Unit 4: Ch. 10,22,28 Flashcards
Define surgical asepsis
totally free of microorganisms, including spores
Medical asepsis
- antimicrobial agent used
- containing
- handwashing
- PPE/ isolation
- clean technique **
Surgical asepsis
- sterilization (physical and chemical)
- surgical hand antisepsis
Sterile techniques
practices that avoid contaminating microbe-free items
Autoclave
pressure steam sterilizer
Principles of surgical asepsis
- sterile with sterile
- partially unwrapped packaging is considered unsterile
- if you question if its sterile, consider it unsterile
- longer the time = less sterile
- expiration dates
- once an item is open its only a matter of time before it is contaminated
- if item gets wet its contaminated
- coughing,sneezing, or excessive talking over a sterile field contaminates it
- dont reach over a sterile field
- below waist level is considered contaminated
Sterile field
work area free of microorganisms
Lipping
before use of a sterile solution, pour and discard small amount of liquid from the mouth of the container to wash away airbourne contaminators
Mask
wear a mask if there is a risk for coughing or sneezing within a radius of 3 feet
Particulate filter respirator
wear if there is a potential for acquiring diseases caused by droplet or airborne transmission
Colonization
condition where microorganisms are present but there are no signs or symptoms
Course of infectious diseases
- incubation period
- prodromal stage
- acute stage
- convalescent stage
- resolution
Incubation period
infectious agents reproduces, but there are no signs or symptoms
Prodromal stage
initial symptoms appear
Acute stage
symptoms become severe and specific to the tissue or organ that is affected
Convalescent stage
symptoms subside
Resolution
pathogen is destroyed, health is restored
When do we wear PPE?
Anytime you are exposed to bodily fluids
Diseases that require isolation
- pulmonary TB
- measles (rubella)
- chicken pox (variscella)
- severe acute respiratory syndrome (SARS)
Transmission based precaution
- isolation precautions
- airborne
- droplet
- contact
Airborne
- private room
- negative air pressure
- 6 to 12 air changes per hour
Airborne protection
- follow standard precautions
- door closed
- wear PPE
- N95 mask
Airborne diseases
- pulmonary TB
- Measles
- chicken pox
- SARS
Droplet
private room
within 3ft
ciughing sneezing etc
Droplet protection
- follow standard precautions
- leave door open or closed
- wear a mask
Droplet diseases
- influenza
- rubella
- strep pneumonia
- meningitis
- whooping cough
Contact
-private room or in a room with similarly infected patients
Contact protection
- standard precautions
- don gloves before entering
- handwashing
- avoid transporting the client
- have equipment exclusively for that specific pt
Reverse isolation
- use with patients who are immunocompromised
- standard precautions AND gown, gloves, mask
- limit visitor contact
- no sick visitors
- no fresh plants or flowers
- no raw or uncooked foods
Providing sensory stimulation
- move bed
- position pt so that they can look out the window
- encourage telephone calls
- converse with pt
- encourage activity
- offer wide choice of foods
Early signs of infection in older adults
change in behavior or mental status
Visitors in isolation rooms
- plan frequent social contact
- encourage visitors to come as often as policy allows
- visitors must follow infection control precautions
Types of drainage
- serous
- sanguineous
- serosanguineous
- purulent
Serous drainage
- mostly clear or slightly yellow
- a bit thicker than water
Serosanguineous drainage
- thin and watery
- pink in color
Sanguineous drainage
- fresh bloody exudate
- bright red, thick
Purulent drainage
- thick with yellow,green, brown color
- foul odor
What type of drainage is a sign of infection?
Purulent
Gauze dressing
- made of woven cloth fibers
- ideal for covering fresh wounds that are likely to bleed or wounds that exude drainage
Transparent dressing
- clear acrylic film wound coverings
- allow nurses to assess wound without removing dressing
- commonly used to cover peripheral and central intravenous insertion sites
Hydrocolloid, hydrogel, and alginate dressings
-self adhesive, opaque, air and water occlusive
keep wound moist
First intention healing
- primary intention
- wound edges are directly next to each other
- small amount of scar tissue
Second intention healing
- wound edges are widely separated
- more time consuming and and complex reparative process
- conspicuous scar
- wound care must be performed cautiously
Third intention healing
- wound edges are intentionally left widely separated and later brought together with some kind closure material
- broad, deep scar
- extensive drainage and tissue debris
TED hose
- compression stockings
- must have physician order
- remove every 8 hours
- apply after elevating legs for 15 minutes
Drains
tubes that provide a means for removing blood and drainage from a wound
Open drains
- flat flexible tubes that empty into a dressing
- use gravity or capillary action
- can be shortened by nurse
Closed drains
- tubes that terminate in a receptacle
- Jackson pratt (PV), hemovac
- use nonmechanical vacuum or negative pressure
Vacuum assisted closure (VAC)
- wound packed with foam filler and sealed with an occlusive dressing
- attached to a suction tube and pump
Factors that negatively impact healing
- compromised circulation
- infection
- purulent, bloody, or serous fluid accumulation
- KEY TO WOUND HEALING IS ADEQUATE BLOOD FLOW*
Pressure ulcer
- decubitus ulcer
- wound caused by prolonged capillary compression that impairs circulation to the skin and underlying tissue
Pressure ulcer stage 1
- intact but reddened skin
- skin that remains red when pressure is relieved