintain MAP of >65
Monitor urine output (>30mL/hr)
Give vasopressors if BP is low or after fluid blouses to maintain MAP >65
Hemodynamic monitoring (watch glucose levels (140-180))

Question 21

Discuss the laboratory assessment for sepsis and septic shock.

Answer 21

Temp: <36 or >38
HR: >90
RR: >20
PaCO2: <32
WBC: >12 or <4

Question 22

How do you calculate long-term fluid maintenance?

Answer 22

Kg x 30mL = mL/day
mL/day divided by 24hr = mL/hr

Question 23

What will the lab results show for a patient who has a fever?

Answer 23

WBC >10,000
Blood culture is positive
Neutrophils >7000
EST (an increase of proteins and decrease of RBS) >20mm/hr

Question 24

List the PPE required for the following

Answer 24

Standard: gloves
Airborne: mask and full face if splashing
Droplet: mask and gloves
Contact: gloves and gowns

Question 25

What does TIME stand for sepsis?

Answer 25

Temperature
Infection
Mental Decline
Extremely Ill

Question 26

What medication is first line for sepsis?

Answer 26

Broad-spectrum antibiotic

Question 27

Why are IV fluids so important in treating sepsis?

Answer 27

Fluids increase the BP which helps prevent and treat sepsis shock.
Help the organs to properly function.