Ch 2 - medical asepsis and OSHA standard

Question 1

list six growth requirements needed by microorganisms to survive

Answer 1

optimum temperature - mos prefer 98.6 F

pH - most prefer neutral

nutrition - autotrophs (uses inorganic) or heterotrophs (uses organic)

darkness

moisture - need moisture for cell metabolism and carry away wastes

oxygen - aerobes or anaerobes

Question 2

definition of medical asepsis

Answer 2

practices that are employed to inhibit the growth and hinder the transmission of pathogenic microorganisms to prevent the spread of infection meaning

that an object or area is clean and free from disease-producing microbes

Question 3

examples of nonintact skin

Answer 3

abrasions, cuts, hangnails, paper cuts, burns etc

Question 4

what are 4 factors that contribute to low resistance and increased susceptibility to being infected by pathogen in a host?

Answer 4

poor health, poor hygiene, poor nutrition, and stress

Question 5

what are means of entry/exit for infection process cycle

Answer 5

mouth, nose, throat, ears, eyes, intestinal tract, reproductive tract, open wounds, breaks in skin, mucous membranes

Question 6

when should you wash hands with soap rather than use alcohol

Answer 6

visibly soiled with dirt or body fluids
before eating
after using the restroom

Question 7

why should you not top off the soap dispenser?

Answer 7

topping off soap to a partially empty dispenser can lead to bacterial contamination of the soap. get a new one

Question 8

how many percent does wearing gloves reduce contamination

Answer 8

70-80%

Question 9

when should you use sterile gloves?

Answer 9

dressing change or assisting provider with minor office surgery

Question 10

what are types of nonlatex gloves?

Answer 10

nitrile, vinyl, polychloroprene

Question 11

Symptoms of allergic reaction to latex?

Answer 11

redness of skin, urticaria, runny nose, asthma symptoms - sob, coughing and wheezing

Question 12

how much soap should you use to wash your hands?

Answer 12

1 teaspoon or the size of a nickel

Question 13

how much gel/lotion type alcohol based rub should you use?

Answer 13

1 ml or the size of a dime for gel or lotion

Question 14

what is the purpose of OSHA

Answer 14

to assist employers in providing a safe and healthy working environment for their employees

Question 15

why did OSHA develop a set of regulations called the Bloodborne Pathogens Standard?

Answer 15

these regulations are designed to reduce the risk of employees of exposure to infectious diseases

Question 16

definition of occupational exposure

Answer 16

reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other OPIM that may result from the performance of an employee’s duties

Question 17

example of serosanguineous fluid

Answer 17

liquid part of blood eg. exudates from wound

Question 18

definition of exposure incident

Answer 18

specific eyes, nose, mouth, or other mucous membrane, nonintact skin, or parenteral contact with blood or OPIM that results from an employee’s duties

Question 19

what is an example of a medication derived from blood

Answer 19

immune globulins

Question 20

what are the components of the OSHA bloodborne pathogens standard?

Answer 20

exposure control plan
labeling requirements
communication of hazards to employees
record keeping

Question 21

what are the three parts of the exposure control plan?

Answer 21

exposure determination
the method of compliance
postexposure evaluation and follow-up procedures

Question 22

what must an exposure determination include?

Answer 22

1. a list of all job classifications in which all employees are likely to have occupational exposure
2. a list of job classifications in which only some employees have occupational exposure; must include a list of tasks in which occupational exposure may occur

Question 23

what must the method of compliance include?

Answer 23

document of the specific health and safety control measures that are taken in the medical office to eliminate or minimize the risk of occupational exposure

Question 24

what must the postexposure evaluation and follow-up procedures specify?

Answer 24

method of documenting 
investigating an exposure incident 
postexposure evaluation
medical treatment 
follow-up that would be made available to the employee

Question 25

what information do you need for an exposure incident documentation?

Answer 25

route of exposure and conditions and circumstances of the exposure incident including engineering controls, work practice controls, PPE being used at the time of incident identify and document the source individual

Question 26

what is a source individual?

Answer 26

any person, living or dead, whose blood or OPIM may be a source of occupational exposure to the health care worker

Question 27

what is the overview/outline of an postexposure evaluation and follow-up procedure?

Answer 27

1. perform initial first aid 2. document exposure details and source individual 3. obtain consent from source individual to test their blood for HBV, HBC, HIV 4. provide exposed employee with results 5. obtain consent to test employee's blood 6. provide exposed employee with postexposure prophylaxis as recommended by US public health service

Question 28

how often should employers present their ECP to their employees?

Answer 28

Employers must present their ECP training at the time of task assignment and at least annually thereafter.

Question 29

what do employers need to include in their records of ECP training? and how long does these records need to be maintained?

Answer 29

1. employers must maintain records of the training sessions, which includes the presentation dates, content, names and qualifications of trainers, and names/job titles of employees who attended. 2. records must be maintained for 3 years

Question 30

what does the OSHA medical record need to include? and kept for how long?

Answer 30

``` employers must include: employee's name SSN hepB vaccination status with dates results of any postexposure examinations medical testing f/u procedures written evaluation of exposure incident must maintain these records for duration of employment plus 30 years ```

Question 31

requirements for sharps injury log?

Answer 31

employers with more than 10 employees at risk type and brand of device involved in the injury location of incident explanation of how incident occurred

Question 32

definition of engineering controls

Answer 32

all measures and devices that isolate or remove the bloodborne pathogens hazard from the workplace

Question 33

definition of work practice controls

Answer 33

reduce the likelihood of exposure by altering the manner in which the technique is performed

Question 34

general categories of regulated medical waste

Answer 34

any liquid or semiliquid blood or OPIM contaminated sharps or other materials contaminated pathologic and microbiologic wastes

Question 35

examples of waste that goes in the regulated waste container?

Answer 35

``` disposable drapes, pt gowns, table paper, sterile or clean gloves, a tinge of blood, thermometer probe covers, tongue depressors, tissue with respiratory secretions, ear speculums empty urine containers urine testing strips disposable diapers feminine hygiene products ```

Question 36

examples of waste that goes into the biohazard bag?

Answer 36

anything saturated with blood/OPIM vaginal speculums and collection devices tissue or fluid removed during minor office surgery microbiologic waste such as specimen cultures and collection devices discarded live and attenuated vaccines

Question 37

how should a biohazard box be labeled?

Answer 37

a warning label that appears on two opposite sides of the box

Question 38

what needs to be included on the biohazard waste form?

Answer 38

type and quantity of waste (weighed in pounds) where it is being sent signature from rep of medical waste service signature from rep of medical office

Question 39

common symptoms of all hepatitis?

Answer 39

fatigue, nausea, loss of appetite, abdominal pain, and jaundice

Question 40

how does hepatitis b survive outside the body?

Answer 40

in a dried state for at least 1 week and can still cause infection. dried blood or body fluids on countertops, equipment and instruments

Question 41

when was the hepatitis c blood test developed?

Answer 41

July 1992

Question 42

why do we not have hepatitis c vaccines?

Answer 42

it is difficult to develop due to the virus mutating so frequently

Question 43

how effective are antiviral drugs for hepatitis c?

Answer 43

40%

Question 44

what happens if individuals are infected with acute hepatitis c?

Answer 44

may develop chronic hep c after 10-20 years develop cirrhosis or liver cancer may die from liver failure

Question 45

CDC definition of AIDS

Answer 45

HIV positive status and a CD4+ Tcell count below 200 cells/uL (normal count is 500-1500cells/uL)

Question 46

how much foam type alcohol based rub should you use?

Answer 46

3 grams for foam or the size of a walnut

Question 47

susceptible host

Answer 47

likely to get infection....

Question 48

recap a needle from medication

Answer 48

is okay

Question 49

which of the following is a violation of the OSHA standard?

Answer 49

eating in the office laboratory

Question 50

what is the name given to a person who cannot fight off a pathogen that has entered his or her body?

Answer 50

susceptible host

Question 51

list 5 common types of microorganisms

Answer 51

bacteria, viruses, protozoa, fungi, animal parasites

Question 52

define reservoir host

Answer 52

one that becomes infected by the pathogen and also serves as a source of transfer of the pathogen the host provides to grow and multiply eg. people and animals

Question 53

define susceptible host

Answer 53

one who is capable of being infected by the pathogen the resistance or that contribute to low resistance and increased susceptibility include poor health, poor, hygiene, poor nutrition, stress

Question 54

define means of transmission the in the infection process cycle

Answer 54

from one person to another includes direct contact with an infected person or discharge. Indirect transfer includes the transfer of microorganisms by droplets of moisture expelled from the upper respiratory tract known as droplet infection, when a person coughs, sneezes; contaminated hands and equipment; contaminated food and water; and insects that carry pathogens

Question 55

list 7 protective mechanisms of the body

Answer 55

skin barrier mucous membranes lines the nose, throat, GI tract, genital tract mucus and cilia in the nose and respiratory tract, mucus traps the smaller microbes and cilia beat toward outside to remove from body coughing and sweating tears and sweat urine and vaginal secretions are acidic stomach acids

Question 56

when to apply an alcohol based hand rub

Answer 56

before direct patient contact after contact with patient's skin before or after gloves after contact with body fluids obviously when moving from a contaminated body site to a clean body site during patient care after contact with inanimate objects when providing health care to a patient

Question 57

stupid soap dispenser

Answer 57

do not add soap to a partially empty liquid soap dispenser. topping off can lead to bacteria contamination of soap correct procedure is either dispose of an empty dispenser or to rinse an empty dispenser thoroughly and then refill it

Question 58

define resident flora

Answer 58

normal flora resides in dermis harmless nonpathogenic difficult to remove

Question 59

define transient flora

Answer 59

picked up from external source resides in epidermis pathogenic easy to remove with proper had hygiene

Question 60

CDC recommends hand washing for how long

Answer 60

at least 15 seconds | birthday song x2

Question 61

define antiseptic

Answer 61

an agent that functions to kill or inhibit growth of microbes antimicrobial soaps deposits an antibacterial film on skin that discourages bacterial growth

Question 62

how much alcohol is in hand sanitizers

Answer 62

60-90% alcohol | ethanol or isopropanol

Question 63

trim fingernails

Answer 63

1/4"

Question 64

define contaminated

Answer 64

presence or reasonably anticipated presence of blood or OPIM on an item or surface

Question 65

define decontaminated

Answer 65

the use of physical or chemical means to remove, inactivate, or destroy pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling use or disposal

Question 66

define postexposure prophylaxis and use Hepatitis B as example

Answer 66

treatment administered to individual after exposure to an infectious disease to prevent the disease 24hours - 7 days Hep B exposure: passive immunizing agent provides temporary immunity to Hep B. giving the active agent a chance to take effect. hepatitis B immune globulin HBIG contains antibodies that provide immunity to hepatitis B for 1 to 3 months active immunizing agent in hep B vaccine produced from altered yeast cells named Recombivax HB and Energix-B is given IM in a series of three doses at 0, 1mth, 6 mth

Question 67

opportunistic infection

Answer 67

an infection that results from a defective immune system that cannot defend itself from pathogens normally found in the environment

Question 68

HIV screening

Answer 68

enzyme immunoassay and enzyme linked immunosorbent assay