-
preparation for entrance/exit into isolations room
- entrance
- hand hygiene
- gown
- mask or respirator
- eyewear or goggles
- gloves
- exit
- gloves
- mask
- eyewear or goggles
- gown
- hand hygiene
-
tier two protective environment
- allogeneic hematopoietic stem cell transplants
- private room
- positive pressure room with 12 or more exchanges per hour
- HEPA filtration for incoming air
- respirator mask
- gloves
- gowns
-
tier two contact precautions
- direct or environmental contact
- colonization or infection with multidrug resistant organism (MDRO) such as VRE and MRSA
- clostridum difficile, respiratory syncytial virus (RSV), draining wounds where secretions are not contained, scabies
- private room or cohort clients
- gloves
- gowns
-
tier two droplet precautions
- droplets > 5mcg
- being within 3ft of client
- diptheria, rubella, streptococcal pharyngitis, pneumonia, scarlet fever (children), pertusis, mumps, sepsis, pneumonic plague
- private room or cohort clients
- mask or respirator
-
tier two airborne precautions
- droplet nuclei < 5mcg
- measles, chickenpox, TB
- private room
- neg. pressure airflow of at least 6-12 air exchanges per hour via HEPA filtration
- mask or respiratory protection device
-
isolation precautions
- tier one- standard/universal precautions
- tier two- transmission categories( airborne, droplet, contact, protective environment)
- psychological implications
- environment
- equipment
- speciment collection
- bagging of trash and linen
- transportation
-
nursing diagnostic process (infection risk)
- check results of lab tests (low WBC count )
- review current meds (immunosuppressants)
- identify potential sites of infection (eg. IV, foley)
-
labs tests for infection
- WBC (count)- 5000- 10,000/mm3; above range indicates infectious process
- erythrocyte sedimentation rate-(ESR, E sed rate)- up to 15mm/hr for men and 20mm/hr for women, above range indicates inflammatory or infectious process
- iron levels- 60-90g/100ml, decreased in chronic infection
- cultures of urine and blood
-
exudates
- fluid and cells that are discharged from cells or blood vessles (eg. pus, serum)
- serous- clear, like plasma
- sanguineous- containing RBC's
- purulent- containg WBC's and bacteria (usually pus and smell. w/ fever)
-
course of infection (stages)
- incubation period- interval between entrance of a pathogen into the body and appearance of first symptoms
- prodromal stage-interval from non-specific to more specific symptoms
- illness- manifestation of s/s specific to the type of infection
- convalescence- interval when acute symptoms disappear to full recovery to previous state
-
modes of transmission
- direct contact
- indirect contact
- droplet
- airborne
- vehicles
- vector- eg ticks
-
portals of exit/entry
- skin and mucous membranes
- respiratory tract
- urinary tract
- GI tract
- reproductive tract
- blood
-
chain of infection
- infectious agent (pathogen)
- reservoir (source for pathogen growth)
- poratal of exit from the reservoir
- mode of transmission
- portal of entry to a host
- susceptible host
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