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IV Therapy - WK2

APIC Association of Practitioners in Infection Control and Epidemiology - 0 tolerance for infections and adverse affects
CDC Centers for Disease Control and Prevention
CMS Centers for Medicare and Medicaid Services
INS Infusion Nurses Society – policies and procedures
TJC The Joint Commission – oversee the healthcare facilities
OSHA U.S. Occupational Safety and Health Administration – law enforcement agency to protect all emp from harm
Primary Immune System Organs Thymus and Bone Marrow
Secondary Immune System Organs Lymph nodes, spleen, liver, Peyer's Patches, appendix, tonsils and adenoids, lungs
Thymus located in the medial stinal cavity; immune function afterbirth and early in life; t-cells developed here
Bone Marrow produces stem cells (precursor to more advanced leukocytes and lymphocytes) done in the sternum, long bones, rib
Lymph nodes inner connected system of vessels; b cells, t cells and macrophages are stored; chained pathway of lymph drainage which filters and drains cellular waste
Spleen left upper quad - under diaphram, stores red cells, leukocytes, lymphocytes and platelets; forms blood cells; filters out antigens;
Liver contains kupffer cells, filter for antigens
Peyer's Patches small patches of lymphoid tissue; walls of sm. Intest.; contain b cells and t cells
Appendix located where large and sm intestines meet; b cells and t cells as well as good bacteria
Tonsils and adenoids contain lymphoid tissue; store b and t cells
Lungs respiratory tree; filter out antigenic material and cellular debris; protects lungs from stuff breathed in
Nonspecific immune responses present at birth; function without prior exposure to an antigen
Specific immune responses Acquired; Functions when there has been prior exposure to antigens; Shot or vaccine
Physical 1st line mechanisms Skin, mucous membranes, respiratory tract cillia
mucous membranes traps pathogens or antigens ; nose, throat and bronchial
respiratory tract cilia traps any debris and prevents them from passing into lungs
Chemical first line mechanisms tears, gastric acidity, vaginal secretions
tears contains sodium and lipid fat
gastric acidity high acid content targets specific bacteria, but allow good bacteria to continue to function
vaginal secretions highly acidic; prevent growth in an area which would be suceptable to bac growth
Mechanical first line mechanism lacrimation, instestinal peristalsis, urinary flow, coughing and sneezing,
Lacrimation releasing tears; flush eyes of antigens; crying
Intestinal peristalsis moves stuff in GI; expell foreign organisms
Urinary flow similar to peristalsis
Coughing and sneezing expel antigens from body
Phagocytosis white blood cells engulf and destroy a pathogen directly (pac-man)
Complement cascade blood proteins called compliment triggers; attack an antigen cell membrane; cell mem. Ruptures causing basophils to release histamine; histamine causes inflam. And coughing & sneezing; damaged cell releases more chemicals and causes a secondary infection
Inflammation and fever when body recognizes it has a foreign invader- increases fever so it can't survive
Tertiary mechanisms Specific immunity, Passive acquired immunity, Active immunity
Specific immunity exposure to specific antigen
Passive acquired immunity occurs when immune cells by gama globulin infusions
Active Immunity occurs when a direct contact w/ the disease
Lymphocytes Bcells and Tcells; recognizes antigens; find foreign invader; neutralizes or tries to stop antigen long enough to be phagosized (engulfed and eaten)
Impaired Host Individuals with major defects related to specific immune responses – every part of immune system doesn't work (late-stage cancer pt on chemo; aids pt)
Primary congenital or inherited; missing immunoglobulin (5 immunoglobulins) @ birth
Secondary caused from a disease or tx that caused it.
Four major factors of immune dysfunction Infections occur frequently Infections are more severe than usual Unusual infecting agents or infections with opportunistic organisms occur Incomplete response to treatment
Epidemiology study of epidemics
Epidemics occurences widespread r/t health and diseases of people
Colonization when microorganism attacks host; grows and multiplies; no S
Short term transient carrier carries disease and not affected by it
Intermediate carrier only carrier while disease is growing
Dissemination shedding of organism into immediate environ. from a carrier or from 1 part of body to another; how diseases can spread
Chain of Infection 1. Causative Agent (microorganism) 2. Reservoir (source) 3. Portal of exit from reservoir 4. Method of transmission 5. Portal of entry to host 6. Suseptible host 4.
Local infection affects 1 part of body
Systemic infection spreads throughout body; becomes septic
Endogenous Produce your own infection (within)
Exogenous infection comes from outside source
Stages of infection 1. Incubation (immed after invasion/ before symptoms) 2. Prodromal (vague symptoms) 3. Illness (specific S&S; ineffective tx may cause death) 4. Decline (microorganisms numbers are declining d/t successful tx) 5. Convulescent (Repair and return
Health Care Associated Infections (HAIs) infections that patients acquire during the course of receiving treatment for other conditions or that health-care workers acquire while performing their duties within a health-care setting
Factors Affecting HAIs 1. more complicated patients with co-morbidities 2. Increasing number of patients who are immunocompromised 3. devices and procedures used for longer duration 4. short staffing 5. Antimicrobial-resistant pathogens 6. Emerging infectious disease
Bloodstream infections (BSIs) least frequently recognized hospital infect. 250,000 cases of central line associated bloodstream infections (CR-BSIs) annually
Sources of Contaminated Catheters Skin flora Contamination of catheter hub Contamination of infusate Hematogenous colonization
Extrinsic contamination During preparation (ungloved; bad hand hygeine; not using aseptic technique)
Intrinsic contamination During manufacturing – not sterile; can cause an epidemic
What to do if Infusion-Related Infection Suspected Obtain culture from suspected source of infection; Always clean golves & good hand hygeine
Infusion related sources of infection Catheter-skin junction Peripheral infusion catheter Administration set Infusate Patient’s blood
catheter-skin junction culturing techniques if suspected is skin, don't cleanse the skin before culture
infusate culturing technique sterile needle, remove 5 mL fluid and put in sterile culture tube
blood culture technique at least 20 mL to Lab; do not discard 1st draw of blood
Strategies to Prevent Infection Follow CDC Standard Precautions Guidelines; hand hygiene; appropriate skin antisepsis prior to procedures; catheter-site dressing regimens; catheter securement devices; antimicrobial/antiseptic-impregnated catheters and cuffs; tissue-interface barriers; I
tissue-interface barriers secures central line from inside out; silver ions and collogen cuff – grows onto skin from inside
Biological Occupational Risks Bloodborne pathogen exposure (HBV, HIV, HCV – all incurable and caught from pts)
Physical Occupational Risks Chemical exposure (Hazardous drugs – ability to cause chromosome breakage in lymphocytes and mutigenic activity and skin necrosis -chemo, radiation (anti-neoplastics) are 2 examples Must have a msds if hazardous drugs are on unit) and Latex exposure
Isolation precautions Contact, Droplet, Airborne
Contact precautions techniques used in addition standard precautions that decrease infections by microorganisms transmitted thru direct contact with pt or pt care items
Droplet precautions Infection d/t inhalation of respiratory pathogens suspended on liquid particles exhaled from someone already infected.
Airborne precautions Techniques used to decrease infection by microorganisms by air.
Aerobic occuring in the presence of oxygen
Anaerobic occuring in the absence of oxygen
Antibodies substance produced by B lymphocytes in response to a unique antigen. Neutralizes or destroys antigen.
Hematogenous produed by or deried from blood; disseminated through bloodstream or by the circulation
Host organism from which a microorganism obtains its nourishment
Immunosuppression Interference w/ the dev. of immunologic responses; may be artificially induced by chemical, biologic, or physical agts or may be caused by disease
Leukopenia any condition in which the number of leukocytes in the circulating blood is lower than normal.
Pathogenicity the state of producing or being able to produce pathological changes and disease
Phlebitis Inflammation of a vein
Reservoir living or nonliving material in or on which an infectious agt multiplies, develops and is dependent of for its survival in nature
resident flora microorganisms that are indigenous to each individual and are present mainly on the skin and in the respiratory, gastrointestinal, and reproductive systems
Septicemia presence of pathogenic microorganisms or their toxins in the blood or other tissues
Transient flora microorganisms that are picked up, usually on skin, that can be removed fairly easily w/ hand hygiene
vector-borne transmission a carrier, usually an insect or other animal, that transmits the causative organisms of disease from infected to noninfected individuals
vehicle-borne transmission any substance that serves as an intermediate means to transport and introduce an infectious agt into a suseptible host thru a suitable portal of entry
Virulence relative power and degree of pathogenicity posessed by organisms to produce disease
Created by: MarieG