Chapter 8: nursing care of patients w/ infections Flashcards
(69 cards)
1
Q
Infection process
A
- chain of infection required
- six links in the chain
- treatment breaks the chain
2
Q
infective (causative) agents
A
- bacteria
- virus
- fungi
- protozoa
- Helminth
- Prion
3
Q
A
4
Q
microbiota
A
microbes occurring naturally in a body part
5
Q
pathogen
A
disease causing microbe
6
Q
reservoir
A
environmental ome for infectious agents
- animate: people, insects, animals, plants
- inanimate: water, soil, medical devices
7
Q
portal of exit
A
path by which infectious agent leaves its reservoir
8
Q
mode of transmission
A
direct
indirect
9
Q
direct mode of transmission: direct contact
A
touching
kissing
sexal contact
10
Q
direct mode of transmission: droplet spread
A
sneezing
coughing
talking
11
Q
disease examples for direct transmission
A
scabies
infectious mononucleosis
STIs
pertussis
influenza
12
Q
prevention of direct contact
A
hand hygiene
aseptic technique
PPE: gloves, surgical masks, goggles, gowns, shoe covers
13
Q
indirect transmission
A
vehicle born transmission by contact w/ contaminated object
14
Q
indirect vehicle examples
A
toys, bedding, dressings, surgical instruments
biological: blood, organs
water/food
15
Q
disease examples of indirect transmission
A
- influenza, norovirus, hepatitis
16
Q
prevention of indirect transmission
A
- hand hygiene, stethoscope cleaning
- cleaning per protocols
- clean water/food
17
Q
Indirect vector
A
born transmission by living source other than humans
- vectors: fleas, mice, mosquitos, rats, ticks
- disease examples: lyme disease, malaria, plague, zika
- prevention: insect repellents, rodent control
18
Q
airborne transmission
A
- dust or droplet nuclei carry pathogen through air
- small particles in air for long time and large distance inhaled/deposited on host mucous membranes
- disease examples: measles, chickenpox, tb
- prevention: high effeciency particulate air (HEPA) respirators
- must have your own fit tested HEPA respirator
19
Q
portal of entry
A
- entry into susceptible host
- portals: respiratory tract, skin, mucoumembranes, gastrointestinal tract, genitourinary tract, placenta
20
Q
susceptible host
A
- occurs from defense breakdown
- increased risk: burns, chronic disease, immunocompromised, invasive procedures, malnourishment, stress, young or old age
21
Q
body’s defense mechanisms
A
- skin and mucous membranes
- cilia
- gastric acid
- immunoglobulins
- leukocytes and macrophages
- lysozymes
- interferon
- inflammatory response
22
Q
inflammatory response
A
- vascular response
- inflammatory exudate
- phagocytosis and purulent exudate
23
Q
immune system
A
- body’s final defense against infection
- immune cells and lymphoid tissue
24
Q
infection
A
results when immune system protection fails
25
localized infection
- microbes in one area
- pain, redness, swelling, site warmth
26
sepsis
- dysregulated host response to infection
- can be life threatening
- organ damage
- can lead to septic shock: decreased bp
27
laboratory assessment
- gram staining
- culture and sensitivity (C&S)
- antibody test
- complete blood count w/ differential
- erythrocyte sedimentation rate (ESR)
28
immunity
- natural immunity: species specific
29
innate immunity
hereditary
30
acquired immunity
exposure
vaccination
immunoglobulin injection
31
infectious mononucleosis
- epstein barr virus usual cause
- contagious
- symptomatic in teens, young adults
- extreme fatigue, anorexia, chills, red sore throat, headache, high fever, tonsils w/ white coating
- supportive care
32
ebola virus disease
- direct contact transmission
- use hand hygiene, specialized PPE
- symptoms appear in 2-21 days
- fever, headache, diarrhea, vomiting, abdominal pain, muscle pain, unexplained bruising/bleeding
- supportive care only
- complications: joint and vision problems
33
zika virus disease
- transmitted by infected aedes specis mosquitos
- use hand hygiene, contact precautions
- symptoms: fever, headache, rash, muscle/joint pain, conjunctivitis
- supportive care: acetaminophen, fluids, rest
- complications: Guillain-Barre syndrome, birth defects
34
community infection control
- world health organization
- centers for disease control and prevention
- local health depts
- home health nurses
35
infection control in health care agencies
- community acquired infection
- healthcare associated infections
36
health care associated infections
- infection from care in healthcare agency
37
risk factors for healthcare associated infections
- host's condition
- multiple antibiotic therapy
- high risk units
38
common pathogens of health care associated infections
- escherichia coli
- staphylococcus aureus
- pseudomonas aeruginosa
39
asepsis
freedom from organisms
40
medical asepsis
clean technique
41
surgical asepsis
sterile technique
42
ultraviolet environmental disinfection
- UV light used to disinfect pt care areas and rooms after traditional cleaning
43
infection prevention: standard precautions
- assume all pts infectious
- blood, body fluids, bdy substances
- hand hygiene, gloves, gowns, masks, goggles, face shields
44
infection prevention: transmission based precautions
- specific infectious diseases
- used w/ standard precautions
45
precautions for vancomycin-resistant enterococci
- private room required
- gloves must be worn by all hospital personnel entering room
- wash hands on entering and leaving room
- gowns: required if contamination of clothing is likely
- decontaminate all equipment used in the room before removal from the room
46
risk factors for respiratory tract infections
invasive tubes
47
prevention of respiratory tract infections
- oral hygiene
- coughing and deep breathing
- ventilator asociated pneumonia bundles
48
risk factors for genitourinary tract infection
urinary catheters
49
prevention of genitourinary tract infections
- appropriate use of urinary catheters
- intermittent catheterization
- strict aseptic technique
- secure tubing as directed
- closed system
- drainage bag below bladder level
50
prevention of surgical wound infections
- sterile technique used for dressing changes
- monitor wound
51
antibiotic resistant infections: methicillin resistant staphylococcus aureus (MRSA)
- difficult to treat
- high mortality rate
- treatment: vancomycin hydrochloride
52
VRE
- direct/indirect transmission
- difficult to treat
- treatment: combination antibiotic therapy
- isolation when hospitalized
53
treatment of infections
- type of organism guides drug selection: antibiotics, antivirals, fungals
- monitor peak/trough levels
54
antibiotics
bacterial infections
55
antivirals
viral infections
56
antifungals
fungal infections
57
antibiotic associated diarrhea
- upset of balance of natural gut microbiota
- harmful bacteria increase
- toxins cause inflammation
- watery stools result
- may resolve when antibiotic stopped
58
clostridium difficile
- gram positive bacterium
- overgrowth w/ imbalance in normal gut microbiota
- often from antibiotic therapy
- serious cause of AAD
- psuedomembranous colitis, a life threatening condition, may result
- transmitted by the fecal oral route
- handwashing essential
- alcohol based rubs not effective
- antibiotic treatment stopped
- treatment: metronidazole or vancomycin
59
fecal microbiota transplantation
- treatment for c diff infection
- restores healthy gut bacteria
- rapid, dramatic results to restore health
- screened healthy donated feces
- transplanted via colonoscopy, sigmoidoscopy, nasogastric or nasoenteric tube, enema, esophagogastroduodenoscopy, or oral capsules
- stool substitutes under study: purified intestinal bacterial cultures, more acceptable to patients
60
nursing responsibilities for care of pts w/ infections
- check allergies
- monitor side effects
- check for signs of superinfection
- monitor peak/trough levels
61
patient education for infections
- take all medication as prescribed
- report side effects
62
respiratory tract infections
- data collection: signs and symptoms, sputum culture
- nursing diagnosis: risk for infection
63
implementation
- coughing and deep breathing
- oral care: toothbrush or suction-type toothbrush and fluoride toothpaste
- hydrate
- manage pain
- elevate head of bed 30 degrees or more for tube feeding
64
evaluation of respiratory tract infections
- oxygen saturation above 90%
- decreased dyspnea
- respirations not labored
- free of infection signs/symptoms
65
GI tract infections
- data collection: signs and symptoms, dehydration, stool culture
- nursing diagnosis: risk for infection
66
implementation for Gi tract infections
- hydrate
- follow standard precautions
- evaluation: free of infection and GI symptoms
67
Genitourinary tract infections
- data collection: signs and symptoms, urinalysis, urine culture
- nursing diagnosis: risk for infection
68
implementation of genitourinary tract infections
- avoid use of urinary catheters
- use sterile technique to insert urinary catheters
- avoid contamination when emptying urinary catheter bags
- report symptoms
69
evaluation of genitourinary tract infections
- normal urine output w/out symptoms
