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nursing safty
test3
| Question | Answer |
|---|---|
| types of infection | *local *systemic *acute *chronic *nosocomial |
| local infection | is limited to a specific part of the body where the microorganism remain |
| systemic infection | microorganism spread and damage different parts of the body |
| bacteremia | is when a culture of the persons blood reveals microorganisms |
| when bactermia results in a systemic infection ithe is referred to as | septicemia |
| acute infection | generally appear suddenly or last a short time |
| chronic infection | may occur slowly over a very long period and may last months or years |
| IF infectious agent can be transmitted by direct or indirect contact or as an airborne infection | communicable disease |
| opportunistic pathogen | cause disease only in a susceptible individual |
| is the principal public health agency at the national level concerned with disease prevention and contron | CDC |
| health departments | track epidemics and illnesses at state level |
| ____ are the most common infection causing microrganisms | bacteria |
| colonization | is the process by which strains of microorganisms become resident flora. in this state micros may grow and multiple but do not cause disease |
| Clostridium difficile (c. diff) | a bacterium. diarrhea to life threating inflammation of th ecolon. comommoly affects older adults in hospitals/LTC facilities after antibiotic use |
| Clostridium difficile common S/S | watery diarrhea, 3 or more times/day for 2 or more days. Mild abdominal cramping/tenderness |
| Severe case of Clostridium difficile S/S | watery diarrhea 10-15 times/day. Severe abd. cramping/pain. FEVER. Blood &/or pus in stool (steatorrhea) Nausea, no appetite. Dehydration. Weight loss |
| Common lab test for C. diff | stool specimen- must be refrigerated if not tested immediately. Can be a clean collection. (usually collect 3 seperate stools) |
| C. diff transmission | *feces *hands of health care workers: can survive on surfaces for weeks |
| prevention of transmission of C. diff | *use soap and water for hand washing *properly diluted chlorine bleach for surfaces *wear PPE *contact isolation precautions (gloves and gown) Alcohol-based handrubbs are not effective! |
| common medical treatment for C. diff | *discotinuation of antibiotic therapy * If no better treatment with Flagyl or Vancomycin |
| Methicillin-Resistant Staphylococcus aureus (MRSA) | a becterium. infection caused by a strain of Stapylococcus aureus that is restant to broad spectrum antibiotics; can be fatal. |
| MRSA common S/S | red, warm, swollen, painful area on skin. drainage of pus or other fluids from the site (abscess) fever |
| Severe S/S of MRSA | chest pain, SOB, chills, fever, fatigue, malaise, muscle aches, bone pain, headache, rash |
| common lab test for MRSA | *wound culture * blood culture |
| MRSA transmission | contaminated surfaces * body fluids * hands of health care workers |
| prevention of transmission of MRSA | wash hands with soap and water/alcohol based hand rubs * surfaces should be cleansed daily with approved cleanser (bleach water) *wear PPE *contact isolation precautions (wear a face sheild if at risk of splashing) |
| Common medical treatments for MRSA | drainage of abscess, Vancomycin (penicillins are ineffective) possibly Bactrim |
| Vancomycin-Resistant Enterococci(VRE) | Enterococci are bacteria normally present in th ehuman intestines, female genital tract, enviroment, but some have become resistant to Vancomycin. Can cause infections (UTI's, bloodstream, wounds) if in susceptible host. Usually occurs in hospitals |
| Common S/S of (VRE) Vancomycin-Resistant Enterococci | wound infections:redness, edema, tenderness, drainage. UTI:burning upon urination, urinary frequency, back pain *weakness, malaise *fever chills |
| VRE common lab test | *stool culture/Rectal swab (must be collected in STERILE specimen container) *wound culture *blood culture *urine culture |
| VRE transmission | hands of caregives *surface contaminations (survives for weeks) *improper dressing change/foley cath insertion |
| common medical treatment for VRE | *not many abx help *removal of foley cath |
| chain of infection | 1. Etiological agent 2.reservoir 3. portal of exit 4. method of transmission 5. portal of entry 6. susceptible host |
| etiological agent | microrganism |
| reservoir | carrier (people, plants, animals, general enviroment, food, water) |
| method of transmission | direct transmission, indirect, vehicle-borne transmission, vector-borne transmission, or air-borne transmission |
| direct transmission | immediate transmission from person to person through touching, biting, kissing, or sexual intercourse. droplet spread is also a form but only can occur if the source and host are within feet of each other (sneezing, coughing, spitting, singing |
| indirect transmission | may be either vehicle borne or vector borne |
| vehicle borne transmission | any substance that serves as an intermediate means to transport and introduce an infectious agent into a susceptible host through a suitable portal of entry. ex. material objects also water and food |
| vector borne transmission | is an animal or insect that serves as an intermediate means of transporting the infectious agent. |
| air borne transmission | involve droplets or dust. the material is transmitted by air currents to a suitable portal of entry, usually the respiratory tract of another person |
| susceptible host | is anyone at risk for infection |
| compromised host | is a person at increased risk, is more likely to acquire an infection |
| body defenses are | nonspecific or specific |
| nonspecific defenses | *anatomic/physiologic(skin, tears, cilia in lung, stomach acidity, peristalsis) *inflammatory response |
| inflammatory response stages | 1st stage:vascular and cellular response 2nd stage:exudate production 3rd response:reparative phase |
| Specific body defenses | antibody mediated defenses(humoral or circulating immunity) Reside ultimately in the B lymphocytes and are mediated by antibodies produced by B cells |
| specific Antibody mediated defenses: active | host produces antibodies in response to natural antigens or artificial antigens Ex.having had the chicken pox |
| Specific antibody mediated defenses: passive | host receives natural or artificial antibodies produced by another sources Ex. breast milk |
| specific cell mediated defenses: cellular immunity | involve T cells and lymph system |
| 3 main groups of T cells | *helper T cells: help immune system to func. *cytotoxic T cells:responsible for attacking/killing foreign organisms (sometimes kill body cells) *suppressor T cells: can suppress helper T cells and cytotoxic T's when needed |
| the nurse knows it is important to wash hands after opening a patients door because the door acts as a | Reservoir |
| exudates | fluid and cells that have escaped from the blood vessels from inflammatory process |
| serous | mostly serum, clear |
| sanguineous | (hemorrhagic) bloody |
| serosanguineous | serum and blood mixed |
| purulent | thick, pus filled (leukocytes, lipuefied dead tissue debris, bacteria) |
| purosanguineous | pus and blood mixed |
| Is the biggest factor in the risk for infection | host susceptibility |
| what makes the host susceptible | age, heredity, level of stress, nutritional status, current medical therapies, preexisting disease process (diabetes) |
| specific factors that increase susceptibility to infection in the older adult | decrease in skin elasticity, decreased cilia, calcification of heart valves, decreased GI acidity and mobility, presence of chronic illness, decreased renal func., dehydration/malnutrition, decreased antibody synthesis, weakened immune system |
| specific factors that increase susceptibility to infection in the older adult (continued) | illness or injury, smoking, substance abuse, multiple sex partners, enviromental factors:more likely to fall or MVA, medications:certain meds can lower immune system or induce resistance in some strains of micros, abuse:starvation or neglect |
| possible alterations in response to infection/inflammation in the older patient | *alteration in cognition:disorientation, dementia, decreased cognitive ability (common, not normal) *no fever *no cough *no urinary pain or discomfort *no increase in WBC's |
| defenses against infection | nutrition, hygiene, rest and activity, stress, immunizations |
| lab measures of infection WBC's | requires blood draw, normal (4,500-11,000/mm3), increased in infection, decreased in some medications |
| lab measures of infection blood culture | obtain sterile blood specimen, takes 72 hours to grow, but will have preliminary results after 24 hours |
| lab measures of infection: wound | take care not to contaiminate the specimen, swab purulent exudates from within the wound (deep) 72 hours to grow, but preliminary results after 24 hours |
| what can the nurse teach about the body's defenses against infection | adequate rest and decreasing stress is important |
| what is the best way for the nurse to prevent the spread of infection between patients? | washing hands before and after care of patient |
| nursing process:assessment | note pertinent history, risk assessment tools, home health appraisal, physical assessment (signs of infection) |
| LOCAL signs of infection | swelling, redness, pain/tenderness, heat at site, loss of function at site, exudates |
| Systemic signs of infection | fever, increased pulse/respiratory rate(due to high fever), malaise, loss of energy, anorexia, N/V, enlargement/tenderness of lymph nodes close to site |
| nursing implementation for risk for infection | observe for redness, warmth, swelling, pain, red streaks, drainage surrounding affected site every 2-4 hours and PRN. asses and doc. skin conditions around (site of orthopedic pins, wires, IV, or other tubes breaking skin integrity) every 2-4 hours & PRN |
| nursing implementation for social isolation | instruct family on proper hand washing and isolation precautions PRN, listen to comments of client regarding sense of isolation every shift and PRN, assess feelings a/b self, sense of ability to control situation, sense of hope, &coping sk. q shift & prn |
| nursing implementation for risk for infection | observe for redness, warmth, swelling, pain, red streaks, drainage surrounding affected site every 2-4 hours and PRN. asses and doc. skin conditions around (site of orthopedic pins, wires, IV, or other tubes breaking skin integrity) every 2-4 hours & PRN |
| nursing implementation for social isolation | instruct family on proper hand washing and isolation precautions PRN, listen to comments of client regarding sense of isolation every shift and PRN, assess feelings a/b self, sense of ability to control situation, sense of hope, &coping sk. q shift & prn |
| implementation on altered protection | irrigate & apply dressing daily & prn, adm meds per orders, encourage protein intake w/each meal & protein rich snacks prn, maintain (specific i.e. contact) precautions throughout hosp. stay |
Created by:
chelsea309
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