Ch. 20 Promoting Asepsis And Preventing Infection (Week 4 Quiz) Flashcards Preview

Nur 23 Fundamentals > Ch. 20 Promoting Asepsis And Preventing Infection (Week 4 Quiz) > Flashcards

Flashcards in Ch. 20 Promoting Asepsis And Preventing Infection (Week 4 Quiz) Deck (56):
1

What is an infection? What is the best way to prevent it?

When microorganisms capable of producing disease (pathogen) invades the body; handwashing.

2

The process by which infections spread is referred to as the _____________ ___ __________.

chain of infection

3

What are the six links in the chain of infection?

1. Infectious agents (bacteria that causes illness; sometimes normal flora can be out of balance and become infectious agents)

2. Reservoir (a human host carrying the bacteria)

3. Portal of exit (leaves human through body fluid such as a sneeze, or through feces, etc.)

4. Mode of transmission (direct vs indirect -kissing vs touching a contaminated fomite - can be airborne/droplet or through vector like mosquito/tick).

5. Portal of entry (eyes, nose, mouth, mucous membrane, cuts, burns, etc.)

6. Susceptible host (person immunity was down when they touched their eyes or nose after touching contaminated fomite).

4

A place where pathogens survive and multiply (human is common one).

reservoirs

4

Pathogens enter and exit through what?

Portals of entry and exit

Examples: Eyes, nose, mouth, Vagina, cuts, wounds
IV or drainage sites, Bite from vector

5

A. The mode of transmission that involves touching, kissing, sexual intercourse is called?

B. The mode of transmission that takes place from touching a contaminated object.

C. _______ transmission occurs when pathogen travels through air directly into another person such as through cough or sneeze. May also occur during suctioning or oral care. It is inhaled or enters the eye of susceptible person. Can travel within few feet of the ill.


D. _____ transmission occurs when smaller organisms float considerable distances on air currents. Can travel through air conditioning/heat system. Tuberculosis is an example. Highly contagious.

A. Direct contact


B. Indirect

C. Droplet

D. Airborne

6

A. The mode of transmission that involves touching, kissing, sexual intercourse is called?

B. The mode of transmission that takes place from touching a contaminated object.

C. _______ transmission occurs when pathogen travels through air directly into another person such as through cough or sneeze. May also occur during suctioning or oral care. It is inhaled or enters the eye of susceptible person. Can travel within few feet of the ill.


D. _____ transmission occurs when smaller organisms float considerable distances on air currents. Can travel through air conditioning/heat system. Tuberculosis is an example. Highly contagious.

A. Direct contact


B. Indirect

C. Droplet - gown/gloves/mask

D. Airborne - gown/gloves/special fitted mask

7

A person who is at risk for infection because of inadequate defenses against invading pathogen?

susceptible host

9

What are the 5 stages of infection?

IPIDC

1. Incubation-the time between the infection and symptoms.

2. Prodromal- beginning symptoms like throat irritaion.

3. Illness-characteristic signs and symptoms (if it's food poisoning, this is the part where you can't leave the toilet and your head is in the trash can)

4. Decline-after you've taken antibiotics for a couple days and start to feel better because the microbes are declining in numbers.

5. Convalescence -return to health (in some cases-tissue repair)

9

Pathogen acquired from the healthcare environment.

Exogenous healthcare related infection (EXO is outside of the body).

10

Presence of bacteria in blood is called...

bacteremia

11

Anatomical features that limit pathogen entry (Ex. Skin, tears, mucous membranes, normal flora in GI and urinary tract )

Primary Defense

13

This type of HRI is caused when normal flora multiply, causing infection AS A RESULT OF TREATMENT.

Endogenous Healthcare Related Infection (ENDO - inside what normally lives there goes haywire).

14

A ___________ is caused by the use of broad spectrum antibiotics to treat infection, which causes elimination of normal flora, allowing pathogens to multiply.

superinfcetion

15

Pathogens that get past primary line of defense begin to release waste and secretions and cause breakdown of cells/tissue. The presence of such chemicals activates ______ _______ .

secondary defenses

Examples: phagocytosis, complement cascade (triggers release of chemicals to attach invaders), inflammation, and fever

16

______ is a process that begins when histamine and other chemicals are released from damaged cells or basophils in response to the activation of the compliment. Typical signs are localized warmth, swelling, pain and redness.

inflammation

17

What are the classic sign of inflammation?

CALOR (heat),
DOLOR (pain),
TUMOR (swelling),
RUBOR (rednessaka erythemia)

18

Humoral (body fluid) immunity - such as B-Cell production; And Cell-mediated immunity - such as direct destruction of infected cells by T cells are both ______ defenses

Tertiary

Remember 1st and second defenses are ALWAYS there and ready for invasion. Those described in tertiary have to be manufactured, and would only be ready if infected a second time...so they are tertiary.



18

Factors that increase infection risk

Age
Developmental stage
Breaks in skin
Illness or chronic disease
Lifestyle
Multiple sex partners
Meds and hospital procedures

20

Name some factors that increase infection risk ...

Age
Developmental stage
Breaks in skin
Illness or chronic disease
Smoking/Substance abuse
Multiple sex partners
Medications
Hospital procedures

21

______ _______ is a state of cleanliness that decreases the potential for the spread of infection.

Medical Asepsis

21

If you were to test for immunoglobulins,and found IgM and NOT IgG, is this the first or second infection?

IgM meas this is the first encounter with the antigen.
M as in MY first time

IgG means this is not the first time.
G as in I Got this before.

22

List ways to promote medical asepsis:

-Maintain a clean environment -Clean hands
-Follow CDC guidelines
-Clean spills/surfaces promptly
-Disinfect
-Remove Clutter
-Consider any supply brought into a to room to be contaminated.

23

For how long must you wash your hands in a nonsurgical setting?

How about in a surgical setting?

15 seconds; 2-6 minutes

24

Why would a patient be put into protective isolation?

This is meant to help protect immunocompromised patients from organisms PPE is meant to protect the patient, not you. Also, a nurse assigned to protective will not work with actively sick persons as well to be extra cautious.

26

Before you enter a patients room, look at the precaution signs on the door.

If you see contact what do you wear?

Droplet?

Airborne?

1. gloves (gown too if you think you will have excessive contact

2. add mask and eye protection and gown

3. special mask for you and mask pt if they leave the room




27

A client exhibits all of the following during a physical assessment. Which of these is considered a primary defense against infection?

1) Fever
2) Intact skin
3) Inflammation
4) Lethargy

Answer:
2) Intact skin

Rationale:
Intact skin is considered a primary defense against infection. Fever, the inflammatory response, and phagocytosis (a process of killing pathogens) are considered secondary defenses against infection.

28

A client with a stage 2 pressure ulcer has methicillin-resistant Staphylococcus aureus (MRSA) cultured from the wound. Contact precautions are initiated. Which rule must be observed to follow contact precautions?

1) A clean gown and gloves must be worn when in contact with the client.
2) Everyone who enters the room must wear a N-95 respirator mask.
3) All linen and trash must be marked as contaminated and send to biohazard waste.
4) Place the client in a room with a client with an upper respiratory infection.

Answer:

Answer:
1) A clean gown and gloves must be worn when in contact with the client.

Rationale:
A clean gown and gloves must be worn when any contact is anticipated with the client or with contaminated items in the room. A respirator mask is required only with airborne precautions, not contact precautions. All linen must be double-bagged and clearly marked as contaminated. The client should be placed in a private room or in a room with a client with an active infection caused by the same organism and no other infections.

29

A client requires protective isolation. Which client can be safely paired with this client in a client-care assignment? One

1) admitted with unstable diabetes mellitus.
2) who underwent surgical repair of a perforated bowel.
3) with a stage 3 sacral pressure ulcer.
4) admitted with a urinary tract infection.

Answer:
1) admitted with unstable diabetes mellitus.

Rationale:
The client with unstable diabetes mellitus can safely be paired in a client-care assignment because the client is free from infection. Perforation of the bowel exposes the client to infection requiring antibiotic therapy during the postoperative period. Therefore, this client should not be paired with a client in protective isolation. A client in protective isolation should not be paired with a client who has an open wound, such as a stage 3 pressure ulcer, or with a client who has a urinary tract infection.

30

Which action demonstrates a break in sterile technique?

1) Remaining 1 foot away from nonsterile areas
2) Placing sterile items on the sterile field
3) Avoiding the border of the sterile drape
4) Reaching 1 foot over the sterile field

Answer:
4) Reaching 1 foot over the sterile field

Rationale:
Reaching over the sterile field while wearing sterile garb breaks sterile technique. While observing sterile technique, healthcare workers should remain 1 foot away from nonsterile areas while wearing sterile garb, place sterile items needed for the procedure on the sterile drape, and avoid coming in contact with the 1-inch border of the sterile drape.

31

A mother who breastfeeds her child passes on which antibody through breast milk?

1) IgA
2) IgE
3) IgG
4) IgM

Answer:
3) IgG

Rationale:
The antibody IgG is passed to the child through the mother's breast milk during breastfeeding. IgA, IgE, and IgM are produced by the child's body after exposure to an antigen.

32

What is the rationale for hand washing? Hand washing is expected to remove:

1) transient flora from the skin.
2) resident flora from the skin.
3) all microorganisms from the skin.
4) media for bacterial growth.

Answer:
1) transient flora from the skin.

Rationale:
There are two types of normal flora: transient and resident. Transient flora are normal flora that a person picks up by coming in contact with objects or another person (e.g., when you touch a soiled dressing). You can remove these with hand washing.

Resident flora live deep in skin layers where they live and multiply harmlessly. They are permanent inhabitants of the skin and cannot usually be removed with routine hand washing.

Removing all microorganisms from the skin (sterilization) is not possible without damaging the skin tissues. To live and thrive in humans, microbes must be able to use the body's precise balance of food, moisture, nutrients, electrolytes, pH, temperature, and light. Food, water, and soil that provide these conditions may serve as nonliving reservoirs. Hand washing does little to make the skin uninhabitable for microorganisms, except perhaps briefly when an antiseptic agent is used for cleansing.

33

______ infections refer to hospital-acquired infections.

nosocomial

Hospital acquired infection


do not confuse with healthcare associated infections. This refer to all health setting including homecare.

34

____ is an ORGANISM that carries pathoen to a susceptible host (typically through bite, sting)

vector

mosquito, fleas, ticks are common one

35

An ______ is an outbreak of a disease that suddenly affects a large group of people in a geographic region.

epidemic

36

What is the difference between primary and secondary illness?

Primary is first illness. Secondary is the second illness caused because primary made pt immunocompromised. Came in sick with shingles and end up with pneumonia

37

Due to bacteria mutation, some microorganisms are said to be ______ _______.

drug resistant

38

T or F: hands of healthcare workers is a common mode of transmission for resistant microbes (MDROs)

True

MDRO - multidrug resistant organisms

39

MRSA (methicillin-resistant staph aureus) is spread through....

skin to skin contact.

40

What ppe should you wear when treating an MRSA patient?

protective gloves and gowns.

41

Patients are at risk of _____ infections if they are hospitalized, have week immune system, have undergone surgical procedure, have catheter including PICC.

VRE (Vancomycin Resistant Enterococci

42

___ ______ is caused by a spore forming organism. Although we may always carry this, it becomes dangerous when antibiotics destroy healthy bacteria that normally protect against it. It can cause severe diarrhea that can be treated by fecal transplant

C. Diff.

43

immune system video....

https://www.youtube.com/watch?v=zQGOcOUBi6s

44

____ is a term that means absence of contamination by disease causing microorganism

asepsis

45

How long should you wash your hands in a non surgical setting?

vigorously for at least 15 seconds. longer if soiled.

46

How long should you wash your hands in a surgical setting?

two to 6 minutes depending on instructions for soap

47

What temp should water be when handwashing?

warn water. hot can break down skin

48

CDC recommends using a ___% alcohol based solution for routine hand cleansing or antimicorbial soap and water when hands are visibly dirty.

60% (remember lower alcohol means slower evaporation and more germ killin!)

49

t or f: If there is potential for contact with bacterial spores you can still use hand sanitizer

false. must use soap an water. sanitizier cant do squat against spore former.

50

When using hand sanitizing agent, how long do you leave it on?

Until dry

51

What is a latent infection?

infection present with no discernable symptoms (HIV is an example)

52

What is good nutrition to support defenses (immune)?

high protein, vitamin D, C and Zin. Mg Ca help with healing process. ALso fluids

53

If a pathogen is spread by direct contact, what type of precaution sign will be on the door?

Contact Precaution

PPE: gown/gloves

Most common

Sources of infection: draining wounds, secretions, supplies
Precautions include:
Possible private room
Clean gown and glove use
Disposal of contaminated items in room
Double-bag linen and mark
Not assigned to immunocompromised and VRE?MRSA types

54

Difference between disinfection and sterilization?

disinfection removes virtually all pathogens on an inanimate object. not as good as sterilizing

sterilization is elimination of ALL pathogens!

55

Steps in donning surgical attire

1. change into scrub suit
2. cover hair and shoes
3. facemask (w/goggle is splashing is possible)
4. surgical hand scrub
5. gown last if required

56

Types of immunity:

Naturally acquired active immunity :
occurs when the person is exposed to a live pathogen, develops the disease, and becomes immune as a result of the primary immune response.

Artificially acquired active immunity:
can be induced by a vaccine, a substance that contains the antigen.

Artificially acquired passive immunity:
is a short-term immunization by the injection of antibodies, such as gamma globulin, that are not produced by the recipient's cells.

Naturally acquired passive immunity:
occurs during pregnancy, in which certain antibodies are passed from the maternal into the fetal bloodstream.

Read more: immunity: Active and Passive Immunity http://www.infoplease.com/encyclopedia/science/immunity-active-passive-immunity.html#ixzz3WaG3pANH

Read more: immunity: Active and Passive Immunity http://www.infoplease.com/encyclopedia/science/immunity-active-passive-immunity.html#ixzz3WaFuXdKX