question

Joseph Lister

answer

(1827-1912) "father of aseptic technique" helped reduce morbidity adn mortality from surgery / wound care

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non-pathogenic

answer

harmless microbes do not produce disease

question

pathogen

answer

cause disease and infection

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Infection chain of events

answer

1. Infectious agent -- pathogen 2. Reservoir -- where the pathogen can grow 3. Exit route from reservoir 4. Method / vehicle of transportation 5. Entrance --through skin, mouth, mucous lining 6. Host --another person or animal cycle must be interupted to prevent the spread of microorganisms

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common multi-drug-resistant bacteria

answer

-MRSA -VRE

question

MRSA

answer

methicillin-resistantStaphylococcus aureus -serious sometimes fatal infection -transmitted from healthcare workers hands -can live up to 3 hours on hands -effects GI tract & Respiratory tract -does not show signs / symptoms immediatly -not immediatly recognized as a resovoir Precautions: -gown & gove

question

VRE

answer

vancomycin resistant -live in GI tract, female genital area -transfered on equipment and surfaces precaustions: -gown & glove -do not leave equipment on patients tables, etc.

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bacteria

answer

round, oblong, and spiral (many variations) -aerobic / anaerobic -motility = flagella

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aerobic

answer

bacteria grow only in presence of oxygen

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anaerobic

answer

bacteria grown only in absense of oxygen

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spore

answer

round body that is formed by the bacterium when conditions are unfavorable for growth -surrounded by a capsule -high degree of resistance to heat / disinfectants -cannot be stained -can lay dormant in soil for years -capsule can prevent antibiotics from working

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Gram stain

answer

use of dye's - gram + = stain remains - gram - = stain is not retained

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Culture

answer

specific medium with specific nutrients to promote growth of microbes

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Culture and Sensitivity tests

answer

determine which antibiotics inhibit growth of bacteria

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bacterial movement

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makes it possible for bacteria to travel from person to person

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oportunistic microbes

answer

take opportunity to infect host when immune system defenses are low ex: the very old or the very sick

question

streptococcus bacterium

answer

responsible for more diseases than any other organism

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anthrax

answer

spore-forming bacterium bacillus anthracis acute infection occurs in 3 forms: 1. cutaneous (skin) (most common) 2. Inhalation 3. Gastrointestinal -most likely transission : breathing in spore , or spore contact with the skin -not transmitted by coughing or sneezing or casual contact with person -detected in blood, skin lesions, or respiratory secretions by means of a lab culture or measurement of specific antibodies -can be fatal if untreated

question

staphaureus

answer

causes many acute severe infections manitol (carb) fermenting gram + ex: infantigo, wound infections, toxic shock syndrome

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rock mountain spotted fever

answer

most lethal / reported rickettsia in US symptoms occur 3-12 days post tick bites 1. headache 2. fever 3. rash -diagnosed by blood test

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Viruses

answer

smallest known agents to cause disease not complete cell, composed of RNA or DNA consist of a protein coat around a nucleic acid core adn depend on metabolic processes of the cell they enter

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viral infections

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usually self-limiting run a given course recovery usally occurs (except rabies or AIDS)

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common cold

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= virus sympotms: aching feeling fever chilling relieved by bed rest and certain over the counter remedies no medicine will cure the cold / will only relieve discomfort

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classification of viruses

answer

either by the characteristics of a specific group -or- according to the human disease they cause

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Fungi

answer

mycotic infections are among the most common disease found in humans -most are harmless -caused by yeast and molds they prefer moist, dry, places

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Protozoa

answer

single-celled animals exsist everywhere in nature parasitic- found in intestinal tract, circulatory system disease producing - malaria, amebic dysentery, african sleeping sickness

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reservoir

answer

organisms require food and a proper atmosphere (food, oxygen, water, temp, pH, and light) ex: soiled or wet dressings

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carrier or vector

answer

person or animal who does not become ill but harbors and spreads an organism causing disease in others

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Exit route

answer

gastrointestinal respiratory genitrourinary systems tissue blood and wounds

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hand hygiene

answer

can prevent the spread of pathogens

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contamination

answer

condition of bein soiled, stained, touched by, or otherwise exposed to harmful agents

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fomite

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nonliving object ex: computer, medical records, scissors, needles

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indirect method of transmission

answer

vector or fomite

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vector

answer

living carrier of pathogen

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transmission in hosp.

answer

air currents - do not shake linens when making a bed floors - dirtiest area in building

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entrance of microbes

answer

once microbe has exited resovoir & is transmitted to suseptable host organism must find a way to enter -eyes -mucous membranes -resp. tract -breaks in skin -placenta -easiest when hosts defense mechanisms are down

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how to prevent entrance of microbe

answer

1. kee skin intact (1st line of defense) 2. avoid accidental needle sticks (never recap) 3. correct cleansing of wounds 4. proper care of foley catheters

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Host

answer

an organism in which another, usually parasitic, organism is nourished and harbored

question

factor affecting immunologic defense mechanisms

answer

-increasing age and extreme youth -stress -nutritional status -hereditary factors -disease processes -enviromental factors - medical therapy -chempotherapy -radiatin -lifestyle -occupation -diagnostic procedures -travel history -trauma

question

cardinal sign of infection

answer

increased white blood cell count

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stages of an infectious process

answer

1. incubation period 2. prodromal stage 3. illness 4. convalescence

question

incubation period

answer

interval between entrance and 1st symptoms

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prodromal stage

answer

interval from onset and nonspecific signs and symptoms to more specific symptoms

question

illness stage

answer

interval when patient manifests signs and symptoms

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convalescence

answer

interval when acute syptoms of infection disappear

question

localized infection

answer

(ex: superficial wound infection) proper care controls the spread adn minimizes the illness symptoms occur at wound site

question

systemic infection

answer

affects the entire body has potential to become fatal

question

inflammatory response

answer

can occur w/o infection bodys response to injury or infection at the cellular level -protective vascular reaction that delivers fluid, blood products, and nutrients to interstitial tissues in the area of an injury -neutralizes and eliminates pathogens , establishes means of repairing

question

signs of inflammation

answer

edema rubor (redness) heat pain tenderness loss of function in affected body part

question

systemic inflammation

answer

other signs and symptoms develop fever leukocytosis malaise anorexia nausea vomiting lymph node enlargement

question

triggers of inflammation response

answer

physical agents: micoorganisms mechanical traua temp extremes radiation chemical agents: external / internal irritants harsh poisons gastric acid microorganisms

question

#1 single most critical way to reduce spread of microbes

answer

HAND WASHING

question

acute inflammation

answer

short term inflammation cellulitus = spreads to surrounding tissues absess = puss surrounded by swelling -fever , lymphnode enlargement, loss of appetite

question

chronic inflammation

answer

slower onset can last months to years treatments: antipyretics wound care balanced diet rest antibiotics antiinflammatories

question

infection vs. inflammation

answer

infection: invasion & multiplicaiton of infectious agents illness or injury damages to tissue and cells inflammation: protective response condition resulting from irritation pain, heat, redness

question

how many people are admitted to hosp. each yr

answer

more than 40 million , 10% of them acquire a health care associate infection

question

(HAI) Health care associated infection

answer

NOSOCOMIAL INFECTION occurs @ least 48 hrs after hospitilization usually highly virulent -direct contact of professionals to patient or patient to patient -pt's immune system is already low so @ higher risk for worsened disease -significantly increase health care costs / extend length of stay in hosp.

question

Virulent

answer

of or pertaining to a highly pathogenic or rapidly progressive condition

question

exogenous

answer

growing outside of the body

question

exogenous infection

answer

caused by microbes from another person

question

endogenous

answer

growing within the body

question

endogenous infection

answer

infection is caused by the patient's own normal microbes which become altered and overgrow or are transferred from one body site to another

question

CMMS for catheters

answer

medicaid and medicair no longer reimburse hospitals for catheter-associated urinary tract infections and blood stream infections

question

Infection prevention / control team

answer

valuable discipline in the health care arena

question

infection preventionist

answer

specially trained nurse for infection prevention responsibilities: advising hosp personnel on safe patient care delivery practices & monitor health care outbreaks -staff edu -review pt med records and labs -screen pt records for community aquired infections -consult with occupational health departments -compiling data / analyzing for epidemiology of health care -notify PHD of incidence of communicable disease -confer w/ other hospitals / departments to investigate cluster of infections -edu pt and families -assess microbe sensitivity to antibiotics

question

Occupational Health Services

answer

play important role in prevention or control of infection in health care setting -measures taken to protect health care worker & pt's

question

hep B

answer

most common transmitted by contaminated needles

question

Nurses Responsibility in infection control

answer

1. hand washing 2. bein immunized 3. personal protection agents 4. dispense of sharps appropriatley 5. clean technique / standard precaustions

question

Standard Precautions

answer

1. univerasal blood and body fluid precautions 2. universal precautions ( Guidelines set in place by the CDC ) -designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infections -promote hand hygiene and use fo gloves, masks, eye protectin, gowns when appropriate for pt contact

question

CDC role in infection control (standard precautions)

answer

center for disease control -guidelines for isolation precautions in hospitals -goal = interrupt the chain of infection and reduce transmission of bloodborne pathogens adn other potentially infectious materials from moist body substances 1. blood 2. all body fluids 3. nonintact skin 4. mucous membranes

question

Hand Hygiene is essential

answer

single most important basic preventative technique for interrupting the infectious process

question

when to wash hands

answer

- when visibly soiled -before and after care -after contact with organic material -in prep for invasive procedure -before having contact with open wound -after disposable gloves or handling contaminated equipment -before / after using the toilet -before and after eating -beginning and end of shift

question

standards of handwashing

answer

2 min hand wash 1st time on shift 15 to 30 seconds between each pt using hospital approved soap (ETOH based hand rub is ok if hands are not visibly soiled- let air dry) running hands under warm water

question

standards of ETOH based hand rub

answer

only if hands are not visibly soiled 1. apply an ample amount to palm of one hand 2. rub hands together, cover all surfaces 3. rub for several seconds until dry -air dry (15-25 seconds) before gloves 4. small amounts of hospital grade lotion or barrier cream may be applied if chapped

question

Personal Protective gear

answer

-uniform -scrubs / suits / gowns -gloves -maks -protective eye wear -hair / shoe covers

question

Gloving guidelines

answer

-don gloves if there is any possibility of contact with infectious materials- 1. wash hands 15-30 seconds 2. chose right size 3. don gloves 4. change when going infected to uninfected area 5. dont touch anything in room w/ gloves on -wear only once, then dispose of -change if contaminated during care -wash hands after removing

question

Gowning guidelines

answer

...

question

Mask

answer

maks should fit snugly below chin and securly over nose and mouth, and top edge will fit below eyeglasses change mask at least every 20-30 minutes or if moist do not reuse or allow to dangle from neck & then reuse

question

why wear a mask

answer

-protect wearer from inhaling microorganisms via airborne droplets -in case of splashing -pt wears mask to prevent inhalation of pathogens -discourage pt from touching moth, nose , or eyes -keeps infected from transmitting infectious materials

question

disposing of contaminated equipment

answer

specially labeled (usually red) bags = removal from nursing unit -sharps puncture proof container for needles/blades

question

double bagging

answer

CDC reccommends contaminated items be double bagged -used to safely removed contaminated article from the room -label and color code (no longer a universal precaution)

question

Isolation Techniques

answer

CDC 2 tiered approach: 1. Standard Precaution: precautions designed to care for all pt as presumed infectiousness 2. Disease-Specific Precautions: condenses into disease specific categories via mode of transmission (i.d.'s pt w/ highly transmittable pathogens)

question

modes of transmission

answer

1. airborne 2. droplet 3. contact 4. vector 5. fomite 6. 7.

question

Which Isolation Technique to use

answer

-depends on how transmissible the pathogen is (follow basic principles regardless of technique) -hand hygiene when entering and leaving room -use proper barriers as related to disease transmission mode -dispose of contaminated articles / equipment properly -protect others who will potentially be exposed (reverse isolation: pt in mask and gown)

question

airborne precaution

answer

measles, varicella, tuberculosis

question

droplet precaution

answer

flu, meningitidis, diptheria, pertussis, pneumonia, strep, mumps, rubella, TB single room for infected pt wear mask w/i 3 feet of pt seperate roommate with 3 ft @ least contact precautions: gloves gown

question

TB precautions

answer

isolation is manditory room with negative-airflow pt wears HEPPA respirator when outside of room health care workers wear N-95 or higher mask

question

contact precautions

answer

when pt has illness that can be contracted via contact to contact or fomite

question

immunocompromised patient

answer

@ an increased risk for suseptability -require private room (Reverse isolation) : pt wears mask, etc. -no fresh fruit or flowers allowed in room -avoid invasive procedures -special air purification procedures ex: leukopenic pt or neutropenic pt

question

reverse isolation

answer

pt wears gloves, gown, face mask, eye protectant, covered shoes, etc.

question

Isolation technique: basic principles

answer

1. hand washing!! 2. know disease process / barriers that will protect form it 3. dispose of contaminated equipment immediatly and properly 4. reverse isolation when transporting 5. private room for pt 6. maintain asepsis of patients arcticles

question

Negative Pressure room

answer

air vented outside

question

Positive Pressure room

answer

air in room does not leave and new air does not come in to prevent organisms from entering room

question

droplet/ contact protective wear removal

answer

1. remove gloves 2. wash hands 3. remove gown 4. wash hands 5. remove eye protection 6. remove mask 7. wash hands

question

surgical asepsis

answer

(sterile technique) maintaining absence of ALL microbes, including pthogens and spores, from an object used in: operating room, labor and deliver room, major diagnostic procedure areas, patients bedside examples used for: inserting catheter, IV, suctioning trach, reapplying sterile dressings

question

Sterile field

answer

free of microbes and prepared to recieve sterile items -room to handle / place sterile items for sterile procedures

question

principles of sterile technique

answer

1. steril object remains sterile only when touched exclusively by other sterile objects 2. place only sterile objects on sterile field 3. sterile object or field out of the range of vision or an object held below a person's waist is contaminated 4. sterile object or field becomes contaminated by prolonged exposure to air 5. when a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated 6. fluid flows in the direction of gravity 7. consider the edges of a sterile field or container to be contaminated (assemble all of the equipment necessary for a sterile profcedure before the procedure begins)

question

How to avoid patient contamination of sterile field

answer

explain: -not to make sudden movements of body parts covered by sterile drapes -refrain from touching sterile supplies, drapes, or nurse's gloves or gown -avoid coughing, sneezing, or talking over a sterile area

question

Sterile packages

answer

items packaged in paper or plastic containers are impervious to microbes as long as they are dry adn intact - always check expiration dates -if pckg intergrity is compromised DO NOT USE

question

Pouring sterile solutions

answer

a bottle containing a sterile solution is sterile on the inside and contaminated on the outside -never place cap sterile side down -"lip" the bottle by pouring a small amount into a disposable cup and discarding it (cleans lip of the bottle) -do not let recieving container touch edge of bottle -do not cause splashing onto the sterile field while pouring -hold bottle outside of the edge of the sterile field

question

Sterile glove methods:

answer

1: open method: when gloves come in sterile pkg 2. closed method :keep hands covered with sterile gown and use it to aid in gloving (glove dominant hand first)

question

Antimicrobial agents

answer

soap detergent alcohol iodine chlorine chlorhexide gluteraldhyde

question

bacteriostatic solutions (antiseptic)

answer

inhibit the growth of microbes, does not kill them

question

cleaning

answer

removal of foreign materials from an object -water + mechanical actions w/ or w/o soap

question

reusable objects / equipment

answer

must be thoroughly cleaned, disinfected, and sterilized if not discardable -when cleaning, don gloves and goggles

question

disinfectant

answer

(disinfectant / bactericidal solutions) used to destroy microbes -does NOT destroy spores (too strong for human skin only use on inanimate objects) 1/10 solution

question

sterilization

answer

methods used to kill microorganisms including spores 2 types: 1. physical 2. chemical

question

physical sterilization

answer

heat radiation

question

chemical sterilization

answer

chemical sprays iodine chlorine

question

patient teaching

answer

use of infection prevention and control practices pt is less aware of factors that promote/spread infection andways to prevent transmission -nurse is obligated to to educate pt about nature of infection adn techniques to control and prevent

question

Home / Hospice infection control

answer

wounds developing 30 days after discharge from hospital are @ times and outcome of hospitalization and need to be reported to infection preventionist

question

Home setting infection control

answer

1. hand hygiene 2. food preparation (temp, etc) 3. tube feeding (clean properly) 4. linens (hot soapy water & 1 cup bleach per load) 5. waste containers (flush bodily fluids down the toilete) 6. body fluid spills (clean up as soon as possible, spray 1 cup bleach diluted with 10 cups water over spill)

question

WELCOME

answer

W -wash hands / wear gloves E - explain procedures L - locate i.d. band / i.d. pt C - comfort of you and pt O - obtain privacy M - maintain good body mechanics E - ensure to be safe w/ pt care

question

Gowning

answer

remove watch, push up sleeves wash hands don gown remove after care discard appropriatley

question

Removing mask

answer

dont touch during use change if it gets moist -wash hands -remove gloves -handle by strings -dispose of properly -wash hands

question

microorganism

answer

any tiny, usually microscopic, entity capable of carrying on living processes -naturally present on and in the human body as well as in the enviroment

question

infection prevention and control

answer

consists of the implementation of policies and procedures in hospitals and other health care facilities to minimize the spread of health care-associated or community acquired infections to patients

question

asepsis

answer

absence of pathogenic microorganisms

question

medical asepsis

answer

inhibits growth adn spread of pathogenic microorganisms (clean technique) ex: washing hands

question

surgical asepsis

answer

destroys ALL microbes and their spores (sterile technique) ex: preparing for surgery

question

vehicle

answer

means by which microbes are carried about and transported to the next host once they leave the resovoir

question

contamination

answer

condition of bein soiled , stained, touched by , or otherwise exposed to harmful agents

Infection Control / Hand washing fundamentals of nursing chpt 12 – Flashcards

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