Unit 4 Review (Exam 3) Flashcards
What are Microorganisms?
Germs/Microbes; Able to be seen under a microscope.
What is a virulence?
The ability to overcome the immune system.
10 Types of Microorganisms
- Nonpathogens
- Pathogens
- Bacteria
- Viruses
- Fungi
- Rickettsiae
- Protozoans
- Mycoplasmas
- Helminths
- Prions
Survival of Microorganisms
- Warmth
- Darkness
- Oxygen
- Water
- Nourishment
What is the Chain of Infection?
I.R.E.M.P.S.
- Infectious Agent
- Reserviors
- Portal of Exit
- Means of Transmission
- Portal of Entry
- Susceptible Hosts
What are the causes of Antibiotic Drug Resistance?
Taking an antibiotic w/ absence of infections.
What is the Means of Transmission?
How infectious microorganism move to another location.
What is Biologic Defense Mechanisms?
Anatomic or physiologic methods that stop microorganisms from causing an infectious disorder.
What are the 2 types of Biologic Defense Mechanisms?
Mechanical - physical barriers (skin)
Chemical - destroys or incapacitate microorganisms through natural biologic substances (saliva, acids, GI Tract).
What is the number range of WBC (White Blood Count)?
5,000 - 10,000 Infections
2 Types Pharmacologic Considerations for Antibiotics
- Broad Spectrum Antibiotics; Active against a wide range of bacteria.
- Narrow-spectrum; Antibiotic targets specific bacteria, less likely to kill nonpathogenic bacteria or results in resistance.
Concept Mastery Alert
Breaking the chain of infection can significantly reduce the risk for infectious diseases.
Gerontologic Considerations for Chain of Infection
Pneumonia, Influenza, Urinary Tract and Skin Infections, and TB are common in older adults.
What is Asepsis?
Practices that decreases contamination of microorganisms.
What is Health Care-Associated Infections?
Nosocomial Infection while a person is receiving care in a health care agency.
What is Medical Asepsis
Practice of clean techniques
Examples of Medical Asepsis
Handwashing, PPE (Personal Protective Equipment)
Types of Antimicrobial Agents
Soap, Detergent, Alcohol, Iodine, etc.
What are Antiseptics?
Bacteriostatic agents, inhibit the growth of, but do not kill microorganisms.
What are Disinfectants?
Germicides and bacteriocides that destroy active microorganisms but not spores.
What are the 2 Anti-Infective Drugs?
- Antibacterials
- Antivirals
Pharmacologic Considerations for Anti-Infective Drugs
The discovery and use of antiviral medications has turned deadly viruses (HIV; Hepatitis C) into chronic illnesses.
What is Hand Hygiene?
Removing surface contaminants on the skin by either hand washing or hand antiseptics.
What is hand washing?
Medical Asepsis practice that involves cleaning the hands with soap, water, and friction to mechanically remove dirt and organic substances.
What are the guidelines for handwashing and hand antiseptics?
- When hands are visibly dirty
- When hands are contaminated with proteinaceous material
- Before eating and after using the restroom
- Before having direct contact with clients
- After contact with a client’s intact skin
- Before donning sterile gloves to insert invasive devices.
What are Resident Microorganisms?
Nonpathogens that are present on the skin.
What are Transient Microorganisms?
Pathogens that are picked up during brief contact with contaminated person.
Advantages of Alcohol-Based Hand Rubs
- Take less time drying; Doesn’t require paper towels
- More accessible; Doesn’t require sinks/water
- Easier to perform
- Convenient
- Reducing costs; Less paper towels/waste management
- Less irritating/drying than soap; contains emollients.
5 Moments of Hygiene
- Before touching a patient
- Before clean/aseptic procedures
- After body fluid exposure risk
- After touching a patient
- After touching patient surroundings
What are Surgical Hand Antiseptics?
Medically aseptic hand-hygiene procedure that is performed before donning sterile gloves and garments.
Why do we wear Personal Protective Equipment?
To reduce the transfer of microorganisms between ourselves and clients.
Why do we wear Uniforms?
To reduce the spread of microorganisms onto or from the surface of clothing worn from home.
Why do we wear Scrub Suits and Gowns?
Often worn instead of a uniform; to prevent from bringing microorganisms on clothing into working environment.
Why do we wear Respirators?
To prevent the transmission of TB (Tuberculosis).
Why do we wear gloves?
- To prevent direct hand contact with blood, bodily fluids, secretions, excretions, mucous membrane, and nonintact skin.
- To protect clients from microorganisms transmitted from nursing personnel when performing procedures.
- To protect ourselves from potential transfer of microorganisms from one client or object to another.
Why do we wear Hair and Shoe Covers?
To reduce the transmission of pathogens present on the hair or shoes.
Why do we wear Protective Eye Wear?
A possibility that bodily fluids will splash into the eyes.
Why are Confining Soiled Articles done?
To contain reservoirs of microorganisms.
What are the 2 types of Utility Rooms?
- Clean Room
- Dirty Room
TRUE/FALSE: The dirty or soiled utility room contains covered waste receptors.
TRUE
Examples of Waste Receptables
- Sharps Containers
- Plastic Bags
- Waste Baskets
Who is responsible for keeping the environment clean?
Housekeeping Personnels
What is a Concurrent Infection?
Measures that keep the client environment clean on a daily basis.
What is a Terminal Disinfection?
Measures used to clean a client’s environment after discharge.
What are Sterile Techniques?
Practices that avoid contaminating microbe-free items.
What is Sterilization?
Physical and chemical techniques that destroy all microorganisms, including spores.
What is Surgical Asepsis?
Once equipment and areas are free of microorganisms, you can remain in that state if contamination is prevented.
What does Physical Sterilization consist of?
Microorganisms/Spores are destroyed physically through radiation/heat, boiling water, free-flowing steam, dry heat, and steam under pressure.
What does Chemical Sterilization consist of?
Gas and liquid chemicals are used to sterilized invasive equipment.
Review the “Principles of Surgical Asepsis”.
Nursing Skills and Concepts Textbook, pg. 150.
How do you create a Sterile Field?
Use the inner surface of a cloth or paper wrapper that holds sterile items (table cloth).
True/False: The Nurse must be careful to keep the inside of the wrapper and its contents sterile.
TRUE.
True/False: Sometimes, it is necessary to add sterile items or sterile solutions to the sterile fields.
TRUE
What are Sterile Solutions?
- Known as Normal Saline
- Some containers are sealed with a rubber cap or screw top.
How do we put on/remove Sterile Gloves?
Use the process of Asepsis; put on/remove sterile gloves without touching their more contaminated other surface.
Nurses generally identify pertinent nursing diagnosis like those that follow when caring for particularly susceptible client by?
- Risk for Infection
- Ineffective Protection
- Delayed Surgical Recovery
- Deficient knowledge
- Readiness for enhanced knowledge
True/False: Never turn your back on sterile equipment
TRUE.
What are Infectious diseases?
Diseases that are spread by pathogens or toxins among susceptible individuals.
What are Communicable Diseases?
Diseases that are transmitted from one source to another by infectious bacteria or viral organisms.
What are Contagious Diseases?
Communicable diseases that can spread rapidly among individuals in close proximity to each other.
What are Community-acquired infections?
Those that are not present or incubating prior to care provided by healthcare providers.
What are Health care-associated infections?
Acquired within a health care facility in any setting.
What are Noncommunicable diseases?
Toxins from food poisoning or in the environment.
What is Colonization?
A condition in which microorganisms are present but the host does not manifest any signs or symptoms.
Examples of Infection Control Precautions
- Hand Hygiene
- Standard Precautions
- Transmission-based precautions
- PPE
- Cleaning/Disinfecting/Sterilizing Equipment
- Keeping environment clean
Why should we exercise Droplet Precautions?
To reduce the risk of transmitting pathogens within most droplets larger than 5 microns.
True/False: Make sure you have all your equipment before going into an isolation room.
TRUE
What are PPE’s?
- Gloves
- Mask
- Goggles
- Face Shield
- Respirators
True/False: Always wash hands after taking off gloves.
TRUE
True/False: Geriatric patients are more susceptible for infections due to decreased immune response.
TRUE
Nursing Implications for Infections
- Risk for infection
- Ineffective Protection
- Risk for Infection Transmission
- Impaired Social Interaction
- Social Isolation
- Risk for Loneliness
- Deficient Diversional Activity
- Powerlessness
- Fear
What is a N95 Respirator?
- Filtering face piece respirator used to filter microorganisms.
True/False: HIV is usually transmitted through sexual contact.
TRUE.
True/False: Gown, gloves, and mask are not necessary all the time.
TRUE.
When do we need to wear PPE’s (Personal Protective Equipment)?
Consistenly.
Initial actions when placing patient on isolation precautions
- Make sure to have all supplies when going into an isolation room.
- Make sure room is clean and disinfected.
What is the Course of Infectious Diseases?
- 1st Stage: Incubation (Agent is present, Host is asymptomatic)
- 2nd Stage: Prodromal (Mild Symptoms)
- 3rd Stage: Acute (Severe Symptoms)
- 4th Stage: Convalescent (Symptoms subside)
- 5th Stage: Resolution (Recovery, pathogen is destroyed.)
How do you get rid of soiled materials?
Double Bagging
What is a Wound?
Damaged Skin/Soft Tissue resulting from trauma/injury.
What are the two types of Wounds?
- Open (surface of skin/mucous membrane not in tact)
- Closed (No opening in skin/mucous membrane)
What is an Incision?
Clean separation of skin. (stitches)
What is a Laceration?
A deep cut within the skin.
What is an Abrasion?
Surface layers of skin are scraped away.
What is an Avulsion?
large areas of skin removed; cartilage/bone exposed.
What is an Ulceration?
Shallow crater; mucous membrane is missing.
What is a Puncture?
Opening of skin caused by narrow, sharp, pointed object.
What is a Contusion?
Bruise
What are the 3 Wound Repair Stages?
- Inflammation (2-5 days)
- Proliferation (2 days - 3 weeks)
- Remodeling (6mo. - 2 yrs.)
What are the factors of Wound Healing?
- Type of injury
- Expanse of depth of wound
- Quality of circulation
- Amount of wound debris
- presence of infection
- Status of Client’s health
What does 1st Intention Healing consists of?
Primary Intention; Wound edges are directly next to each other.
What does the 2nd Intention Healing consists of?
Wound edges are widely separated; resulting in deep scar.
What does the 3rd Intention Healing consists of?
Wound edges are intentionally left opened; delayed closure.
True/False: The key to wound healing is adequate blood flow to the injured tissue.
TRUE.
Factors that interfere with Wound Care
- Poor circulation
- Infection
- Fluid accumulation
- Tension/pulling on wound edges
- Poor Nutrition
What do you assess for Wound Healing Complications?
- Undermining (erosion of tissue from under intact skin)
- Slough (Dead tissue around the wound surface)
- Necrotic Tissue (Dry; brown/black in color devitalized tissue)
True/False: Necrotic tissue and slough must be removed for healing to take place.
TRUE.
What is Dishiscience?
The separation of wound edges
What is Evisceration?
Would separation with exposed organs
True/False: Wound healing generally occur within 7-10 days after surgery.
TRUE.
What is a Dressing?
A cover over a wound.
What is the purpose of Dressings?
- Keep wound clean
- Absorb draining
- Control bleeding
- Hold medication in place
- Protect wound from further injury
What are the types of Dressings?
- Gauze (woven, cloth fibers; great for great wounds
- Transparent (Clear, acrylic wound covering; common for IV/Central Line Catheters.
- Hydrocolloid
- Hydrogel
- Alginate
( Above: Self-Adhesive, opaque; contains granules of gelatin or pectin; repels body subtances such as urine and stool, need an 1 inch margin around wound)
What are the procedures for Wound Dressing?
- Pre-medicate
- Wash cands
- Don clean cloves
- Remove old dressings
- Wash hands
- Don clean/sterile gloves
- Cleanse per Dr. order
- Apply dressing per Dr. order
- Wash hands
What is the method for documenting Wound Care?
S.A.L.T.T. Method
S - Size A - Appearance L - Location T - Treatment T - Tolerance
What are the 3 Types of Drains?
- Open (flat, flexible tubes that empty to dressing)
- Closed ( Tubes that terminate in receptacle; Jackson-Pratt)
- Vacuum-Assisted Closure/VAC (Wound packed with foam filler/sealed with occlusive dressing attached to a suction tube and pump.
What are Sutures and Staples?
- Sutures: Knotted ties that hold an incision together
- Staples: Wide, metal clips
What are Bandages?
A strip or roll of cloth wrapped around a body part.
What are Binders?
A type of cloth applied most commonly to abdomen or breasts.
What are Antiembolism Stockings?
- TED Hose
- Compression Socks
- Must have physician order
What are the 4 methods of Debridement?
S.E.A.M.
S - Seam
E - Enzymatic
A - Autolytic
M - Mechanical
What is a Debridement?
Removal of necrotic tissue to promote healing
True/False: Always assess before applying heat/cold applications.
TRUE.
What are Pressure Ulcers?
Pressure related injuries, bed sores, bed ulcers; most often appear over bony prominences.
What are the 4 stages of Pressure Ulcers?
Stage I - Intact, reddened skin
Stage II - Red and accompanied by blistering/skin tear without slough
Stage III - Shallow skin that extends; serous/purulent drainage
Stage IV - Life-threatening, muscle/bone is exposed, foul order present, may present sepsis.
What is a Serous Drainage?
Leaking plasma; Yellow, Clear fluid
What is a Serosanguinous Drainage?
Thin, watery, and pink in color.
What is a Sanguineous Drainage?
Fresh, bloody exudate (bright red/thick)
What are some risk factors of Pressure Ulcers?
- Inactivity
- Immobility
- Malnutrition
- Dehydration
- Sedation
- Vascular Disease
