Ch. 34 Infection Prevention & Control

Clients in all health care settings are at risk for acquiring infections because of

In acute care or ambulatory care facilities, clients can be exposed to

In all settings, clients & their families need to be able to recognize

Client teaching needs to include

Health care workers protect themselves from contact with infectious material, sharps injury, and/or exposure to a communicable disease by

Which diseases require a greater emphasis on infection prevention & control techniques?

Infection

pathogen

colonization

An infectious disease

Illnesses like viral meningitis or pneumonia

if the infectious disease can be transmitted directly from one person to another

if the pathogens multiply & cause clinical signs & symptoms

if clinical signs & symptoms are not present, illness is termed

A communicable disease that can be asymptomatic

Infection occurs in a cycle that depends on the presence of all of the following elements:

Microorganisms include

Microorganisms on the skin are either

Resident (normal flora)

transient microorganisms

potential for microorganisms or parasites to cause disease depends on the following factors:

sufficient # of organisms

ability to survive in the host or outside the body

susceptibility of the host

impaired immune system

Resident skin microorganisms can cause serious infection when

a place where a pathogen can survive but may or may not multiply

most common resevoir

persons who show no symptoms of illness but who have pathogens on or in their bodies that can be transferred to others

To thrive, organisms require

Microorganisms require nourishment.
Clostridium perfringens (causes gas gangrene) thrives on ____________
Escherichia coli consume ____________

aerobic bacteria require

anaerobic bacteria thrive

Clostridium difficile

Bacteria: Escherichia coli
Major Reservoir: ________
Major Infections/Diseases: __________

Bacteria: Staphylococcus aureus
Major Reservoir: ___________
Major Infections/Disease: _________

Bacteria: Streptococcus (beta-hemolytic group A) organisms
Major Reservoir: ____________
Major Infections/Diseases: __________

Bacteria: Streptococcus (beta-hemolytic group B) organisms
Major Reservoir: ___________
Major Infection/Diseases: ________

Bacteria: Mycobacterium tuberculosis
Major Reservoir: ___________
Major Infection/Disease: __________

Bacteria: Neisseria gonorrhoeae
Major Reservoir: __________
Major Infection/Diseases: __________

Bacteria: Rickettsia rickettsii
Major Reservoir:____________
Major Infection/Diseases:____________

Bacteria: Staphylococcus epidermis
Major Reservoir: __________
Major Infection/Diseases: __________

Virus: Hepatitis A
Major Reservoir: ____________
Major Infection/Diseases: __________

Virus: Hepatits B
Major Reservoir: __________
Major Infection/diseases: _________

Virus: Hepatitis C
Major Reservoir: __________
Major Infection/Disease: _________

Virus: Herpes simplex virus (type 1)
Major Reservoir: _________
Major infection/disease: _________

Virus: Human Immunodeficiency virus (HIV)
Major Reservoir: ___________
Major Infection/Disease: ________

Fungi: Aspergillus organisms
Major Reservoir: ________
Major Infection/Disease: __________

Fungi: Candida albicans
Major Reservoir: __________
Major Infection/Disease: _________

Protozoa: Plasmodium falciparum
Major Reservoir: _________
Major Infection/Disease: ________

Most organisms require water or moisture for survival. A frequent place for microorganisms is

spore

Microorganisms can live only in certain temp ranges. Each species of bacteria has a specific temp at which it grows best. The ideal temp for most human pathogens is

bactericidal

bacteriostasis

acidity of an environment determines

most microorganisms prefer an environment within a pH range of

bacteria thrive in urine with an

most organisms cannot survive the acid environment of the

Acid-reducing medications (antacids and H2 blockers) may cause an __________________, which can contribute to _________________.

Microorganisms thrive in ____________ environments such as those ____________.
(Light)

after microorganisms find a site to grow and multiply, they must find a ____________ if they are to enter another host and cause disease

portals of exit include:

the presence of purulent drainage is a

skin may be considered a portal of exit because any ____________ may allow pathogens to exit the body

Pathogens that infect the respiratory tract (like Mycobacterium tuberculosis or influenza virus) can be released from the body when ______________

clients with artificial airways such as tracheostomy or endotracheal tubes, organisms easily exit the ____________ through these devices when the device is ________________

Normally urine is sterile. However, when a client has a ____________, microorganisms exit during urination or through urinary diversions such as ____________

The _____________ is one of the most bacterially contaminated sites of the human body, but most of the organisms are ______________.

Organisms that are normal flora in one person can be _________ in another

Gastrointestinal tracts include

HIV is present in much ___________ numbers in semen than in female vaginal secretion

Blood is normally a sterile body fluid, but in the cases of _________ such as __________________ it becomes a reservoir for pathogens

each disease has a specific mode of

vector

Varicella zoster (chicken pox) may be spread by

The major route of transmission for pathogens identified in the health care setting is the

organisms enter the body through ____________ they use for exiting

Factors that reduce the body's defenses __________ the chances of pathogens entering the body

whether a person acquires an infection depends on ______________ to an infectious agent

______________ depends on the individual degree of resistance to a pathogen (immune response)

The more _________ an organism, the _________ the dose, the more likely a person will develop an infection

Some of the factors that influence a person's susceptibility (resistance) include

Organisms with resistance to key antibiotics are becoming ____________ in health care settings, but especially ___________

the resistance to key antibiotics is associated with

what are the modes of transmission?

the three contact routes of transmission are

person-to-person (fecal,oral) or physical contact between source and susceptible host (touching client feces and then touching your inner mouth or consuming contaminated food) is what kind of contact

personal contact of susceptible host with contaminated inanimate object (e.g. needles or sharps objects, dressings, environment)

large particles that travel up to 3 feet and come in contact with susceptible host (coughing, sneezing, or talking)

droplet nuclei, or residue or evaporated droplets suspended in air (coughing, sneezing,) or carried on dust particles

contaminated items, water, drugs, solutions, blood, food (improperly handled, stored, or cooked; fresh or thawed meats) are what type of contact?

external mechanical transfer (flies, mosquitos, louse, flea, tick)

When the client acquires an infection observe for

The severity of the client's illness depends on the _________ of the infection, the ___________ of the microorganisms, ____________ of the organism , and the ____________ of the host.

example of a localized infection

if an infection is localized the patient usually experiences ___________ symptoms

an infection that affects the entire body instead of just a single organ or part is

the course of the infect influences the

supportive therapy to bolster the defenses against the infectious process includes

if a nurse has an open area too large to be covered with a dressing,

normal body flora that reside inside and outside of the body protect

linings of the nasal passageways act to

a protective reaction that serves to neutralize pathogens and repair body cells

Each ____________ has defense mechanisms that work to prevent exposure to infection

What are the nonspecific defenses that protect against microorganisms regardless of prior exposure?

the immune system is composed of ______________ that help the body resist disease

There are _________ and ________ responses of the immune system

a person normally excretes ___________ of microbes daily through the intestines

normal flora of the ____________ exist in large numbers without causing illness

normal flora excrete __________ within the intestine walls

the skin's normal flora exert a protective, bactericidal action that

the use of broad-spectrum antibiotics for the treatment of infection can lead to

develops when broad-spectrum antibiotics eliminate a wide range of normal flora organisms, not jus those causing infection

What three organ systems are easily accessible to microorganisms

hairlike projections in the airways of lungs that rhythmically beat to move mucus or cellular debris up to pharynx to be expelled

the body's cellular response to injury, infection, or irritation

a protective vascular reaction that delivers fluid, blood blood products, and nutrients to an area of injury

interval between entrance of pathogen and appearance of first symptoms

interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms. During the time, microorganisms grow and multiply and client may be capable of spreading disease to others.

interval when client manifest signs and symptoms specific to type of infection

interval when acute symptoms of infection disappear (length of recovery depends on severity of infection and client's host resistance; recovery may take several days to months)

What are the stages of the course of infection

necrotic

signs of localized inflammation may include

signs of systemic inflammation

the inflammatory response may be triggered by

What response is this?
1. Vascular and cellular responses
2. Formation of inflammatory exudates
3. Tissue repair

exudates

acute inflammation is an immediate response to

the redness of inflammation is caused by

localized warmth at site of inflammation is caused by

local vasodilation delivers_________ and ________ to injured tissues

kinin, vasoactive amines, prostaglandins, and certain complement components that play a major role in inflammation

serum proteins serve to increase

these are present at the site of infection and serve as the first line of defense from microorganisms

swelling

pain of inflammation is caused by

injury causes tissue damage and possibly necrosis, as a result the body releases chemical mediators that increase ______________; as a result, fluid, protein, & cells enter interstitial spaces; this accumulation of fluid causes localized _____________

the eyes defense mechanism against infection

defense mechanism of respiratory tract

defense mechanisms of urinary tract against infections

defense mechanisms of GI tract against infections

defense mechanism of vagina against infection

defense mechanisms of mouth against infection

defense mechanisms of skin against infection

contains fatty acid that kills some bacteria

body's first line of defense against infection

a process that involves the destruction and absorption of bacteria

cellular response of inflammation involves

which WBCs specialize in process of phagocytosis

an increase in the number of circulating WBCs ( the body's response to WBCs leaving blood vessels)

normal serum WBC: ________
during inflammation: _________

Fever is caused by phagocytic release of ___________ from bacterial cells that cause a rise in the ______________ set point

Exudate may be ____________ , _________ , or ________.

serous

sanguineous

purulent

fibrinogen

tissue that is not as strong as tissue collagen and assumes the form of scar tissue when inflammation is chronic

Health care-associated infections (HAIs) are formerly called what

infections that result from delivery of health services in a health care facility

a type of HAI from a diagnostic or therapeutic procedure

HAIs are either ______ or _________.

organism that is present outside the client (HAI)
postoperative infection

organism that are part of normal flora or virulent organisms residing that could cause infection (HAI); can occur when part of the client's flora becomes altered and an overgrowth results (ex: client is placed on several antibiotics in hospital setting and develops an infection)

the major sites for HAIs include

TJC has listed several national safety goals focusing on care of older adults, such as

an age-related decline in immune system function

older adults are less capable of producing ___________ to combat challenges to the immune system

risks associated with the development of HAIs in older clients

after age 70, older adults appear likely to produce _________ that attack parts of the body itself instead of infections

infants have immature defenses against infection because

breast fed infants have greater what?

what are the most common cause of communicable illness in young or middle-age adults

what infection in children and adolescents has been decreased by 98% since the major effort to vaccinate all children in 2000?

the immune response, particularly ____________, declines with age

when protein intake is inadequate as a result of poor diet or debilitating disease, the rate of ______________ exceeds that of _______________/

what nutrients are important for the body's defenses against infection and impairs wound healing?

the body responds to emotional or physical stress by the

the basal metabolic rate increases as the body uses energy stores

infected drainage may be what color

Nursing Assessment Questions relating to infections

lab value for WBC cournt

Lab value for erythrocyte sedimentation rate

lab value for iron level

Differential Count (% of each type of WBC)
Neutrophils:
Lymphocytes:
Monocytes:
Eosinophils:
Basophils

a risk for infection is a WBC of __________

potential sites of infection

to identify the causative organism, the nurse collects

systemic infections require measures to prevent

a client's increased metabolic rate with infection requires an

base efforts to minimize the onset and spread of infection on the principles of

the absence of pathogenic (disease-producing) microorganisms

practices/procedures that assist in reducing the risk for infection

the two types of aseptic technique are

procedures used to reduce the number of organisms present and prevent the transfer of organisms
(hand hygiene, using gloves)

object that becomes unsterile or unclean is considered

to prevent and control infection and its spread

using an instant alcohol hand antiseptic

act of washing hands with soap and water

________________ is the removal of all soil (organic & inorganic material) from objects & surfaces; generally involves water & mechanical action with detergents or enzymatic products

detergents should have a ______________ pH

failure to follow the manufacturer's recommendations transfers liability from the ___________ to the ________ if an infection occurs from improper processing

Cleaning Equipment:
When first rinsing the equipment, you use what temp of water? When rinsing the equipment after cleaning, you use what temp of water?

a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects

what are the two types of disinfection?

what do you use to accomplish disinfecting

the complete elimination or destruction of all microorganisms, including spores

what are the most common sterilizing agents?

what are the three categories of device classification for sterilization, disinfection, and cleaning?

critical items must be _________

semicritical items must be _________________ or __________

noncritical items must be _______________

___________ use moist heat from steam to sterilize items

How does ethylene oxide (ETO) gas destroy spores and microorganisms?

what is cough etiquette

a nurse who has a _________________ should be placed on work restriction

as long as urinary catheters and drainage sets are closed and intact, they are considered ___________

______________ on drainage bags should remain closed to prevent entrance of bacteria

make sure the site from which a drainage tube exits remains clear of ________ or ____________

you only open drainage receptacles when it is necessary to _______ or _________

the surgical wound is considered to be _________

to prevent entry of microorganisms into the wound, always clean ________ from wound site

a client's resistance to infection improves as the nurse protects ________ against infection

S. aureus

the separation and restriction of movement of ill persons with contagious disease

_____________ includes the appropriate use of gowns, gloves, masks, eyewear, and other protective devices or clothing

Centers for Disease Control & Prevention Isolation Guidelines has a two-tiered approach.
First Tier:
Two Tier:

wear _____________ when you anticipate splashing or spraying of blood or body fluid into the face or when working with a client placed on airborne or droplet precautions

when collecting a specimen, put it in a medium that __________________

____________ reports determine the antibiotics used in treatment