Week 9 - Assessment and Management of Infection

Question 1

What should you assess for in infection? (3)

Answer 1

1. Hx
2. Physical examination - local vs systemic signs
3. Diagnostic testing (chest, abdominal, etc)

Question 1

Which diagnostic tests can you perform to assess infection? (3, 4)

Answer 1

1. Laboratory tests
2. Radiographic tests
   - helps visualize certain body tissues to gain insight into possibility of infection
3. CXR/ABX. CT, MRI

Question 2

What are the clinical manifestations of a local infection (3, 5)

Answer 2

1. Signs of inflammation
   - redness, pain, heat, swelling
2. Exudate may be present
3. Lymphadenopathy
   - swollen and tender lymph nodes

Question 3

What are the clinical manifestations of a systemic infection? (5)

Answer 3

• fever
• fatigue
• headache
• anorexia and nausea
• malaise and myalgia (ie. joint and muscle pain)

Question 4

What are the clinical manifestations of organ specific (systemic) signs? Provide answers for GI, Resp, and GU tract only.

Answer 4

1. GI - vomiting or diarrhea
2. Resp - sneezing, coughing and difficulty breathing
3. GU - painful urination, frequency in urination

Question 5

What occurs when there are complications with infection?

Answer 5

• infections that are severe, poorly responsive to therapy, or untreated can lead from systemic infections (sepsis) to multi-system organ failure (MSOF) or septic shock

Question 6

What are the clinical manifestations of septic shock? (7)

Answer 6

• hypotension
• tachycardia
• tachypnea
• oliguria or anuriqa
• hypoxia
• hypercapnia (increase CO2)
• seizures or coma

Question 7

What lab values can we assess for infection, in terms of biochemistry? (4, 6)

Answer 7

1. Sodium - dehydration
2. Potassium - GI infection (diarrhea, vomiting)
3. Creatinine - Perfusion to kidneys (hypovolemia)
   - elevated if we are not eating or drinking
4. Lactate - sign of sepsis/MSOF
   - cell not getting O2

note that biochemistry tells us how the body is coping, not if there is an infection

Question 8

What lab values can we assess for infection, in terms of complete blood count (CBC)? (3)

Answer 8

1. WBC count
   - elevated B and T lymphocytes, neutrophils, monocyes = bacterial or viral
   - elevated basophils/eosinophils = parasitic

Question 9

What does cultures and sensitivity (C&S) help us assess in infection?

Answer 9

• urine, sputum, throat, blood, wounds, spinal fluid
• equipment

always done if we suspect an infection to identify pathogen

Question 10

What other tests can we do to assess infection? (2)

Answer 10

• ESR for chronic patient and long-term infection
• Antibody Tests - hepatitis, HIV

Question 11

What are the methods of infection control and prevention? (3)

Answer 11

• hand hygiene
• standard precautions
• Transmission-based precautions

Question 12

What are the isolation precautions to take in transmission-based precautions? (3, 6)

Answer 12

1. Contact
   - MRSA
   - C. Difficile (superinfection bc too many antibiotics)
2. Droplet - COVID
3. Airborne - TB
   - need n95

Question 13

What are some collaborative interventions to do for infections? (6)

Answer 13

• Antimicrobial drug therapy
• fluid and electrolytes
• rest
• nutrition
• managing fever
• infection control and prevention

Question 14

How should you treat a fever if patient is hyperthermic? How about Hypothermic? (5)

Answer 14

Cooling
- ice packs, sponge bath, cooling blankets
- remove clothing
- Antipyretics: unless pt is uncomfortable, not necessary all the time

Hypothermic - Warming blankets
- note that this is a late sign, pt must be very immunocompromised

Question 15

Example of complication in infection

Answer 15