Unit 10 Flashcards
Define and describe the concept of infection as it applies to nursing practice.
Parasitic or protozoal infection
Fungal infections
Bacterial infections
Viral infections
Notice risk factors that place individuals at risk for infection.
Age (young and old)
Uninsured
Residents of geographic areas where an infection is prevalent
Decreased immune system secondary to disease
Compromised skin integrity
Recognize when an individual has an infection.
Fever is 100.4
Local infections
WBC differential (left shift)
What is left shift?
Bacterial infection which shows an increased # of immature neutrophils
Bands > 6
Neutro >62
Lump <25
WBC > 10
Describe the signs and symptoms of seasonal influenza.
Severe headache and muscle aches
Chills
Fatigue
Severe diarrhea and cough
Fever Hypoxia
Discuss the health promotion and maintenance and nursing interventions of a client with influenza.
MAINTAIN DROPLET AND CONTACT PRECAUTIONS
Provide saline gargles
Monitor for hydration status (I/Os)
Administer fluid therapy as prescribed
Monitor respiratory status
What allergy should you check before giving the flu vaccine?
Eggs
Review the causes of antibiotic resistance.
Not finishing antibiotics
Taking too many antibiotics without a need to.
What are superbugs?
Organism of bacteria that mutates to resist antibiotics
Cues of infection (antibiotic resistance)
Nausea
Fever
Chills
Interventions for infection (antibiotic resistance)
Contact precautions
Get labs and cultures
HAND HYGIENE
EDUCATION OF PATIENT FOR HAND HYGIENE AND TAKING ABX AS PRESCRIBED AND FULLY
Discuss MRSA (methicillin-resistant Staphylococcus aureus) and VRE (vancomycin-resistant enterococci), including prevention and treatment.
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
Discuss the best way to prevent infections in the hospitalized client.
HAND HYGIENE
Describe the pathophysiology of sepsis
A systemic response to infection secondary to the release of cytokines
Describe the pathophysiology of septic shock.
Poor global perfusion of the major organs manifested by either HYPOTENSION that is unresponsive to fluid or a serum lactate >4mmol/L
What is severe sepsis?
Results in one or more organ dysfunctions (decreased output, respiratory distress)
MODS (Multi-organ dysfunction) – septic shock with organ dysfunction and no coming back
What is SIRS?
Systemic inflammatory response syndrome (response to inflammation)
Review conditions predisposing to sepsis and septic shock.
Malnutrition
Immunosuppression
Large, open wounds
GI ischemia
Cancer
Age (>65 or <1)
Alcoholism
Chronic diseases (kidney failure, DM)
Hepatitis, HIV/AIDS
Recognize cues of sepsis.
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)
Describe the interventions for sepsis and septic shock (including the hour-1 bundle)
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))
Discuss the laboratory assessment for sepsis and septic shock.
Temp: <36 or >38
HR: >90
RR: >20
PaCO2: <32
WBC: >12 or <4
How do you calculate long-term fluid maintenance?
Kg x 30mL = mL/day
mL/day divided by 24hr = mL/hr
What will the lab results show for a patient who has a fever?
WBC >10,000
Blood culture is positive
Neutrophils >7000
EST (an increase of proteins and decrease of RBS) >20mm/hr
List the PPE required for the following
Standard: gloves
Airborne: mask and full face if splashing
Droplet: mask and gloves
Contact: gloves and gowns
What does TIME stand for sepsis?
Temperature
Infection
Mental Decline
Extremely Ill
What medication is first line for sepsis?
Broad-spectrum antibiotic
Why are IV fluids so important in treating sepsis?
Fluids increase the BP which helps prevent and treat sepsis shock.
Help the organs to properly function.
