Chapter 23: Care of Patients with Infection

Helpfulness: 0
Set Details Share
created 2 years ago by mens05
106 views
Care of Patients with Infection
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

Pathogen

A microorganism capable of producing disease.

2

communicable

Transmitted from person to person.

3

Not Communicable

Microorganisms with differing levels of pathogenicity (ability to cause disease) surround everyone.

4

Virulence

A term for pathogenicity, is related more to the frequency with which a pathogen causes disease (degree of communicability) and its ability to invade and damage a host.

5

Colonization

Microorganisms that are often pathogenic may be present in the tissues of the host and yet not cause symptomatic disease because of normal flora.

6

Centers for Disease Control and Prevention (CDC)

Collects information about the occurrence and nature of infections and infectious diseases.

7

Infection Control Practitioner (ICP)

Is responsible for tracking infections (surveillance) and ensuring compliance with federal and local requirements and accreditation standards.

8

Transmission of Infectious Agents Three Factors:

  • Reservoir (or source) of infectious agents
  • Susceptible host with a portal of entry
  • Mode of transmission
9

Reservoirs

Sources of infectious agents, include people, animals, and insects, soil, water, other environmental sources, and medical equipment.

10

Asymptomatic Carrier

One who harbors an infectious agent without active disease.

11

Immunity

Is resistance to infection; it is usually associated with the presence of antibodies or cells that act on specific microorganisms.

12

Passive Immunity

Is of short duration (days or months) and either natural by transplacental transfer from the mother or artificial by injection of antibodies.

13

Active Immunity

Lasts for years and is natural by infection or artificial by stimulation of the body's immune defenses.

14

Respiratory Tract Route

Microbes in droplets are sprayed into the air when people with infected oral or nasal tissues talk, cough, or sneeze.

15

GI Tract Route

Some stay there and produce disease, others invade to produce local and distant infection.

16

Genitourinary Tract Route

Urinary tract infection (UTI) is one of the most common health care–associated infections

17

Bacteremia

Bacteria in the bloodstream

18

Methods of Transmission

  • Contact transmission (indirect and direct)
  • Droplet transmission
  • Airborne transmission
19

Contact Transmission

Is the usual mode of transmission of most infections.

20

Direct Contact Transmission

The source and host have physical contact, often called person-to-person transmission.

21

Indirect Contact Transmission

The transfer of microorganisms from a source to a host by passive transfer from a contaminated object.

22

Droplet Transmission

Are produced when a person talks or sneezes, they travel short distances.

23

Airborne Transmission

Occurs when small particles enter the air containing pathogens leave the infected source and enter a susceptible host.

24

Physiologic Defenses for Infection

  • Body tissues
  • Phagocytosis
  • Inflammation
  • Immune systems
25

Body tissues

Intact skin forms the first and most important physical barrier to the entry of microorganisms.

26

Phagocytosis

Occurs when a foreign substance evades the first-line mechanical barriers and enters the body.

27

Inflammation

Occurs when tissue becomes damaged.

28

Immune systems

The antibody-mediated system produces antibodies directed against certain pathogens. These antibodies inactivate or destroy invading microorganisms as well as protect against future infection from that microorganism.

29

Health Care–Associated Infection (HAI).

Acquired in the inpatient health care setting (not present or incubating at admission).

30

Endogenous

From a patient's flora

31

Exogenous

From outside the patient, often from the hands of health care workers, tubes, or implants

32

Methods of Infection Control and Prevention

  • Hand hygiene
  • Disinfection/sterilization
  • Standard Precautions
  • Transmission-Based Precautions
  • Staff and patient placement and cohorting
33

Hand Hygiene

Refers to both washing and alcohol-based rubs

34

Sterilization

Destroying all living organisms and bacterial spores.

35

Disinfection

Does not kill spores and only ensures a reduction in the level of disease-causing organisms.

36

Standard Precautions

Based on the belief that all body excretions, secretions, and moist membranes and tissues, excluding perspiration, are potentially infectious.

37

Personal Protective Equipment (PPE)

Refers to gloves, isolation gowns, face protection (masks, goggles, face shields), and powered air purifying respirators (PAPRs) or respirators.

38

Airborne Precautions

Used for patients known or suspected to have infections transmitted by the airborne transmission route.

39

Droplet Precautions

Used for patients known or suspected to have infections transmitted by the droplet transmission route.

40

Contact Precautions

Used for patients known or suspected to have infections transmitted by direct contact or contact with items in the environment.

41

Adequate Staffing

Having enough nurses is an essential method for preventing infection.

42

Patient Placement

The placement of patients has been used as a way to reduce the spread of infection.

43

Cohorting

The practice of grouping patients who are colonized or infected with the same pathogen.

44

Patient Transport

Limiting movement to other areas of the facility, using appropriate barriers like covering infected wounds, and notifying other departments or agencies who are receiving the patient about the necessary precautions.

45

Which statement by a nursing student indicates a need for further teaching by the nurse regarding infection control for a client who has an open, draining wound?

“I will wear a mask each time I enter the client's room.”

46

Biofilm

Also called glycocalyx, is a complex group of microorganisms that functions within a “slimy” gel coating on medical devices.

47

Staphylococcus Aureus (S. aureus)

A common bacterium found on the skin and perineum and in the nose of many people.

48

Health Care–Associated MRSA, or HA-MRSA

Organism enters into deep wounds, surgical incisions, the lungs, or bloodstream, more serious infections occur that require strong antibiotics like methicillin.

49

Community-Associated MRSA, or CA-MRSA

Causes infections in healthy, nonhospitalized people, especially those living in college housing and prisons.

50

A client is admitted with a catheter-associated methicillin-resistant Staphylococcus aureus (MRSA) infection. Which personal protective equipment is appropriate when providing client care? Select all that apply.

  • Gloves
  • Gown
51

Vancomycin-Resistant Enterococcus (VRE)

Are bacteria that live in the intestinal tract and are important for digestion.

52

Carbapenem-Resistant Enterobacteriaceae (CRE)

Most often given for abdominal infections such as peritonitis, have been used extensively for the past 15 years.

53

Occupational Safety and Health Administration (OSHA)

A federal agency that protects workers from injury or illness at their place of employment.

54

Noncompliance

Deliberate failure to take the drug

55

Nonadherence

Accidental failure to take the drug

56

Septic Shock

Insufficient cardiac output is compounded by hypovolemia.

57

Lymphadenopathy

Enlarged lymph nodes

58

Hyperthermia

Fever

59

Culture

Isolation of the pathogen by cultivation in tissue cultures or artificial media.

60

Antimicrobial Sensitivity Testing

Is performed to determine the effects of various drugs on that particular microorganism.

61

Serologic testing

Is performed to identify pathogens by detecting antibodies to the organism.

62

Antimicrobials

anti-infective agentS

63

Antipyretic drugs

Are often given to reduce fever

64

External Cooling

Hypothermia blankets or ice bags or packs can be effective mechanisms for reducing a high fever.

65

Superinfection

Reinfection or a second infection of the same kind

66

C. Difficile–Associated Disease (CDAD)

Spread by indirect contact with inanimate objects like medical equipment and commodes, and its toxins cause colon dysfunction and cell death from sepsis.

67

Which statement about handwashing is in accordance with recommendations by the Centers for Disease Control and Prevention?

Handwashing must be done after contact with the client’s intact skin, such as when taking a pulse.

68

While in the hospital, the client has developed a methicillin-resistant infection in the foot. The client had undergone surgical débridement for gangrene. Which precaution is best for this client?

Wear a gown and gloves to prevent contact with the client or client-contaminated items.

69

Which intervention is the most appropriate to address the priority problem of feelings of isolation when caring for a client who is placed on Transmission-Based Precautions?

Provide education on the mode of transmission of infection.

70

A client who was treated last month for a bad case of bronchitis and walking pneumonia reports many of the same symptoms today. Which factor in the client’s antibiotic therapy most likely caused the client’s relapse?

Taking the antibiotic most days

71

Which precaution is best for the nurse to take to prevent the transmission of Clostridium difficile infection?

Wear gloves when contact with body secretions or body fluids is expected.

72

Which client is at greatest risk for developing an infection?

A 65-year-old woman who had coronary bypass surgery 4 days ago.

73

Which information does the nurse include when teaching a client about antibiotic therapy for infection?

Take all antibiotics as prescribed, unless side effects develop.

74

Which is a common clinical manifestation of infectious disease?

Fever

75

A 14-year-old client has severe fatigue, swollen glands, and a low-grade fever. Which blood test result is used to confirm a diagnosis of mononucleosis?

Decreased neutrophil count

76

Which statement about the transmission of hepatitis C is correct?

Equipment or linen soiled with blood or body fluids should be washed with bleach or a disinfectant to prevent infection.

77

Which statement about why multidrug-resistant organisms and other infections are increasing in incidence is correct?

Antibiotics have been given to clients for conditions that do not require antibiotics.

78

Which nurse does the charge nurse assign to care for a 64-year-old client who has pneumonia and requires IV antibiotic therapy and IV fluids at 200 mL/hr?

A float RN with 7 years of experience on the inpatient oncology unit.

79

The nurse manager for a long-term care facility is in charge of implementing a plan to decrease the spread of infection within the facility. Which part of the plan is most appropriate to delegate to nursing assistants working at the facility?

Reinforcing the need for handwashing after caring for clients.

80

A priority problem of hyperthermia is identified by the long-term-care RN who is caring for a client with a urinary tract infection. Which intervention is most appropriate to delegate to a nursing assistant?

Increase fluid intake by assisting the client to choose approved and preferred beverages.

81

Which actions aid in the prevention and early detection of infection in a client at risk? (Select all that apply.)

  • Promote sufficient nutritional intake.
  • Obtain cultures as needed.
  • Remove unnecessary medical devices.