Chapter 29: Infection Prevention and Control

Question 1

Infection:

Answer 1

Invasion of a susceptible host (human being)

Question 2

Pathogens:

Answer 2

microorganisms that lead to disease

Question 3

Colonization:

Answer 3

presence and growth of microorganisms within a host but without tissue invasion or damage

Question 4

Disease or infection results only

Answer 4

if the pathogens multiply and alter normal tissue function.

Question 5

Some infectious diseases such as viral meningitis and pneumonia have a

Answer 5

low or no risk for transmission even though they are serious for patients, they do not pose a risk to others

Question 6

Communicable disease:

Answer 6

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

Question 7

If pathogens multiple and cause clinical signs and symptoms, the infection is:

Answer 7

symptomatic

Question 8

If clinical signs and symptoms are not present, the illness is termed

Answer 8

asymptomatic

Question 9

Infection occurs in a cycle that depends on the presence of which elements (6)

Answer 9

infectious agent or pathogen

reservoir or source for pathogen growth

port of exit from reservoir

mode of transmission

port of entry to a host

susceptible host

Infection can develop if this chain remains uninterrupted

Question 10

Virulence (3)

Answer 10

ability of microorganisms to produce disease

ability to enter and survive in a host

susceptibility of host

Question 11

Most effective way to break chain of infection

Answer 11

HAND HYGIENE

Question 12

Reservoir is a

Answer 12

place where microorganisms survive, multiple, and await transfer to a susceptible host

Question 13

Common reservoirs:

Answer 13

humans

animals

insects

food

water

organic matter on inanimate surfaces

Question 14

Human reservoirs are divided into 2 categories:

Answer 14

Acute/symptomatic

Those who show no signs of diseases but are carriers!

Question 15

Aerobic organisms can cause:

Answer 15

more infections in humans than anaerobic organisms

Question 16

Ideal temperature for most human pathogens:

Ideal pH for microorganisms:

Answer 16

68-109 F

5.0-7.0

Question 17

Portals of exit include:

Answer 17

Blood

Skin

Mucous membranes

Respiratory tract

Genitourinary tract (GU)

Gastrointestinal tract (GI)

Transplacental (mother to fetus)

Question 18

Major route of transmission for pathogens identified in the health care setting:

Answer 18

unwashed hands of healthcare worker!!!

Question 19

Modes of transmission (6)

Answer 19

Direct
- person to person (fecal, oral) physical contact between source and host)

Indirect
- personal contact of host with contaminated inanimate object (needles, dressings, environment)

Droplet
- large particles that travel up to 3 feet during coughing, sneezing, talking and come in contact with susceptible host

Airborne
- Droplet nuclei, residue or evaporated droplets suspended in air during coughing or sneezing or carried on dust particles

Vehicles

• contaminated items
• water
• drugs, solutions
• blood
• food

Vector

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

Question 20

Course of infection by stage: (4)

Answer 20

Incubation period

Prodromal stage

Illness stage

Convalescence

Question 21

Incubation period:

Answer 21

interval between entrance of pathogen into body and appearance of first symptoms

chickenpox 14-16 days after exposure

Common cold 1-2 days

influenza 1-4 days

Question 22

Suprainfection:

Answer 22

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

When normal bacterial floras are eliminated, body defenses are reduced

Question 23

Serous fluid

Answer 23

clear, like plasma

Question 24

Sanguineous fluid

Answer 24

containing red blood cells

Question 25

Purulent fluid

Answer 25

containing WBCs and bacteria

Question 26

Major sites for HAIs (health care associated infections (4)

Answer 26

surgical or traumatic wounds urinary tract respiratory tract bloodstream

Question 27

Natural defense mechanisms against infection (7)

Answer 27

Skin Mouth Eye Respiratory tract Urinary tract Gastrointestinal tract Vagina

Question 28

HAI infections are either:

Answer 28

exogenous endogenous

Question 29

Exogenous infection comes from

Answer 29

microorganisms found outside the individual

Question 30

Endogenous infection occurs when part of the

Answer 30

patient's flora becomes altered and an overgrowth results (staph, yeasts)

Question 31

Iatrogenic infections are

Answer 31

a type of HAI caused by an invasive diagnostic or therapeutic procedure

Question 32

Factors influencing infection prevention control

Answer 32

age nutritional status stress disease process

Question 33

A reduction in the intake of protein and other nutrients such as carbs and fats

Answer 33

reduces body defenses against infection and impairs wound healing

Question 34

Risk factors of infection in adults (8)

Answer 34

Chronic disease Lifestyle- high-risk behaviors Occupation Diagnostic procedures Heredity Travel history Trauma Nutrition

Question 35

Examples of nursing diagnoses in the making:

Answer 35

risk for infection imbalanced nutrition: less than body requirements impaired oral mucous membrane risk for impaired skin integrity social isolation impaired tissue integrity

Question 36

Examples of common goals:

Answer 36

Preventing further exposure to infectious organisms Controlling or reducing the extent of infection Maintaining resistance to infection Verbalizing understanding of infection prevention and control techniques (hand hygiene)

Question 37

Medical asepsis:

Answer 37

absence of pathogenic (disease producing) microorganisms.

Question 38

Aseptic technique refers

Answer 38

to practices that reduce risk for infection

Question 39

2 types of aseptic techniques

Answer 39

Medical Surgical

Question 40

Basic medical aseptic techniques

Answer 40

break the chain of infection Use this technique for all patients, even when no infection is diagnosed

Question 41

Medical asepsis:

Answer 41

aggressive preventive measures such as hand hygiene barrier techniques routine environmental cleaning

Question 42

Disinfection

Answer 42

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

Question 43

2 types of disinfection:

Answer 43

disinfection of surfaces high-level disinfection -required for some patient care items such as endoscopes and bronchoscopes

Question 44

Sterilization and methods

Answer 44

eliminates or destroys all forms of microbial life, including spores methods include: steam, dry heat, hydrogen peroxide plasma, ethylene oxide

Question 45

Factors that influence the efficacy of the disinfecting or sterilizing method (6)

Answer 45

concentration of solution and duration of contact type and number of pathogens surface areas to treat temperature of environment presence of soap presence of organic materials

Question 46

Critical items for sterilization (4)

Answer 46

Items that enter sterile tissue or the vascular system...Must be free of EVERYTHING!! Surgical instruments Cardiac or intravascular catheters urinary catheters implants

Question 47

Semicritical items for sterilization (5)

Answer 47

Items that come in contact with mucous membranes or non intact skin. These items must be free of all microorganisms (except bacterial spores), must be high leveled disinfected or sterilized Respiratory and anesthesia equipment endoscopes endotracheal tubes GI endoscopes Diaphragm fitting rings

Question 48

Noncritical items:

Answer 48

Items that come in contact with intact skin but not mucous membranes. Must be disinfected Bedpans Bloodpressure cuffs Bedrails Linens Stethoscopes Bedside trays and patient furniture Food utensils

Question 49

Order of putting ON PPE

Answer 49

Gown Mask Goggles Gloves

Question 50

Order of taking OFF PPE

Answer 50

Gloves Goggles Gown Mask

Question 51

Infection prevention and control to reduce reservoirs of infection(8)

Answer 51

Bathing Dressing changes Contaminated articles Contaminated sharps Bedside unit Bottled solutions Surgical wounds Drainage bottles and bags

Question 52

Contact precautions:

Answer 52

Used for DIRECT and INDIRECT contact Care and handling of contaminated body fluids (blood) Gown and gloves used

Question 53

Droplet precautions:

Answer 53

Focuses on diseases that are transmitted by large droplets (greater than 5 microns) expelled into the air and by being within 3 FEET OF PATIENT Mask needed Influenza

Question 54

Airborne precautions

Answer 54

focuses on diseases transmitted by smaller droplets that remain in air for long time specifically equipped room with a negative air flow (airborne infection isolation room) air is not returned to the inside ventilation system but is FILTERED through a high-efficiency particulate air (HEPA) filter and exhausted directly OUTSIDE wear an N95 respirator every time they enter room

Question 55

Protective environment:

Answer 55

Very limited patient population specialized room with POSITIVE airflow Airflow rate is set at GREATER than 12 air exchanges per hour and all air is filtered through a HEPA filter. Masks!