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What are two ways that a causative agent may cause disease?
They may cause disease by producing toxic substances or by destroying parts of the cells they have invaded.
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Where do normal flora originate?
We contract normal flora from exposure to various sources within our environment.
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What type of relationship develops when a host is exposed repeatedly to a pathogen but is never successful in eliminating it?
The relationship is called commensalism. After repeated exposure the host will develop a tolerance for the pathogen. As long as the balance is not disturbed no infection occurs.
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How do carriers differ from individuals who actually develop an infectious disease?
A few individuals are able to withstand the effects of the pathogen. They will show no symptoms of infection. Although they are not affected, they are still able to pass the pathogen to other, more susceptible individuals.
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What type of pathogen uses parts of the hosts tissue as nutrients?
Parasitic or infectious agents that act parasitic.
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What is the average rate of reproduction for bacterial cells?
Bacterial cells divide every 30-120 minutes. They reproduce by binary fission.(cells divide into daughter cells which divide into daughter cells ect.)
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What physical characteristics of bacteria are used to determine their classification?
Size, shape, and attachements.
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What are the three basic bacterial shapes?
- a. Coccus or spherical
- b. Bacillus or Rod-shaped
- c. Spirochaetes or spiral
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What type of organism causes Rocky Mountain Spotted Fever?
Rocky Mountain Spotted Fever along with scrub typhus are two infections caused by Rickettsiae. ( Rickettsiae are spread by insect bites or vectorborne)
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List three useful functions of Fungi:
- a. Edible- mushrooms
- b.Fermentation- alchohol or bread
- c. Antibiotics- Penicillin
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What unique quality does the cell wall of the protozoa possess and what does it allow the cell to do?
Protozoa are surrounded by a cell membrane instead of a cell wall. This allows them to assume a variety of shapes.
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What enables the amoebae to propel itself and ingest food particles?
Amoebae shoot out projections called pseudopods or "false feet".
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What is the smallest know microorganism?
Viruses are the smallest known microorganism and can only be seen using an electron microscope. They are so tiny that they can pass through bacterial filters.
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In what stage do helminthes normally enter the human host?
Typically the helminth enters a human host during a larval stage.
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List the components of the chain of infection:
Infectious agents, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host
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What are the normal exit portals for infectious agents?
- a.Respiratory-cough/sneeze
- b.Gastrointestinal-feces(typhoid bacillus)
- c.Skin/Mucus membranes
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Describe indirect contact:
When you touch objects(forks/medical equipment) that are contaminated with an infectious agent.
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Describe Droplet Transmission:
Droplet transimission occurs when infectious agents are transmitted through the air short distances like less than three feet.
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What are the stages of an infectious disease?
- a.Incubation-growth and reproduction
- b.Pordromal-Nonspecific symptoms
- c.Illness-Specific symptoms
- d.Convalescence-Recovery
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How much can the prodromal period vary for different diseases?
The Prodromal period can last a few hours to a few days depending on the disease.
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What is the body's best natural barrier to infection?
The skin.
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How do mucous membranes defend against infection?
Mucous membranes trap and destroy pathogens with a massive influx of White blood cells.
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How do tears defend against infection?
Tears are the eyes protective bath. They wash away dirt, debris, and microorganisms.
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What role does the lymphatic system play in the body's disease defense system?
It produces lymphocytes(WBC's) that fight infections. Lymphatic vessels also transport pathogens to regional lymphnodes or glands to be trapped and destroyed.(regional infection)
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What are antibodies?
Substances created by the body to attack specific foreign substances.(Antigens)
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What is a regional infection?
Regional infection is when the lymphatic system transports pathogens to regional lymphnodes to be destoryed.
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What are the two recommended tiers of isolation precautions developed by the Centers for Disease Control(CDC)?
- a.Standard Precautions
- b.Transmission-based Precautions
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Why were Standard Precautions developed?
They were developed to prevent nosocomial infection.
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When is it important to use masks, goggles, or face shields?
When splashing or splattering of bodily fluids is possible.
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What are the three types of Transmission-based Precautions?
- Airborne-More than 3 ft
- Droplet-Less than 3 ft
- Contact
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Describe how to reduce the risk of spreading infectious agents by the airborne route:
- a. Wear a mask.
- b.negative airflow rooms
- c.Private rooms with closed doors.
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If droplet precautions are in effect, when should you wear a mask?
Wear a mask when working within 3 ft of Patient.
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Describe the primary purpose of having housekeeping duties?
To control the spread of infection.
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Define Hepatitis:
Hepatitis is an inflammation of the liver caused by bacteria, viruses, protozoa, helminths, chemicals, and drugs. There are 5 varieties:A,B,C,D,E
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What is meningitis and what is the most serious type?
Meningitis is the inflammation of the meninges covering the brain and/or spinal cord. It is caused by virus, bacteria, fungi, and parasites. The three kinds are Bacterial, viral, and pneumococcal. Bacterial is the most serious.
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What is the most common type of meningitis?
Viral or Aseptic meningitis is the most common form.
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Briefly describe AIDS disease and the virus known to cause it:
AIDS(acquired immunodeficiency syndrome) is a disease that completely destroys the body's immune system. The host is susceptible to all pathogens. It is caused by HIV(human immunodeficiency virus)
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What is the most common/serious complication of gonorrheal infections in women?
Gonorrheal pelvic inflammatory disease is the most common/serious complication. It occurs in 50% of cases and can lead to sterility.
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List the five stages of syphilis:
- a.Primary-communicable/chancre forms
- b.Secondary-communicable/mucous membrane lesions
- c.Latent-asymptomatic
- d.Late-Destructive stage/cardiovascular or Central nervous system
- e.Congenital-Prenatal
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How does a physician notify Public Health of a reportable disease?
The physician can contact Public Health by phone or by locally derived form. Make the notification while the patient is still in the clinic.
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What directive lists how reportable disease lists must be updated?
AFI 48-105
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Who ensures civilian agencies are notified of reportable dieases?
Public Health
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What does the term "asepsis" mean?
To be free of Pathogenic microorganisms or free from infection.
Medical asepsis or surgical asepsis
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What is another term used for Medical asepsis?
The clean technique
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What is another term for Surgical asepsis?
The sterile technique
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What procedure is designed to destroy pathogens but usually does not affect spores?
Disinfecting is designed to destroy pathogens, but usually does not affect spores.
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What is the difference between disinfectants and antiseptics?
- Disinfectants are meant to destroy microorganisms and are to be used on inanimate objects.
- Antiseptics halt the growth and development of microorganisms and are to be used on living tissue.
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What is the purpose of isolation precautions?
Isolation precautions are designed to prevent the spread of microorganisms among patients, personnel, and visitors.
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What are 3 reasons non-medical individuals contaminate themselves when attempting to deal with isolation?
Some do not believe they can be contaminated. Some do not understand what they are supposed to do. Some are illiterate or do not speak english.
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Why do medical staff members violate isolation principals?
Staff get in a hurry and take shortcuts. They do not understand how to follow precautions or believe that they do not apply to them.
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Under what conditions can a roomate be placed with an isolation patient?
Cohorting is allowed if the patients have the same disorder. It is also allowed if both patients are cooperative, understand the infectious process, and are taught isolation procedures.
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Why are contaminated articles bagged before they are taken out of the isolation unit?
Items are bagged to avoid contaminating the general environment or other people.
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Define Routine and Terminal cleaning:
- Routine cleaning is done every day.
- Terminal is directed primarily toward objects the patient may have come in contact with.
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What additional precautions should be taken with cleaning equipment if the patients condition requires a private room?
Cleaning equipment should be conducted using an approved disinfectant before goin to another room.
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How is the solution that is used for terminal cleaning selected?
The solution is selected by the local infection control and is based on EPA(Environmental Protection Agency) standards.
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What should infectious patients wear when they are being transported through the hospital?
They should be given a gown, mask, and gloves. The unit of transfer should also be notified so they can prepare.
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Why is a private room the most effective type of isolation unit?
Private rooms are best because the patient is physically seperated from others and personnel are more apt to wash hands before moving on.
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How do masks protect the wearer?
They protect the wearer from Large Droplets that travel a short distance in the air, droplet nuclei that may stay in the air and travel further, and against direct contact with mucous membranes.
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When should you put on and take off a mask?
The mask should be put on before entering the room, and removed before exiting.
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For what reasons are gloves worn?
- Gloves provide a protective barrier for the hands form bodily fluids.
- Gloves reduce the chance of microorganisms being transferred during procedures and surgeries.
- Gloves reduce the chance of microorganisms being transferred and infecting other patients.
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What should you do with disposable equipment when it becomes contaminated?
It should be bagged, tagged, and disposed of according to local policy.
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What should you do with an isolation patients food tray?
There are no special precautions. Disposable items can be thrown away and reusables can be cleaned in the hospital dishwasher.
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What general tasks are included in the sterilization process?
Sterilization procedures include cleaning, disinfecting, wrapping, and sterilizing.
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For what purpose is low-level disinfection useful?
Low-level disinfection is useful for general cleaning purposes. It destroys fungi, some forms of active bacteria, some viruses, but does not affect spores or other forms of bacteria or viruses.
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What type of disinfection is done by placing small items in boiling water for a specific period of time?
Pasteurization is an intermediate to high-level nontoxic disinfection process. Effective on fungi and some forms of bacteria. Limited effect on viruses.
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What is the method of choice for chemical disinfection?
Sterilization is the method of choice for all surgical supplies, equipment, and instruments because it destroys all pathogens.
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What does the EPA classify chemical disinfectant solutions as?
sporicides, general disinfectant, hospital disinfectant, sanitizers, and other.
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What are the disadvantages of formaldehydes?
The solution is irritating to skin, eyes, and mucous membranes due to its toxicity.
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What special precautions must you take when using ultraviolet irradiation?
Because ultraviolet irradiation is irritating to eyes and skin, you should wear a gown, gloves, and protective glasses.
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List three example of semicritical items:
Semicritical items are one that come in contact with mucous membranes but normally do not penetrate body surfaces. Examples-fiber-optic endoscopes, endotracheal tubes, and cystoscopes.
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What factors determine the cleaning method to be used for equipment?
The method used depends on local policy, type of object being cleaned, and the amount of organic material on the object.
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When cleaning equipment, what things should you do to prevent self-contamination?
Always wear gloves, eye protection, and adhere to locally required protection.
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Briefly describe ultrasonic cleaning:
The sonic energy equipment cleans by passing ultrasonic waves through a fluid. This produces submicroscopic bubbles that collapse and pull dirt from objects by suction.
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What characteristics should wrapping material for sterile packs have?
The wrapping material should allow the sterilizing agent to pass through without allowing dust and microorganisms to pass, it should be durable and able to stand up to sterilization and storage, it should be flexible to form around whatever is inside, it should be able to be opened without contaminating the sterile field, it should protect the item inside, and it should be cost effective.
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Why should you avoid adding extra supplies or equipment to a sterile pack?
Sterile packs are for one time use. Adding supplies will get in the way and be wasteful.
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Which wrapping method is used for most packages?
The diagonal method is used for most items.
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Why should you avoid using pins, clips, or staples when securing sterile packages?
Pins, clips and staples will put holes in the wrapping that a microorganism may be able to pass through. They also can cause the package to be wrapped to tightly.
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What type of instrument should you use to lable a sterile package?
You can use either pre-typed indicator tape or the external chemical indicator tape. Mark it with a felt tipped marker or other indelible ink.
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What information should be included on the label?
The information should include the contents of the package and the initials of whoever put it together. It may also include the unit it is for.
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What are the three basic methods of sterilization?
The basic methods are physical sterilization, chemical sterilization, and ionizing sterilization.
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Which type of sterilization includes gravity displacement sterilizers, prevacuum sterilizers, and washer-sterilizers?
Physical or steam sterilization.
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When does a steam sterilizer begin timing the actual sterilization cycle?
When the air is removed and the heat reaches the preset temperature.
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What are disadvantages of steam sterilizers?
Not all items are durable enough to go through a steam sterilizer.
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What is the difference between the gravity displacement sterilizer and the prevacuum steam sterilizer?
The gravity displacement sterilizer uses a valve at the bottom along with gravity to empty air form the chamber while the prevacuum steam sterilizer has a vacuum unit that literally sucks all the air out of the chamber. This makes the sterilization cycle faster on the prevacuum unit.
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What is the primary function of washer-sterilizers?
Terminally sterilizing patient care items.
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How should items be loaded in a steam sterilizer?
It must permit free access to all surfaces and areas in the load. There should be no air pockets formed inside cups, basins or glasses.
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A washer-sterilizer cycle should only be used for what type of sterilization?
Terminal sterilization. The must be sterilized by a more permanent method before being used on a patient.
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When monitoring the sterilization cycle, what are soem problems to look for?
- Unsaturated steam
- Wet Steam
- Incomplete air removal from the chamber
- Automatic timer failure and other mechanical failures
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What should you always do before opening a sterilizer door?
Always check the chamber pressure before opening the sterilizer door.
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How many type of processing trays are there for the paretic acid sterilizer?
- There are two:
- general processing tray
flexible processing tray
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What are some disadvantages to the peracetic acid sterilizer?
- The acid must contact all surfaces of items
- All items must be thoroughly cleaned and free of grease and oil.
- For Just-in-time sterilization only.
- Cannot sterilize items that cannot be submersed in liquid.
- Must avoid contact with skin because the acid is corrosive.
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How often should biological testing be conducted?
It should be done and logged atleast weekly.
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What are the four methods to monitor and control the sterilization process?
- The LCD monitor
- Paper printouts
- Beeps
- Status indicator lights
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When unloading the sterilizer, you must first make sure the chemical strips have changed to what color?
They will change from red to yellow.
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For what purpose is ionizing radiation used?
It is used commercially, primarily for bulk sterilization
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What are three types of disinfection?
Pasteurization, chemical disinfection, and ultraviolet radiation.
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