Identify the bodies normal defenses agains infection.
barriers against entry into the body like skin, mucous membranes;body fluids such as sebum, saliva, acidity of stomach secretions; normal flora; cilia, macrophages and the flushing flow of urine
inflammatory response; immune response
Describe the 4 stages of infection.
Incubation period: the time from when the pathogen enters the body to the time when the first unspecific symptoms occur
Prodromal stage: the time from the onset of the non-specific symptoms (malaise, low grade fever, fatigue) to specific symptoms ( this is the stage where the microorganisms grow and multiply, they are contagious)
Illness stage: you have the signs and symptoms specific to the type of infection (a cold, sore throat, sinus congestion or high fever)
Convalescence Stage: when acute symptoms disappear and the body starts getting better
Identify factors which increase an individual's risk for infections.
pt's susceptibility to infection: (family hx)
age: (infants have fewer defenses and OA have impaired skin and respiratory integrity)
nutritional status: (reduction in protein, carbs and other nutrients reduce defenses and impair wound healing)
disease process: ( AIDS, Leukemia...)
medical therapies: (some drug and medical therapies compromise immunity to infection)
Explain conditions that promote the transmission of HAI's.
-the use of invasive devices such as IV's, catheters and syringes
-over use of broad spectrum antibiotics
-poor aseptic technique or sterile technique
-improper hand washing
Identify sites and causes in the body for HAI's.
Explain the difference b/t cell-mediated immunity and humoral immunity.
Cell Mediated Immunity: T-lymphocytes recognize an antigen via receptors and release lymphokines that attract macrophages and stimulate them to attack the antigen which in turn is killed (non-specific)
Humoral Immunity: the stimulation of B cells triggers this response, when it is stimulated it causes the synthesis of immunoglobulins or antibodies that destroy the antigen (specific)
Differentiate b/t natural and acquired immunity.
Natural Immunity: results after having had a certain disease (varicella); it is usually life long
Acquired Immunity: comes from the receipt of a vaccine (tetanus or polio); the duration is variable and may require a booster
Give an example for preventing infection for each element of the chain of infection.
Control or eliminate reservoirs: control or eliminate bodily fluids, drainage or contaminated solutions
Control portals of exit: cover mouth and know when coughing or sneezing, use contact precautions
Control of Transmission:client should use their personal items only, handwashing
Control portals of entry: maintain skin and mucous membrane integrity, dispose of sharps
Protect the susceptible host
What health promoting actions by the nurse minimize or prevent infections in 1. reservoirs 2.portals of exit 3. transmission 4.portals of entry.
Explain how infection control measures may differ in the home vs the hospital.
Why are dedicated articles and equipment used for a pt infected with MRO?
Dedicated articles are used for individuals with MRSA, C-diff, and VRE because they become colonized and must be sterilized before used by others
Explain the use of white blood count with differential.
Explain the use of culture and sensitivity (C&S)
What are their normal values?
What effect does inflammation and infection have on the values?
WBC: normal is 4.5-11 mm3; this value increases with acute infection and decrease in certain viral or overwhelming infections
WBC w diff:
when the WBC are broken down to show % of each type of WBC
Neutrophils- 55-70% increased in acute infection, decreased in overwhelming bacterial infection
Lymphocytes- 20-40% increased in chronic bacterial and viral infections, decreased in sepsis
Monocytes- 5-10% increased in protozoan, rickettsial and TB infections
Eosinophils- 1-4% increased in parasitic infections
Basophils- 0.5-1.5% normal during infection ESR: (Erythrocyte sedimentation rate) <15mm/hr for men; <20mm/hr for women; increased in the presence in infection
Iron Level: 60-90g/100ml; decreased in chronic infection
Cultures: urine, blood (sterile), sputum and drainage. the cultures are to detect the presence of infectious microorganism growth.
Identify and describe the CDC recommended adult immunization schedule for 2005, including purpose, scheduling and nursing indications.
Describe the methods used to prevent the transmission of disease recommended by the CDC identified as tier 1.
Contact Precautions: (transmitted by touch); private or cohort; gloves, gown and committed equipment.
Droplet Precautions: (transmitted via the air > 5 micrometers); private; mask
Airborne Precautions: (transmitted via the air < 5 micrometers); negative pressure private; N95 mask
Identify the psychological implications of isolation and appropriate nursing interventions.
Your pt is in a private, negative air pressure room with a suspected dx of TB. Airborne precautions are being followed. You notice the pt's MD entering the room without a mask. What would you do?
You observe that the nurses aide has not changed her gloves after bathing a pt and then proceeds to prepare her roommate for a bath. What would you do?