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Infection Control

Agents causing infection Bacteria, viruses, fungi, parasites, prions, multi resistant organisms
Infectious diseases MRSA- Tx Vancomycin. VRE- Tx synercid & zyvox. AIDS. Hepatitis A: fecal oral; hepatitis B: blood. Influenza. TB (Tuberculosis)- Tx combination of antibiotics
Modes of transmission Contact (direct-skin to skin, indirect-touch surfaces others have touched, droplet-large particle). Vehicles. Droplet. Airborne- tiny particles that hang in air. Vectorborne- ex. mosquito
Universal Standard Precautions decrease transmission from blood borne pathogens regardless of diagnosis
Body Substance Isolation Decrease transmission from moist body substances- wear gloves when handling feces, urine, nasal secretions, vomitus, and sputum
OSHA (Occupational Safety and Health Admin) Federal Agency. Requires employers to have a plan which includes: Universal precautions, personal protective equipment, hepatitis B vaccine, exposure follow-up, employee training, monitoring compliance. Has right to conduct work inspections without notice
Medical (Clean technique) Includes all measures aimed at reducing the number or spread of microorganisms. Ex: handwashing, gloving, gowning, disinfecting
Surgical (Sterile technique) Prevent introduction of microorganisms from the environment into pt. Ex: surgical procedures, procedures involving bloodstream, breaking of the skin or mucous membranes, certain dressings, insertion into body cavities, high risk pts
Aseptic Practices Hand hygiene, disinfection, sterilization, PPE- masks, gown, gloves, caps. Isolation rooms- negative airflow.
Transmission-based precautions Additional isolation after an organism has been identified: airborne, droplet, contact, enteric, strict, protective, drainage/secretion
Normal resistance to infection Normal flora. Barriers to infection: skin, WBCs, inflammatory response, fever
Specific Acquired Defense: Immunity Antigens (antibodies), T-lymphocytes (cellular immunity)- cells attack microbe at the site of invasion and/or keep a memory of the antigen. B-lymphocyte (humoral immunity)- occur in bloodstream: produce antibodies which produce resistance.
Active immunity vaccination
Passive immunity mom to baby
Lifespan considerations Newborn and infant: immunity fully functional at 6 months. Toddler and preschooler: needs supervision. Child and adolescent: skin disease, lice, staph infections. Adult and older adult: immunity established, chronic disease, HAI
Compromised Host Breaks in skin and mucous membranes, invasive devices, stasis of body fluids, inadequate nutrition, stress/hyperglycemia, immune system dysfunction, co-existing medical problems, drug therapy
Types of infection Colonization (organism grows in pt). Nosocomial (hospital acquired). Local (infection in one area) vs systemic (entire body). Acute vs chronic. Sepsis.
Healthcare-Associated infections Include the following Settings Acute care settings, extended care facilities, ambulatory care centers, homes, schools
Nosocomial Infections 2 million each year with 90,000 deaths. UTI most common (35%)- followed by surgical site, bloodstream, and resp. HANDWASHING is the key to preventing HAIs
Iatrogenic Infection Results from a therapeutic or diagnostic procedure. Ex: UTI
Exogenous Infection Organisms external to pt not normally present. Ex: salmonella or C diff
Endogenous infection Microorganisms that exist as part of the normal flora become pathogenic. Ex: E-coli, yeasts
Factors Predisposing to common infections urethral/urine, wound, resp
Incubation period of infection time between the pathogen's entrance and appearance of symptoms
Prodromal stage of infection nonspecific symptoms such as nausea, fever, weakness (malaise), or pain
Acute Phase of Illness Specific symptoms occur and lab analysis can identify disease
Convalescence Stage of Infection Completes the progress of an infection- antibodies appear in blood, and body systems return to normal
Communicable Diseases Transmittable between one person and another- contagious. Childhood disease.
Manifestations of an Infection Fever- chill phase, fever phase, crisis phase. Increased pulse and resp rate. Inflammation. Pain. Purulent drainage. Enlarged lymph nodes. Rash. GI symptoms: anorexia, nausea, vomiting, diarrhea.
Localized Inflammatory response Erythema- Blood accumulating in the dilated vessels. Warmth- from heat of blood. Swelling- fluid accumulation. Pain- pressure or injury to local nerves.
Ways to reduce or prevent transmission in healthcare Avoid recapping needles. Immunizations. Needleless systems. Gloves. Handwashing. Proper waste disposal. Work restriction of ill employees. Use of barriers: gloves, gowns, masks, goggles. isolation
Subjective Data Rest and exercise, nutrition, use of herbs and vitamins. Knowledge base, Risk identification: exposure.
Objective Data General Inspection, vital signs, auscultation, lymph node assessment, diagnostic tests and procedures.
WBCs Normal: 5,000-10,000/mm3. Increased during infection (leukocytosis). Leftward shift
ESR (Erythrocyte Sedimentation Rate) Spins blood around. Sees how blood cells settle. More than it should indicates inflammation
Nursing Diagnosis Risk for infection (only one NANDA accepts)
Implementation Comfort measures to relieve pain/fever. Fever managements: antipyretics, tepid baths, cooling blankets. Ambulation & positioning. Pulmonary activities:coughing & deep breathing, incentive spirometer. Pt & family education Antibiotics. Standard precautions
Neutropenia Precautions Neutropemia ANC < 1000. Precautions ANC < 500. ANC = WBC x neutrophil count.
Created by: senmark
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