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Integumentary > Infection Control > Flashcards

Infection Control Flashcards

(63 cards)

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1
Q

Defenses Against Infection

A 
Microflora
Acidic pH of skin
Immune cells
Inflammatory response
Complement system- release of proteins that  promote phagocytosis, the inflammatory response, and disruption of bacterial cell membranes
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2
Q

Microflora

A

A small number of bacteria and fungi normally reside in skin and digestive tract
Protect the body from pathogenic organisms

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3
Q

Contamination

A

presence of microbes on wound surface

normal

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4
Q

Colonization

A

presence of replicating microbes on wound surface

normal

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5
Q

Critical colonization

A

increasing wound bioburden reaches critical point and begins to adversely affect hos
abnormal
plateau or decline in wound status

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6
Q

Infection

A

replicating microbes invade viable body tissue
abnormal
decline in wound status

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7
Q

Wound healing =

A

(number of bacteria x bacterial virulent)+interaction between microbes/host resistance+ modifying factors

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8
Q

Modifying factors:

A

host’s overall health; presence of underlying pathologies, such as diabetes or peripheral vascular disease; steroid use; presence of nonviable tissue; and proper wound management

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9
Q

Adverse Effects of High Concentrations of Microbes

A

Compete with host cells for available oxygen and nutrients
Bacterial exotoxins may be cytotoxic
Bacterial endotoxins may activate host inflammatory processes
Wound infections delay and may prevent wound healing

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10
Q

Factors That Increase the Risk of Infection

A

Host characteristics

Local factors

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11
Q

Host characteristics:

A 
Break in skin integrity
Diabetes
Malnutrition
Obesity
Steroid use
Immuno-compromise
Increased age
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12
Q

Local factors

A

Ischemia
Necrotic tissue
Wound debris
Chronic wounds

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13
Q

Inflamed Rubor

A

Well-defined erythemal border

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14
Q

Infected Rubor:

A

Poorly defined erythemal border
Disproportionate amount of erythema
Possible proximally directed erythemal streaking

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15
Q

Inflamed Calor:

A

Localized increase in temperature

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16
Q

Infected Calor:

A

Large localized increase in temperature over wide area

May be febrile

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17
Q

Inflamed Tumor

A

Small amount of edema

Proportionate to wound

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18
Q

Infected Tumor:

A

Edema is disproportionate to wound size

Periwound may be indurated

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19
Q

Inflamed Dolor

A

Pain proportionate to wound size/extent

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20
Q

Infected Dolor:

A

Increased pain
New-onset pain
Pain disproportionate to wound size/extent

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21
Q

Inflamed Functio Laesa

A

Temporary decrease in function of affected area

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22
Q

Infected Functio Laesa

A 
Malaise
Tachycardia
Hypotension
Altered mental status
Altered function of affected area
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23
Q

Inflamed drainage:

A

Proportionate to
size/extent of wound
Thin consistency
Serous or serosanguinous

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24
Q

Infected drainage:

A

Disproportionate to size/extent of wound
Thick, purulent, creamy consistency
May be white, green, blue
May have distinctive odor

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25
Inflamed decline in wound status:
Follows 3 phases of wound healing if treated appropriately
26
Infected decline in wound status:
``` Plateau in healing Granulation tissue: Decreased amount Friable Cobblestone-like Color change ```
27
Who is at risk for a silent infection?
Patients who are immunocompromised or have inadequate perfusion
28
Examples of silent infection:
Abscess | Patient with arterial insufficiency and gangrenous toe
29
Biofilms:
Communities of microorganisms attached to wound surface encased in a glycocalyx Protected against harsh environments, antiseptics, and antimicrobials May increase bacterial virulence and resistance
30
Where are biofilms found?
devitalized tissues, implanted devices, and within gastric mucosa
31
Gold standard for diagnosing wound infection:
tissue biopsy
32
Microbe ID Bacteria:
``` Unicellular Rigid cell wall Lack nuclear membrane Require external medium for growth Reproduce by cellular division ```
33
Most common skin and nail fungi
Tinea | Candida
34
Patients with increased risk | for fungal infection:
On antibiotics Have immune system diseases Have diabetes Have moist, occluded areas of skin
35
Antimicrobial Agents
Destroy unicellular organisms | Used to treat infection or prophylactically
36
Antibacterials
Bactericidal | Bacteriostatic
37
Antifungals
Yeasts | Molds
38
Types of antimicrobials
``` penicillins cephalosporins erythromycins amino glycosides tetracycline quinolones sulfonamides ```
39
Sensitive
Bacteria unable to grow in the presence of a certain antimicrobial
40
Resistant
Bacteria that continue to multiply in the presence of a drug | May be natural or acquired
41
Nosocomial
``` Increased age Diabetes Immunosuppression Malnutrition Recent surgery Immobility/debility Large burns Prior antimicrobial use ```
42
Community Acquired
Prisons Contact sports teams Military People with AIDS
43
MRSA
``` Can live hours to days on surfaces Spread by: Nosocomial: environmental contact Community: person to person Can cause cellulitis, osteomyelitis, abcess Rx: mupirocin ```
44
VRE
Commonly seen in surgical wounds and UTIs | Rx: ampicillin-amoxicillin
45
Causes of Resistant Bacteria
``` Misuse of antimicrobials in humans Prescribed without infection present 50% deemed unnecessary Wrong antimicrobial prescribed Taken incorrectly ```
46
Misuse of antimicrobials in animals
24.6 million pounds to livestock/yr in the U.S. Build muscle faster Banned in European Union
47
Adverse reactions:
Mild skin reactions, hives Difficulty breathing, anaphylactic shock Photosensitivity, hearing loss, fever Hepatitis, kidney damage
48
Delayed sensitivity
``` Neomycin Gentamycin Bacitracin Lanolin-containing Don’t use for prolonged periods ```
49
Topical Antimicrobial Therapy
``` Types Ointments Creams Solutions Applied to wound surface Reapply every 8–24 hours ```
50
Antimicrobial-Impregnated Dressings
``` Silver, iodine Broad-spectrum antimicrobials Increase cost Overuse may contribute to resistance Must stay in contact with wound bed Lack of scientific evidence ```
51
Advantages of topical antimicrobial therapy:
Lower cost than systemic therapies Reduce bacterial load Effective in treating where circulation is compromised
52
Disadvantages of topical antimicrobial therapy:
Higher cost than nonantimicrobial agents Need for frequent applications Sensitivity or allergic reaction Potential for resistance
53
Antiseptic Agents
Prevent infection by killing microorganisms Proper uses Surgical scrub, hand washing, cleansing intact skin
54
Advantages of systemic antimicrobial therapy:
Reduce bacterial load Easy to provide Maybe better adherence
55
Disadvantages of systemic antimicrobial therapy:
``` Adverse reactions More frequent/severe Resistance Missed doses Higher cost ```
56
Prevent Infections in Open Wounds
Hand washing Universal precautions/Standard precaution Avoid strike-through drainage, control excessive moisture (medium for bacteria) Reduce bioburden
57
Clean technique
Reduce number of microorganisms present to decrease risk of transmission Standard
58
Sterile technique
``` Only sterile equipment contacts patient’s wound Used for: Surgical debridement Severe burns Immunocompromised patients ```
59
Clean
free of gross contamination
60
Disinfect
to clean a surface with an antimicrobial
61
Sterile
environment free of microbes
62
Contamination
presence or anticipated presence of blood, wound fluid, or other potentially infectious waste
63
Proper Wound Care Procedures
Sequence wound procedures to minimize contamination If multiple wounds, treat most infected wound last and change gloves in between wounds Remove gloves and wash hands upon completion Thoroughly disinfect treatment area after procedures Properly dispose of infectious waste and sharps Check expiration dates Open supplies just prior to use Seal remaining supplies Store meds according to JCAHO standards Keep wounds covered except during examination and procedure Change dressings if contaminated or ineffective

Integumentary (18 decks)

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