Nur 122

• So the RN can prevent the acquisition of infection
• Recognize the S&S if infection does occur
• Implement treatment of infection

Organisms that are capable of producing disease.

• Bacteria
• Viruses
• Fungi
• Helminths
• Priors

• Better nutrition
• Immunization
• Sanitation
• Antimicrobials

• Pneumonia/ Influenza 6th
• HIV 8th in US (Virus)

• Very young
• Very old
• Debillitated
• Poorly nourished
• Immunosuppressed

Study of how a disease is produced in a population; not only infectious diseases.

A significant increase in the number of cases of a particular infection, much more than expected.

An infection that is routinely found in certain populations

A world-wide epdiemic, i.e. Aids and certian flu

When its capable of producing disease in the host

The ability to produce disease, "Pathogencity"

• The pathogen usually attaches itself to the host
• This is a parasitic realtionship- the pathogen damage the host
• Infection occurs when the host- pathogen relationship is established.
• Infectious disease occurs when observable S&S indicate that the host has been damaged
• Each organisms is distinct- how it invades and reproduces, and how it is transmitted.

• P= N x V
• R
• P= probability of infection
• N= number of organisms
• V= virulence of organisms
• R= resistance of host

• Physical=skin and mucous membranes
• Chemical= secretions (hydrochloric acids in stomach. acidity in urine and normal flora
• Immune system=targets pathogens for destruction immune system is affected bay age, genetics, psych and enviromental factors

Do not require a host, merely use the host as a source of nutrition or enviromental for growths

• Shape
• Staining
• Oxidative state
• & how they produce disease

• Rods or cocci (spheres)
• Gram + & Gram - (accept a stain or not)
• Aerobic (require 0₂)
• Anaerobic (without air)

• Infection occur when the bacteria ovecome the host defense.
• Organisms invades, multiplies spreads
• Some produce adherens (allows them to attach strongly) (strep)
• Some develope capsules that protect them from phagocytes (pneumooccous)
• Some produce leukocidins which detroy the pathogen (staph)

Allows for growth and causes illness

• Proteins secreted into surrounding medium highly antigenic, specific or general small quantities may be fatal
• A posionous substance produced by bacteria.

• Toxic shock syndrome
• HUS
• Diptheria
• Cholera

Component of the cell wall of Gram - bacteria, released during cell divison or cell distruction

Are ones that produce pain and fever in the host and cause release of vasoactive peptides--vasodiliation--hypotension--| perfusion --septic shock

• Special chatacteristics with regard to shape, size, staining properties
• Little relationship to each other, except that they cause disease in humans
• Gram - bacteria

• Small intracellular organsims
• Nt complete cells exist as parasites on living cells
• Use the biochemical products & machinery of the host to replicate
• Classified as RNA or DNA according to genetic material

• Attach to host cell
• penetrate or inject its DNA into host cell
• synthesize nucleic acid and assembles new viral particles
• release viral particles into the extracellular enviroment

Antibody production

Cell-mediated immunity

• Caused by T-lymphocyte activity
• Mediated thru contact between T cell and antigen and by cytokines
• Reaction produces memory and subsequent exposure triggers the antigen repsonse.

Small soluble proteins

• interleukins
• interferons
• tumor necrosis factor
• transformation growth factor
• Essentially these are immunotransmitters

• Antigen specific cells accumalte ---inflammatory response
• Macrophages attach to virus---synthesis of IgM & IgA
• When coated with antibody-- rendered non-infectious

Viruses also-- production of interferon proteins that inhibit viral spread.

• Eah virus affects the host differently --S&S unique to virus
• Vary from no apparent damage to death
• Viruses attack virtually every system

Many remain latent for years, active disease with exposure to other virus

• Early
• malasie
• weakness
• myalgia
• headache
• fatigue
• anorexia

• As disease progresses
• Flushing
• Chills
• Dehydration
• Lymphadenopathy
• Increased WBC's
• confusion
• Delirium

• Bacterial -
• ↑Neutrophils
• ↓Eosinphils and lymphocytes

as infection ↑ monos and lymphs

↓RBC, H&H, compromised Fe delivery

↑ESR Platelets an fibrinogen

• Usually only with severe infection
• Vasodilation → hypotension
• ↑ Heart rate and cardiac output
• May develope septic shock

• Proteinuria - 2˚ fever or direct infection of kidney (protein in urine)
• Glycosuria - 2˚ ↓ reabsorption (glucose in urine)
• Oliguria 2˚ hypotension or septic shock (less than 400ml/day)

• Age→ very young and very old most vunerable
• Nutritional state-inadequate protein stores
• Stress --general adaptation syndrome→↑cortisone(↓ resistance
• Heredity

Immune system disease -leukemia, AIDS, Lymphoma, aplastic anemia

chronic disease - diabetes and MS

Diseases that impair defenses- COPD, cancer, PVD, burns

Drugs may compromise immunity: steroids, chemo amd immunosupressants

• Local - redness and swelling 2˚ inflammation
• drainage
• pain/ tenderness

Local infection may become systemic (gets in the blood or becomes and abbcess)

fever, malaise and fatigue

• lymphadenopathy
• n/v
• anorexia
• May also have resp. GI GU Sx

Elderly often have advanced infection before clinical sign become apparent

Assess specifically the likely sites

• Wash your hands
• Nutritional support-great nutrition good protein
• Immunizations
• Control of transmission - early discharge

2nd leading cause of death in americans 25-44

Most sever form of a continuum of illness assocaiated with HIV

Is a retrovirus (RNA as opposed to DNA)

• By way of body fluids that contain the CD4+ T Lymphocytes or the HIV virus:
• serum
• amniotic fluid
• seminal fluids
• breast milk
• vaginal secretions

• anal intercourse taumatizes the rectal mucose which increase chance of transmission
• Multiple partners
• Heterosexual transmission is increased

• direct clood exposure to contaminated needles and syringes
• sharing needles increases risk
• Blood and blood products risk greatly decreased
• Risk health care workers estimated 0.3%

Risk to health care workers 0.3%

• Resp: SOB dyspnea cough chest pain
• = PCP, Mycobacterium TB
• Gastro: Anorexia N/V thrush (canadice) weight loss
• Skin: KS lesions dermatitis eczema psoriasis
• Neurologoical: HIV encephalopathy AIDS dementtia complex CNS changes end stage
• In woman: Yeast infection HPV PID Vernearl warts

• Based on clinical history:
• identification of risk factors
• physical exam
• lab evidence of immune dysfunction
• ID HIV antibdodies
• T cell counts

• ELISA
• Western Blot assay
• IFA

• Treat infection and malignancies
• Antiviral agents to arrest HIV replication
• Support and restore the immune system

Supportive care: malnutrition Skin Mobility and altered mental state