chapter 27

  1. chain of infection
    • 1. infectious agent
    • 2. reservior host
    • 3. portal of exit
    • 4. mode of transmission
    • 5. portal of entry
    • 6. susceptible host

    wearing appropriate protective equipment and effective hand washing can break the chain of infection
  2. disease
    . an alteration in the normal stucture or function of an organism or a cell

    . causes specific clinical signs, symptoms, and laboratory findings that set it apart

    .  can be inherited , drug-induced, autoimmune , degenerative or infectious

    . any disease caused by the growth of pathogenic microorganisms in the body is considered and infectious disease
  3. cardinal sign of illness is
  4. microbial can be
    • bacterial
    • viral
    • parastic
  5. single most universal precaution is
    hand washing
  6. conditions required for microbial growth
    to maintain a healthcare environmnet that is as free as possible of pathogenic organisms the medical assistant must prevent or eliminate as many growth requirements as possible

    • . nutrients
    • . moisture
    • . temperature
    • . oxygen- aerobed or anaerobes
    • . neutral ph = 7
  7. anaerobic
    is any organism that does not require oxygen for growth
  8. anaerobe
    is any organism that requires oxygen for growth
  9. reservior host
    an infected patient

    examples: people, insects, animals, water, food, contaminated insturments
  10. portal of exit
    how the pathogen exits the reservoir host

    examples: coughing, sneezing, blood, product, specimen

    standard precautions prevent spread
  11. transmission
    direct- contact with infected person or with discharges

    examples: feces, urine, sputum , contaminated hands equipment or supplies , air borne, contaminated food or water

    indirect- from droplets expelled with coughing, sneezing or speaking, vectors contaminated food or objects

    can be controlled with sanitization, disinfection, sterilization
  12. portal of entry
    how the pathogen gaines entry to a new host

    exposure to contaminated equipment , inhalation, broken skin
  13. susceptible host
    must be capable of supporting the pathogen

    unvaccinated, weak , debilitated individual
  14. viruses
    smallest: obligate intracellular parasites palliative treatment

    example: hepatitis B

    obligate = can only live inside the blood cells

    virus can not be treated with antibiotics, they are resistant to antibiotics
  15. bacteria
    classified by their morpholgy, some produce spores , normal flora vs. pathogenic microbes

    example: tuberculosis
  16. protozoa
    unicellular parasites frequently transmitted by vectors

    example: glardiasis
  17. fungi
    molds and yeast mycotic infections and tineas

    example: candidiasis
  18. rickettsiae
    similar to both viruses and bacteria carried by vectors

    example: rocky mountain spotted fever
  19. antibiotic resistance
    is one of the world's most significant public health problems ( MRSA)
  20. infectious microorgaisms
    whose presence were once easily treated with antibotics are growing increasingly resistant to the drugs
  21. resistance occurs
    when an antibiotic is used inappropriately to treat an infection
  22. the pathologic organism mutates
    decreasing the effectiveness of the drug
  23. CDC recommendations
    . prescribe antibiotic therapy only when it will benefit the patient

    . bacterial infections can be treated with antibiotics but viral inections, because they involve viral takeover of celluar DNA or RNA material cannot

    . treat the patient with an antibiotic that is specific to the bacterial infection

    . precribe the label-recommended dose and time interval for the medication
  24. body's natural protecion
    . intact skin

    . mucous membranes protect underlying tissues and trap foreign substances

    . cilia trap invading microbes

    . sneezing and coughing expel organisms

    . body secretions such as tears and sweat expel foreign substances from the body

    . pH of many of the body's organs discourages microbial growth
  25. process of phagocytosis attraction to site
    1. chemotaxis: release of chemical agents attracts WBCs

    2. ameboid movement: movement

    3. diapedesis: seep out

    4. phagocytosis: ingestion and digestion

    WBCs are responsible for phagocytosis
  26. wicking
    dry surface is wet to seep through
  27. four classic signs and symptoms of inflammation
    . redness or erythema

    . swelling or edema

    . pain

    . heat
  28. inflammatory and infection terms
    lymphadenophathy: blood swollen

    septicemia: infection in the blood stream

    pyemia: pus high white cell count
  29. exposure control plan
    . a plan must detail employee protection procedures

    . include PPE

    . traning

    . follow-up

    . labeling and disposal of biohazard waste

    . must be reviewed and updated at least annually to incorporate the use of safer medical devices
  30. hand hygine
    . visibly soiled hands should be washied for a minimum of 15 seconds with antimicrobial soap and warm running water

    . alcohol-base handrubs
  31. gloves reduce hand contamination by
    70% to 80%
  32. natural nail tips should be no longer than
    ¼ inch
  33. five basic parts of compliance
    . barrier protection: gloves

    . environmental protection: lysol

    . housekeeping controls

    . hepatitis B vaccination

    . postexposure follow-up
  34. personal protective equipment PPE
    • latex gloves
    • face mask
    • face shields
    • protective glasses
    • laboratory coats
    • barrier gowns
    • shoe covers
    • mouth pieces
    • resuscitation bags
  35. environment protection
    . observe warning labels on biohazard containder and equipment

    . minimize splashing, spraying and spattering of drops

    . bandage any breaks on hands before gloving

    . do not recap, bend, break or resheath contaminated sharps

    . immediately after use dispose of sharp items in a labeled, leak proof, puncture- resistant biohazard container 
  36. Hepatitis B vaccination
    . must be available free of charge within 10 days of starting employment to all employees who are at risk

    . intramuscular injection in three doses, second injection 4 weeks after the first and third injection 6 months after first

    . employees have the right to decline declination form must be signed.
  37. postexposure follow-up
    . postexposure follow-up involes immediate cleansing of the site

    . completion of an exposure incident form

    . confidential medical evaluation examination of the source ndividual and worker's blood

    . health couseling and confidential treatment of all medical records 
  38. medical aseptic techniques
    create an environment as free of pathogens as possible to prevent reinfection or cross-infection
  39. surgical aseptic or sterile technique
    used when the patient's skin or mucous membranes are disrupted. prevents patient exposure to all microbes
  40. proper hand washing depends on two factors
    warm running water and friction
  41. nosocomial infection
    inquired by the hospital staff to patient cross containiation
  42. communicable infection
    patient having infection
  43. disinfection
    . process of killing pathogenic organisms or making them inactive

    . not always effective against spores and viruses

    . follow the manufacturer's guidelines

    • bleach solution
    • 1 part bleach
    • 9 parts water
  44. disinfection errors
    . insturments not thoroughly sanitized and organic matter inhibit or prevent action

    . moisture on instruments dilutes disinfectant solution beyond effective concentraction

    . solution left in an open container

    . solutions not changed as recommended and expire

    . not prepared properly

    . recommended manufacturer's temperature for use and storage is not maintained
  45. santitization
    cleaining of contaminated articles or surfaces to reduce the number of microorganiasms to a safe level as dictated in public health guidelines

    remove debris such as blood and other body fluids from insturments or equipment

    must wear utility gloves to prevent possible personal contamination

    completed immediately after use in a separated workroom or area to avoid cross-contamination
  46. sterilization
    . complete destruction of all microorganisms
  47. body temperature
    98.6° F


    37° C
  48. pathogen prefer a ___ pH for optimum growth
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chapter 27
chapter 27