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Immune
Immune system
| Question | Answer |
|---|---|
| Pathogenicity | ability to produce disease (potency) |
| Pathogen | microorganism that causes disease |
| Opportunistic pathogen | only susceptible hosts |
| Asepsis | absence of disease-causing microbes |
| The infectious agent can be transmitted by direct or indirect contact or by airborne particles | Communicable Disease |
| Infectious diseases are a major cause of death worldwide | Communicable Disease |
| Limits the number, growth, and transmission of microorganisms | Medical Asepsis |
| Clean (almost all organisms absent ) | Medical Asepsis |
| Dirty (organisms likely to be present) | Medical Asepsis |
| Practices that destroy all microorganisms and spores | Surgical Asepsis |
| Sterile Technique | Surgical Asepsis |
| Sepsis—whole body inflammatory process, resulting in acute illness | Surgical Asepsis |
| Generally referred to as state of infection | Surgical Asepsis |
| Opportunistic pathogens | cause disease only in susceptible host |
| True pathogen | causes disease or infection in healthy individual |
| Bacteria | Most common; several hundred species can cause disease in humans |
| Viruses | consist mostly of nucleic acids and cannot reproduce unless they enter living cells. (hepatitis, rhinovirus, herpes, HIV) |
| Fungi | yeasts and molds (candida) |
| Parasites | live on other living organisms; |
| Protozoa | (malaria), |
| Helminths | (worms), |
| arthropods | (mites, fleas, ticks). |
| Transported via | air, water, food, soil, body tissues & fluid, & inanimate objects (fomites) |
| Septicemia | is bacteremia that results in a systemic infection |
| Acute infections | generally appear suddenly & last a short time |
| Chronic infections | develop slowly over long period of time, and may last months or years |
| bacteremia | In systemic infection, blood culture reveals microorganisms |
| do not normally cause disease during colonization | Resident flora grow and multiply in host |
| Systemic Infection | organisms spread and damage different parts of body |
| Local infection | limited to parts of body where microorganisms remain |
| Colonization | process where microorganisms become resident flora |
| infection Can cause disease if | host defenses ineffective (or organisms out of balance |
| Etiologic agent (microorganism) | The chain of infection chain 1 |
| Reservoir (source) | The chain of infection chain 2 |
| Portal of exit from reservoir | The chain of infection chain 3 |
| Method of transmission | The chain of infection chain 4 |
| Portal of entry to the susceptible host | The chain of infection chain 5 |
| Susceptible host | The chain of infection chain 6 |
| Depends on virulence, potency of microorg., ability to enter body, susceptibility of host, and the ability to live in the body. Smallpox highly virulent; TB less so. | Etiologic agent (microorganism) |
| Humans and their environment most common sources to self & others; a carrier is someone who shows no s/s but can pass on the organism (ex. Flu) | Reservoir (source) |
| Nose/mouth, feces, urine, wounds | Portal of exit from reservoir |
| Break in the skin is most common, or airborne c. diff spores; may enter by same route as it left the source. | Portal of entry to the susceptible host |
| Decreased immunity–immunocompromised--(CA or transplant) and age (young and old) | Susceptible host |
| touch, bite, kiss, sex, or droplet within 3 ft of source of sneeze, cough, spit, etc | Method of transmission direct |
| has to have a vehicle {object that transfers germs such as a toy} or a vector {animal or insect}) vs. airborne (floats in the air by spray or dust such as TB) | Method of transmission indirect |
| Vascular & Cellular Responses | Inflammatory Response |
| Exudates Production | Inflammatory Response |
| Reparative Phase | Inflammatory Response |
| Intact skin and mucous membranes: 1st line of defense | Barriers That Defend Against Infection |
| Moist mucous membranes and cilia of the nasal passages trap dust and particulates | Barriers That Defend Against Infection |
| Oral cavity—saliva inhibits microbial invaders | Barriers That Defend Against Infection |
| Alveolar macrophages: phagocytes devour bacteria and viruses | Barriers That Defend Against Infection |
| Tears: clean eyes of debris | Barriers That Defend Against Infection |
| High acidity of the stomach: Kill bacteria | Barriers That Defend Against Infection |
| Urine flow through the urethra: Washes out organisms such as e- coli | Barriers That Defend Against Infection |
| Nursing Interventions that Break Chain of Infection | Specific to each link Hand Cleansing Hygiene Preventing ideal environment for growth Limiting exposure & transmission Education-Client Teaching , Infection Control, |
| Low pH of the vagina | 3.5-4.5, prevents bacterial growth in warm moist place. ↑ pH and sweetness from diabetes increase infection rate (especially fungal) |
| Peristalsis | moves microorganisms out |
| Normally body’s defenses protect Nonspecific defenses | anatomic, physiological, inflammatory response |
| Normally body’s defenses protect Specific defensess | immune system (antibodies vs. specific antigens) |
| Intact skin, mucous membranes | First line of defense |
| Host susceptibility | Affected by many factors |
| Age for immature immunity | newborns |
| Age for immunity becomes weak | elders |
| Nutritional status | especially if protein reserves depleted |
| Medical therapies | radiation therapy, biopsies |
| Medications | cancer meds, steroids, antibiotics killing normal flora and allowing overgrowth of pathogens |
| Pre-existing Diseases that lower body’s defenses | COPD, PVD, DM, protein wasting, ↓immunity |
| Heredity | immunoglobulin deficiency |
| Physical, emotional stressors- | ↑cortisone; prolonged ↑causes ↓immune response |
| Antiseptics | chemical preparations that inhibit growth of some microorganisms. Used on skin or tissue. |
| Disinfectants | chemicals that destroy pathogens other than spores. Used on inanimate objects. More concentrated solution than antiseptics. |
| Bactericidal Agent | destroys bacteria |
| Bacteriostatic Agent | prevents growth, reproduction of some bacteria |
| Disinfecting and Sterilizing | Etiologic agent and reservoir interrupted |
| Supporting Defenses of a Susceptible Host | Susceptibility degree to which a person can be affected |
| Recommended concentration of disinfectant, duration of contact | Nursing Considerations When Disinfecting |
| Type and Number of Organisms | Nursing Considerations When Disinfecting |
| Presence of soap can inhibit action | Nursing Considerations When Disinfecting |
| Presence of organic materials (saliva, blood, pus, excretions)—can inactivate disinfectants | Nursing Considerations When Disinfecting |
| Surface area to be treated—must cover entire affected area | Nursing Considerations When Disinfecting |
| Sterilization | Destroys all microorganisms, including spores & viruses |
| Sterilization Moist heat | autoclave, steam under pressure |
| Sterilization Gas | ethylene oxide, kills spores, good for heat sensitive objects, toxic to humans |
| Sterilization Boiling water | at least 15”, doesn’t kill spores & some viruses |
| Sterilization Radiation | UV not deeply penetrating; Ionizing good for heat sensitive objects, foods, drugs, but expensive |
| Standard Precautions—used in care of | all hospitalized persons regardless of diagnosis or possible infection status |
| Transmission-Based Precautions | Avoid injury from sharp instruments, prevent exposure, communicate precautions to employees |
| Droplets are smaller than 5 microns (measles, TB, and varicella) | Airborne |
| Pts need a private room with negative pressure air | Airborne |
| Special respirator mask | Airborne |
| Pt must be transported with a mask on the patient | Airborne |
| Protective Isolation | Compromised clients—highly susceptible to infections—from their own flora or other people or objects |
| leukemia | Protective Isolation Example |
| chemotherapy | Protective Isolation Example |
| burns | Protective Isolation Example |
| severe dermatitis | Protective Isolation Example |
| transplant patients | Protective Isolation Example |
| Contact Precautions | Intended to prevent transmission of infectious agents, including epidemiologically important microorganisms, which are spread by direct or indirect contact with the patient or the patient's environment |
| Particle Droplets greater than 5 microns | Droplet Precautions |
| Diphtheria | Droplet Precautions disease |
| Pneumonic plague | Droplet Precautions disease |
| Scarlet fever (infants & young children) | Droplet Precautions disease |
| Strep pharyngitis | Droplet Precautions disease |
| Rubella | Droplet Precautions disease |
| Mycoplasma pneumonia | Droplet Precautions disease |
| Pertussis | Droplet Precautions disease |
| All objects used in sterile field must be sterile | Sterile Field |
| Sterile objects become unsterile when touched by unsterile objects | Sterile Field |
| Sterile items out of vision or below waist or table level are considered unsterile. | Sterile Field |
| Sterile objects can become unsterile by prolonged exposure to airborne microorganisms | Sterile Field |
| Sterile field | microorganism-free area, supplies in wrappers |
| NIOSH | part of CDC, preventing needlesticks |
| OSHA | protect healthcare workers from injuries |
| Report the incident immediately: Identify and document the source | Bloodborne Pathogen Exposure |
| Test the source for Hep B, C and HIV (with consent) | Bloodborne Pathogen Exposure |
| Seek appropriate evaluation and follow-up | Bloodborne Pathogen Exposure |
| Post exposure prophylaxis if indicated (with HIV, must begin within 1 hour of exposure) | Bloodborne Pathogen Exposure Seek appropriate evaluation and follow-up |
| Medical and Psychological counseling | Bloodborne Pathogen Exposure Seek appropriate evaluation and follow-up |
| Puncture/Laceration Encourage bleeding, but do not | squeeze tissues |
| Incubation | Stages of the infectious process |
| Prodromal | Stages of the infectious process |
| Acute—max. impact | Stages of the infectious process |
| Convalescent | Stages of the infectious process |
| Carrier | Stages of the infectious process |
| host defenses eliminate disease, but organism still replicates on mucosal sites | Carrier |
| pathogen actively replicates but does not cause symptoms yet—hrs. (Salmonella) to years | Incubation |
| nonspecific symptoms begin (malaise, fever, myalgias, headache, fatigue) | Prodromal |
| rapid proliferation and dissemination of microorganism; symptoms worse, tissue damage and inflammation | Acute—max. impact |
| infection contained; pathogen gone | Convalescent |
| Specific to infecting organisms, body systems involved | Complications of infectious diseases- |
| Shock, hypotension, impaired organ perfusion | Complications of infectious diseases- |
| Diffuse cell & tissue injury; potential organ failure | Complications of infectious diseases- |
| Urinary Tract | Most common HAI; gram negative septicemia |
| Respiratory Tract | Pneumonia 2nd most common HAI—ventilators, trachs, ET intubation |
| Invasive catheter sites on skin | bacteremia from intravascular and urinary catheters |
| Surgical Wounds | staph, enterococcus, including MRSA, VRE |
| Endogenous | Source of microorganisms |
| Exogenous | Source of microorganisms |
| Iatrogenic | Source of microorganisms |
| Source of microorganisms -from client | Endogenous |
| Source of microorganisms -hospital and staff | Exogenous |
| Source of microorganisms - diagnostic/therapeutic | Iatrogenic |
| HAIs —after 48 hours of hospitalization | Health care-associated infections |
| Nosocomial Infections 2 million clients how many deaths | 90,000 |
| VRE | methicillin resistant Staph Aureus |
| MRSA | Vancomycin resistant Enterococcus |
| Penicillin | resistant Strep. pneumonia (PRSP) |
| C. difficile common cause of | nosocomial diarrhea |
| MDR-TB | Multi-drug-resistant Tuberculosis |
| VISA or VRSA | Vancomycin-resistant or –intermediate S. aureus |
| Prevent infection | 1 of the 4 strategies from CDC to prevent Antimicrobial Resistance in Healthcare Settings |
| Diagnosing and treating infection effectively | 1 of the 4 strategies from CDC to prevent Antimicrobial Resistance in Healthcare Settings |
| Using antimicrobials wisely | 1 of the 4 strategies from CDC to prevent Antimicrobial Resistance in Healthcare Settings |
| Preventing transmission | 1 of the 4 strategies from CDC to prevent Antimicrobial Resistance in Healthcare Settings |
| Antibodies pass from mother to baby through the placenta or in colostrum- lasts 6 mo to a year | Natural passive immunity |
| When the immune serum (antibody) from human or animal is injected – lasts 2-3 weeks (IVIG) | Artificial passive immunity |
| Passive Immunity | Host receives natural or artificial antibodies produced from another source |
| Active Immunity | Host produces antibodies in response to natural antigens or artificial antigens |
| (Have had the disease) Antibodies form in the presence of infection, lifelong immunity | Natural active immunity |
| (Vaccines) Antigens administered stimulate antibody formation, lasts for years – reinforced by booster | Artificial active immunity |
| Fever | Signs of Systemic Infection: SEPTICEMIA |
| Tachycardia and tachypnea | Signs of Systemic Infection: SEPTICEMIA |
| Malaise | Signs of Systemic Infection: SEPTICEMIA |
| Anorexia, nausea and vomiting | Signs of Systemic Infection: SEPTICEMIA |
| Lymphadenopathy | Signs of Systemic Infection: SEPTICEMIA |
| Localized swelling | Signs of Localized Infection: BACTEREMIA |
| Localized redness | Signs of Localized Infection: BACTEREMIA |
| Pain or tenderness with palpation or movement | Signs of Localized Infection: BACTEREMIA |
| Palpable heat in the infected area | Signs of Localized Infection: BACTEREMIA |
| Loss of function of the body part affected | Signs of Localized Infection: BACTEREMIA |
| Localized Infection- | Skin and mucous membranes (swelling, redness, pain, heat, loss of function, wound drainage) |
| Signs of systemic infection | (Fever, ↑pulse, resps., malaise, fatigue, ↓appetite, N, V, ↑lymph nodes) |
Created by:
ED.
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