Exam 2 Flashcards
1
Q
asepsis
A
techniques used to prevent infection
2
Q
infectious agent
A
bacteria, viruses, fungi
3
Q
reservior
A
natural habitat of the organism
4
Q
portal of exit
A
point of escape for the organism
5
Q
Means of transmission
A
direct contact, indirect contact, airborne route
6
Q
portal of entry
A
point at which organisms enter a new host
7
Q
susceptible host
A
must overcome resistance mounted by host’s defenses
8
Q
bacteria
A
most significant and most prevalent in hospital settings
9
Q
virus
A
smallest of all microorganisms
10
Q
fungi
A
plant-like organisms present in air, soil, and water
11
Q
Factors Affecting an Organism’s Potential to Produce Disease
A
Number of organisms, Virulence, Competence of person’s immune system, Length and intimacy of contact between person and microorganism
12
Q
Possible Reservoirs for Microorganisms
A
Other people, Animals, Soil, Food, water, milk, Inanimate objects
13
Q
Common Portals of Exit
A
Respiratory, Gastrointestinal, Genitourinary tracts, Breaks in skin, Blood and tissue
14
Q
Stages of Infection
A
incubation period, prodromal stage, full stage illness, convalescent period
15
Q
incubation period
A
organisms growing and multiplying
16
Q
prodromal stage
A
person is most infectious, vague and nonspecific signs of disease
17
Q
full stage of illness
A
presence of specific signs and symptoms of disease
18
Q
Convalescent period
A
recovery from the infection
19
Q
factors affecting host susceptibility
A
Intact skin and mucous membranes, Normal pH levels, Body’s white blood cells, Age, sex, race, hereditary factors, Immunization, natural or acquired, Fatigue, climate, nutritional and general health status, Stress, Use of invasive or indwelling medical devices
20
Q
outcome identification and planning/infection control
A
Demonstrate effective hand hygiene and good personal hygiene practices, Identify the signs of an infection, Maintain adequate nutritional intake, Demonstrate proper disposal of soiled articles, Use appropriate cleansing and disinfecting techniques, Demonstrate an awareness of the necessity of proper immunizations, Demonstrate stress-reduction techniques.
21
Q
cardinal signs of acute infection
A
Redness, Heat, Swelling, Pain, Loss of function
22
Q
laboratory data indicating infection
A
Elevated white blood cell count—normal is 5,000 to 10,000/mm3, Increase in specific types of white blood cells, Elevated erythrocyte sedimentation rate, Presence of pathogen in urine, blood, sputum, or draining cultures
23
Q
5 moments for hand hygiene
A
Moment 1 – Before touching a patient, Moment 2 – Before a clean or aseptic procedure, Moment 3 – After a body fluid exposure risk, Moment 4 – After touching a patient, Moment 5 – After touching patient surroundings
24
Q
transient bacterial flora
A
attached loosely on skin, removed with relative ease
25
resident bacteria flora
found in creases in skin, requires friction with brush to remove
26
Four Categories Responsible for Majority of Hospital-Acquired Infections (HAIs)
Catheter-associated urinary tract infection (CAUTI), Surgical site infection (SSI), Central-line associated bloodstream infection (CLABSI) , Ventilator-associated pneumonia (VAP)
27
Risk Factors for Vancomycin-Resistant Enterococci (VRE)
Compromised immune systems, Recent surgery, Invasive devices, Prolonged antibiotic use (especially vancomycin), Prolonged hospitalization
28
CDC Recommendations to Prevent C. difficile infection (CDI)
Avoiding the use of electronic equipment that is difficult to clean (electronic thermometers), Disinfecting dedicated patient care items and equipment (stethoscopes) between patients, Using full-barrier contact precautions (gown and gloves), Placing patients in private rooms; cohort patients with the same strain of CDI, Performing meticulous hand hygiene, Performing environmental contamination of rooms, Educating health care providers (and patients/families as appropriate) on clinical presentation, transmission, and epidemiology of CDI, Using antimicrobials at an appropriate dose and only when indicated
29
body's defense against infection
Body’s normal flora, Inflammatory response, Immune response
30
Factors Determining Use of Sterilization and Disinfection Methods
Nature of organisms present, Number of organisms present, Type of equipment, Intended use of equipment, Available means for sterilization and disinfection, Time
31
standard precautions
Used in the care of all hospitalized patients regardless of their diagnosis or possible infection status, Apply to blood, all body fluids, secretions, and excretions except sweat (whether or not blood is present or visible), nonintact skin, and mucous membranes, New additions are respiratory hygiene/cough etiquette, safe injection practices, and directions to use a mask when performing high-risk prolonged procedures involving spinal canal punctures
32
transmission-based precautions
Used in addition to standard precautions for patients in hospitals with suspected infection with pathogens that can be transmitted by airborne, droplet, or contact routes, The 2007 guidelines include a directive to don personal protective equipment (PPE) when entering the room of a patient on contact or droplet precautions, Previously, PPE was only required when the nurse was delivering care within 3 feet of the patient, These categories recognize that a disease may have multiple routes of transmission: airborne, droplet, contact)
33
aseptic technique
Includes all activities to prevent or break the chain of infection, Two categories: Medical asepsis: clean technique, Surgical asepsis: sterile technique
34
use of surgical asepsis
Operating room, labor and delivery areas, Certain diagnostic testing areas, Patient bedside, For example, for procedures that involve insertion of urinary catheter, sterile dressing changes, or preparing and injecting medicine
35
patient teaching for medical asepsis at home
Wash hands before preparing or eating food, Prepare foods at high enough temperatures, Use care with cutting boards and utensils, Keep food refrigerated, Wash raw fruits and vegetables, Use pasteurized milk and fruit juices, Wash hands after using bathroom, Use individual care items
36
definition of safety
“avoiding injuries to patients from the care that is intended to help them.”, “minimizing risk of harm to patients and providers through both system effectiveness and individual performance."
37
definition of scope
Broad concept with key elements for understanding levels of errors, types of errors, placement of errors and ways of building a culture of safety
38
levels of errors
adverse event, near miss, sentinel event
39
adverse event
An event that results in unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient
40
near miss
An error of commission (did not provide care correctly) or omission (did not provide care) that could have harmed the patient, but serious harm did not occur as a result of chance, prevention, or mitigation
41
sentinel event
A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome
42
types of errors
diagnostic errors, treatment errors, preventive errors, communication failure
43
diagnostic errors
are the result of a delay in diagnosis, failure to employ indicated tests, use of outmoded tests, or failure to act on results of monitoring or testing
44
treatment errors
occur in the performance of an operation, procedure, or test; in administering a treatment; in the dose or method of administering a drug; or in avoidable delay in treatment or in responding to an abnormal test
45
preventive errors
occur when there are failures to provide prophylactic treatment and inadequate monitoring or follow-up of treatment
46
communication failure
can lead to many types of errors
47
active errors
made by those providers (e.g., nurses, physicians, and technicians) who are providing patient care, responding to patient needs at the point of care
48
latent
conditions are the potential contributing factors that are hidden and lie inactive in the healthcare delivery system, originating at more remote aspects of the healthcare system, far removed from the point of care
49
culture of safety
“The safety culture of an organization is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization's health and safety management.”, Focus on: patient outcomes, teamwork to accomplish the goal of safe, high-quality care, what went wrong rather than on who committed the error
50
knowledge
Human factors and basic design principles, Benefits and limitations of safety enhanced technologies, Strategies to reduce reliance on memory, Individual and systems delineating categories of errors and hazards, Factors that create a culture of safety, Processes used in understanding the cause of error and root cause analysis
51
skill
Utilize tools contributing to safer systems, Communication of observations and concerns, Using organizational error- reporting systems, Responsible for own individual practice
52
attitude
Personal and professional, Standardization and reliability, Professional values, Collaboration, Environmental scanning and vigilance
53
just culture
a system's explicit value of reporting errors without punishment, people can report mistakes or errors without reprisal or personal risk, promotes sharing and disclosure among stakeholders, including the patient and family, balance the need to learn from mistakes and the need to implement corrective or disciplinary action, errors in a just culture are commonly addressed by a model that differentiates human error from at-risk behavior and reckless behavior
54
human error
inadvertent action: a slip or lapse, best remedied by training, redesigning the system, and improving procedures
55
at-risk behavior
behavioral choice that increases risk when risk is not recognized or is mistakenly believed to be justified, best mitigated by creating incentives for healthy behaviors, increasing situational awareness, and providing education
56
reckless behavior
behavior choice to consciously disregard a substantial risk, best dealt with by remedial or punitive action
57
safety interrelated concepts
health care quality, communication, collaboration, care coordination
58
factors affecting safety
Developmental considerations, Lifestyle, Social behavior, Environment, Mobility, Sensory perception, Knowledge, Ability to communicate, Physical and psychosocial health state
59
focus of safety assessments
The person, The environment, Specific risk factors
60
nursing history
Assess for history of falls or accidents, Note assistive devices, Be alert to history of drug or alcohol abuse, Obtain knowledge of family support systems and home environment
61
physical examination
Assess mobility status, Assess ability to communicate, Assess level of awareness or orientation, Assess sensory perception, Identify potential safety hazards, Recognize manifestations of domestic violence or neglect
62
Factors That Contribute to Falls
Lower body weakness, Poor vision, Gait and/or balance issues, Problems with feet and/or shores, Use of psychoactive medications, Postural dizziness, Hazards in the home (and community)
63
types of risk factor assessments
Falls, Fires, Poisoning, Suffocation and choking, Firearm injuries
64
Patient Outcomes for Safety
Identify real and potential unsafe environmental situations, Implement safety measures in the environment, Use available resources for safety information, Incorporate accident prevention practices into ADLs, Remain free of injury
65
Health Teaching in the Schools
Monitor the child’s use of the Internet, Get involved in school activities and ask pertinent questions, Volunteer for safety committees that include staff and parents, Ensure that the school’s emergency preparedness plan is current
66
Safety Considerations for Neonates
Avoid behaviors that might harm the fetus, Never leave the infant unattended, Use crib rails, Monitor setting for objects that are choking hazards, Use car seats properly, Handle infant securely while supporting the head, Place infant on back to sleep
67
Safety Considerations for Toddlers/Preschoolers
Supervise child closely to prevent injury, Select toys appropriate for developmental level, Use appropriate safety equipment in the home, Never leave child alone in bathtub, Childproof home environment; prevent poisoning, Be alert to manifestations of child maltreatment or abuse, Use car seats properly, Teach about fire safety/practice emergency evacuation measures
68
Safety Considerations for School-Aged Children
Help to avoid activities that are potentially dangerous, Provide interventions for safety at home, school, and neighborhood, Reinforce teaching about symptoms the require immediate attention, Continue immunizations as scheduled, Teach bicycle safety, Teach about child abduction, Wear seatbelts
69
indications of a concussion
Physical: headache, vomiting, problems with balance, fatigue, dazed or stunned appearance, Cognitive: mentally foggy, difficulty concentrating and remembering, confusion, forgets recent activities, Emotional: irritability, nervousness, very emotional behavior, Sleep: drowsiness, difficulty falling asleep, sleeping more or less than usual
70
Safety Considerations for Adolescents
Teach safe driving skills and avoiding distracted driving, Teach avoidance of tobacco and alcohol, Emphasize gun safety, Follow healthy lifestyle, Teach about sexuality, STIs, and birth control, Get physical examination before participating in sports, Teach risk of infection with body piercing and tattoos, Teach about guns and violence, Discuss dangers associated with the Internet
71
Safety Consideration for Adults
Remind them of effects of stress on lifestyle and health, Enroll in defensive driving course, Counsel about unsafe health habits (reliance on drugs and alcohol), Evaluate workplace for safety, Counsel about domestic violence
72
Safety Plan for Victims of Domestic Abuse
Safety while living with an abusive partner, Safety planning with children, Safety planning for pets, Safety planning during pregnancy, Leaving a relationship
73
Safety Considerations for Older Adults
Identify safety hazards in the environment, Modify the environment as necessary, Attend defensive driving courses or courses designed for older drivers, Encourage regular vision and hearing tests, Ensure hearing aids and eyeglasses are available and functioning, Have operational smoke detectors in place, Objective document and report any signs of neglect and abuse
74
Safety Improvement Strategies
Preventing Falls Targeted Solutions Tool (TST), Falls Toolkit, Falls Prevention Training Program, Root Cause Analysis (RCA)
75
Hendrich II Fall Risk Model
Fall Scene Investigations (FSI), Hourly patient rounding, Root cause analysis (RCA), Get Up and Go Test
76
RACE
Rescue anyone in immediate danger, Activate the fire code and notify appropriate person, Confine the fire by closing doors and windows, Evacuate patients and other people to safe area
77
Procedure-Related Accidents/Possible Errors
Administering medications or intravenous solutions, Transferring a patient, Changing a dressing, Applying external heat to a patient’s extremity
78
Safety Event Reports
Must be completed after any accident or incident in a health care facility that compromises safety, Describes the circumstances of the accident or incident, Details the patient’s response to the examination and treatment of the patient after the incident, Completed by the nurse immediately after the incident, Is not part of the medical record and should not be mentioned in documentation
79
Physiologic Hazards Associated With Restraints
Increased possibility of serious injury due to fall, Skin breakdown, Contractures, Incontinence, Depression, Delirium, Anxiety, Aspiration and respiratory difficulties, Death
80
Maintaining Emergency Preparedness
Addressing biological threats, Addressing chemical threats, Addressing radiation threats, Addressing cyber terror, Preparing for mass trauma terrorism, Identifying disaster resources, Addressing psychological aspects of disasters
81
Factors Affecting Personal Hygiene
Culture, Socioeconomic class, Spiritual practices, Developmental level, Health state, Personal preferences
82
Interview Questions/Skin Alterations
How long have you had this problem?, Does it bother you?, How does it bother you (itching)?, Have you found anything helpful in relieving these symptoms?
83
Factors to Consider When Examining Skin
Cleanliness, Color, Temperature, Turgor, Moisture, Sensation, Vascularity, Evidence of lesions
84
Guidelines for Assessing the Skin
Incorporate assessment of the skin during the assessment of other body systems, Use a good source of light, preferably daylight, Compare bilateral parts for symmetry, Use standard terminology to report and record findings, Allow data obtained in the nursing history to direct the skin assessment, Identify any variables known to cause skin problems
85
Assessment of the Oral Cavity
Lips, Buccal mucosa, Color and surface of gums, Teeth, Tongue, Hard and soft palates, Oropharynx
86
At Risk for Skin Alteration
Lifestyle factors, Changes in health state, Illness, Diagnostic measures, Therapeutic measures
87
Focus of Self-Care Deficit Diagnoses
Feeding, Bathing and hygiene, Dressing and grooming, Toileting
88
Early Morning Care
Assist patient with toileting, Provide comfort measures to refresh patient to prepare for day, Wash face and hands, Provide mouth care
89
Morning Care (a.m. Care)
After breakfast, nurse completes morning care:Toileting, Oral care, Bathing, Back massage, Special skin measures, Hair care, cosmetics, Dressing, Positioning for comfort, Refreshing or changing bed linens, Tidying up bedside
90
Afternoon Care (PM Care)
Ensure patient’s comfort after lunch: Offer assistance with toileting, handwashing, oral care, Straighten bed linens, Help patient with mobility to reposition self
91
Hour of Sleep Care (HS Care)
Before patient retires: Offer assistance with toileting, washing, and oral care, Offer a back massage, Change any soiled bed linens or clothing, Position patient comfortably, Ensure that call light and other objects patient requires are within reach
92
As Needed Care (PRN Care)
Offer individual hygiene measures as needed, Change clothing and bed linens of diaphoretic patients, Provide oral care every 2 hours if indicated
93
Reasons for Providing Back Massage
Acts as a general body conditioner, Relieves muscle tension and promotes relaxation, Provides opportunity for nurse to observe skin for signs of breakdowns, Improves circulation, May decrease pain, distress, and anxiety, May improve sleep quality, Provides a means of communication through use of touch
94
Purposes of Bathing #1
Cleanses the skin, Acts as a skin conditioner, Helps to relax a person, Promotes circulation, Serves as musculoskeletal exercise, Stimulates the rate and depth of respirations, Promotes comfort through muscle relaxation and skin stimulation, Provides person with sensory input, Helps improve self-image, Strengthens nurse–patient relationship
95
Providing a Bed Bath
Provide articles for bathing on overbed table or bedside stand, Provide privacy for patient, Remove top linens and replace with bath blanket, Place cosmetics in convenient place, Assist patients who cannot bathe themselves completely
96
Physical Assessment of Oral Cavity
Observe for oral problems, Dental caries, Periodontal disease, Other oral problems, Identify actual or potential oral problems that nurses can treat, Identify appropriate nursing measures, Carry out the care plan
97
Administering Oral Hygiene
Moistening the mouth, Cleaning the mouth, Caring for dentures, Toothbrushing and flossing, Using mouthwashes
98
Care of Eyes
Clean from inner to outer canthus with wet, warm cloth, cotton ball, or compress, Use artificial tear solution or normal saline every 4 hours if blink reflex is absent, Care for eyeglasses, contact lens, or artificial eye if indicated
99
Ear and Nose Care
Wash external ear with washcloth-covered finger; do not use cotton-tipped swabs, Perform hearing aid teaching and care if indicated, Clean nose by having patient blow it if both nares are patent, Remove crusted secretions around nose by applying warm, moist compress
100
Providing Hair Care
Identify patient’s usual hair and scalp care practices and styling preferences, Note any history of hair or scalp problems such as dandruff, hair loss, or baldness, Treat any infestations, such as pediculosis and ticks, Groom and shampoo hair, Care for beards and mustaches, Assist with unwanted hair removal
101
Nail and Foot Care
Assess nails for color and shape, intactness and cleanness, and tenderness, Check for history of nail or foot problems, Soak nails and feet and assist with cleaning and trimming nails (if not contraindicated), Massage the feet to promote relaxation and comfort, Provide diabetic foot care if indicated
102
Perineal and Vaginal Care
Assess for perineal or vaginal problems and related treatments, Perform a physical assessment of male and female genitalia, Perform perineal care in matter-of-fact and dignified manner according to procedure, Cleanse vaginal area with plain soap and water
103
Ensuring Bedside Safety
The bed is in its lowest position, The bed position is safe for the patient, The bed controls are functioning (bed is electrically safe), Call light is functioning and always within reach, Side rails are raised if indicated, The wheels or casters are locked
104
Patient Outcome Achievement
Level of patient participation in hygiene program, Elimination of, reduction in, or compensation for factors interfering with independent execution of hygiene measures, Changes related to specific skin problems and independent patient management of prescribed treatment program
