Chapter 4

Question 1

Nosocomial Pneumonia

Answer 1

Associated with factors that promote colonization of the pharynx with gram negative bacteria.

Question 2

Most nosocomial PNA occurs in…

Answer 2

Patients having chest or abdominal surgery.

• Normal swallowing and clearance mechanisms impaired.
• The presence of artificial airway increase likelihood of developing nosocomial PNA

Question 3

Who has a greater risk for nosocomial PNA following major surgery.

Answer 3

COPD, Smokers, Obesity, advanced age

Question 4

Colonization

Answer 4

presence of microorganisms in a host

Question 5

Pathogen

Answer 5

microorganisms capable of producing disease in humans

Question 6

infection

Answer 6

when microorganisms cause cell or tissue damage (microorganisms overcomes barriers of hose)

Question 7

What does getting an infection depend on?

Answer 7

Virulence or microorganism, host’s resistance

Question 8

Nosocomial infection

Answer 8

infections acquired in the hospital

Question 9

Asepsis

Answer 9

Absence of disease-producing microorganisms (Bacteria, mycoplasmas, fungi, and viruses)

Question 10

Sterile

Answer 10

Complete absence of all forms of microorgisms

Question 11

Cross-contamination

Answer 11

transmission of microorganisms between places and/or persons

Question 12

What does the spread of infection require?

Answer 12

• source of pathogen
• Susceptible host
• Route or transmission

Question 13

Source of infections (in hospitals)

Answer 13

• people (patients, personal, and visitors)

* Contaminated objects

Question 14

Susceptible Host

Answer 14

resistance to infection varies greatly from one person to the next

Question 15

Host factors the increase the change of infection

Answer 15

• poorly controlled diabetes
• increased age
• chemotherapy
• placement of tubes and catheters (artificial airways)

Question 16

Transmission routes

Answer 16

• contact
• Droplet
• airborne
• common vehicle
• vectorborne

Question 17

Contact Transmission

Answer 17

The most common mode of transmission.
*Direct Contact- Microorganism is transferred directly from one infected person to another without a contaminated intermediate object (fomite) or person
Indirect Contact: Transfer of infectious agent through a contaminated intermediate object or person (Dirty hands)

Question 18

Droplet Transmission

Answer 18

Respiratory droplets, greater then 5 microns that travel relatively short distances through the air, generally considered 3 feet or less.

• generated by coughing, sneezing, and or talking from an infected individual
• These large droplets do not remain suspended in the air, do not require special air handling procedures

Question 19

Airborne Transmission

Answer 19

Airborne dissemination by droplet nuclei or small respirable particles (less then 5 microns)
*easily dispersed by air currents
Requires Negative pressure room and N-95 Masks

Question 20

Droplet Nuclei

Answer 20

Residue of evaporated liquid droplets (TB and Measles form droplet nuclei)

Question 21

Vehicle

Answer 21

Exposure to pathogens in contaminated food or water, not common in the hospital setting

• Salmonella and Hepatitis A are common examples of food borne
• Cholera is a common example of waterborne

Question 22

Vectorborne Transmission

Answer 22

Occurs when an animal (usually insect) transfers an infectious agent from one host to another
*examples, malaria-mosquito; Lyme-tick

Question 23

infection control strategies

Answer 23

Break the chain of events

• decrease host susceptibility
• Eliminating source of pathogen
• interrupting routes of transmission

Question 24

decreasing host susceptibility

Answer 24

Least feasible approach, main focus is on employee immunization (influenza, Hepatitis B, Tetanus)

Question 25

Interrupting routes of Transmission (three major approaches)

Answer 25

* Specialized equipment handling procedures * Barrier/isolation precautions * Single patient use disposable equipment

Question 26

Barrier Measures and Isolation percautions

Answer 26

Hand washing is the single most effective method to prevent the spread of infection. *PPE (Gloves, Mask, Gown, Goggles)

Question 27

Standard Percautions

Answer 27

Primary strategy for preventing transmission of infectious agents among patients and health care workers, Assumes that any body fluids are infectious, decisions about PPE determined by type of clinical interactions with pt

Question 28

Expanded Precautions

Answer 28

Applied with patients who have Known or Suspected infections the require additional control measures (Contact, Droplet and Airborne)

Question 29

Gloves

Answer 29

Used when touching blood, body fluids, secretions, excretions, contaminated items, for touching membranes and non intact skin

Question 30

Gowns

Answer 30

Use during procedures and patient care activities when contact of clothing/ exposed skin with blood/body fluids, secretions, or excretions is anticipated

Question 31

Mask and goggles or a face shield

Answer 31

Use during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions

Question 32

Contact Percautions

Answer 32

Gown and Gloves

Question 33

Droplet Percautions

Answer 33

Surgical Mask

Question 34

Airborne infection isolation

Answer 34

N95 mask

Question 35

Protective environment isolation

Answer 35

Engineering approach to protect highly immunocomprised patients

Question 36

General Sanitation

Answer 36

Reducing pathogens to a safe level * Sanitary (Laundry management, Food preparation, house keeping) * Environmental control of air and water

Question 37

Equipment processing

Answer 37

Decontaminating equipment (my wash all equipment first, getting all the organic material off first) then disinfection and sterilization, it is impossible to eliminate all pathogens

Question 38

Equipment Categories

Answer 38

Based on the risk of infection in equipment is contaminated

Question 39

Critical equipment

Answer 39

Equipment that enters sterile tissues or vascular systems (should be purchased sterile or sterilized before use)

Question 40

Semi-Critical equipment

Answer 40

Equipment that contacts mucous membranes or non intact skin (most respiratory equipment, requires at least high-level sterilization)

Question 41

Non-Critical equipment

Answer 41

Equipment that come in contact with intact skin, decontamination where they are used (bed rails)

Question 42

Equipment processing

Answer 42

* Cleaning (Step one) Removing dirt and organic material. Failure to clean properly will render subsequent processing ineffective. Designate dirty and clean areas, completely disassemble and wash in hot soapy water (when applicable) dry completely. * If equipment cannot be immersed in water clean and disinfect surface (70% ethyl alcohol or 90% isopropyl alcohol) * disinfect or sterilize (most equipment must also be disinfected or sterilized)

Question 43

Disinfection

Answer 43

Destroys vegetative form of pathogen but cannot kill bacterial spores

Question 44

Sterilization

Answer 44

complete destruction of all forms of microbial life (Sporadical)