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Nursing
Infection Control
| Question | Answer |
|---|---|
| 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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