Infectious Diseases & Precautions

Question 1

When should you wash your hands?

Answer 1

• before, after and between each client you care for
• in between dirty to clean procedures
• before and after most procedures and tasks

Question 2

How long should you wash your hands for?

Answer 2

At least 20 seconds with warm, soapy water.

Question 3

When should you only use soap and water to wash your hands?

Answer 3

When your hands are visibly dirty or the client is on enteric precautions.

Otherwise, it’s OK to use alcohol-based hand sanitizer.

Question 4

What type of disinfectant spray is used on dirty or commonly used areas?

Answer 4

Use alcohol or bleach to clean dirty or commonly used areas such as:

• tables
• door knobs
• handles

Bleach is not used on client’s skin.

Question 5

What type of substances can be used on client’s skin to disinfect it?

Answer 5

Chlorexidine, povidone iodine or alcohol.

Question 6

What are hospital acquired infections?

(HAI)

HAI are sometimes referred to as nosocomial infections.

Answer 6

Infections acquired while in the hospital.

Prevent HAIs by implementing infection control precautions.

Question 7

What are 6 common hospital acquired infections?

Answer 7

1. CLABSI: central line associated bloodstream infection
2. CAUTI: catheter associated urinary tract infection
3. SSI: surgical site infection
4. VAP: ventilator associated pneumonia
5. C. Diff: GI infection
6. MRSA: infection in blood, skin or respiratory tract

Question 8

Describe:

Standard (universal) Precautions

Answer 8

• assumes that blood or body fluids by ANY client can be infectious
• PPE: gloves, goggles, gown, and mask (use your judgment on what to wear)
• use a sharps container
• hand hygiene
• keep 3 feet away and cover mouth when coughing or sneezing
• offer mask to clients with respiratory symptoms

All clients are on standards precautions.

Question 9

Describe:

Transmission-based Precautions

Answer 9

Are beyond standard precautions because the disease is highly contagious:

• Airborne precautions
• Droplet precautions
• Contact precautions

Question 10

Describe:

Airborne Precautions

Answer 10

Are taken for highly contagious diseases that are transmitted by airborne droplet nuclei that go over long distances and remain suspended in the air for long periods.

• PPE: N95 particulate respirator mask
  
  • possible gown, gloves, goggles
• negative pressure isolation room with at least 6 air exchanges per hour
• client wears a surgical mask if leaving room

This includes dried droplets and dust particles containing infectious material.

Question 11

Which diseases use Airborne Precautions?

Use the mnemonic My ChickenS haZ TB to remember the most common.

Answer 11

• measles (Rubeola)
• chickenpox / varicella-zoster
• shingles/herpes zoster
• cOVID-19 (SARS) (can also be droplet)
• tuberculosis

These diseases are also contact precautions.

Question 12

Describe:

Droplet Precautions

Answer 12

Are taken for highly contagious diseases that are transmitted by large-particle droplets that travel up to 3 feet or less through the air.

Droplets come from sneezing, coughing and talking.

PPE: surgical mask if within 3 feet of client (possible gown, gloves, and goggles)

Question 13

Which diseases use Droplet Precautions?

Answer 13

• scarlet fever
• streptococcal pharyngitis
• pertussis/whopping cough
• parvovirus/fifth disease
• pneumonia
• influenza
• diphtheria
• epiglottitis
• rubella / German measles
• meningitis
• mumps
• adenovirus
• covid-19 (can also be airborne)

Use the mnemonic SPIDERMAN to remember.

Question 14

Describe:

Contact Precautions

Answer 14

Are taken for highly contagious diseases that are transmitted by direct or indirect contact.

• always wear gown and gloves
• if splashing is expected, wear goggles and mask

Common sources of indirect contact are the stethoscope and keyboard.

Question 15

Which most common diseases use Contact Precautions?

Answer 15

• multidrug-resistant organisms
  
  • VRE, CRE, MRSA (will have the word “resistant” in the name)
• diarrhea/enteric (in the gut)
  
  • C. diff, E. coli, Shigella, hepatitis A & E, rotavirus, polio
  • any type of diarrhea or diaper changes for children and adults
  • enteroviral
• skin and wound infections
  
  • cutaneous diphtheria, herpes simplex virus, impetigo, abscesses, cellulitis, pressure ulcers, pediculosis, smallpox, staphylococcal furunculosis, scabies, zoster, cytomegalovirus

Most students will not memorize this list, but be able to recognize the disease as contact precautions.

Question 16

Which additional diseases use Contact Precautions?

Answer 16

• eye infections: viral or hemorrhagic conjunctivitis
• viral blood infections: Ebola, Lassa, Marburg
• respiratory syncytial virus, parainfluenza virus

If client is coughing, also wear a mask.

Question 17

Describe:

Enteric precautions

Answer 17

Are taken to prevent infections that are transmitted by fecal material. Enteric precautions include:

• Contact Precautions
• washing hands with soap and water (no alcohol)
• PPE: gloves and gown (goggles and mask if splashing is expected)

Question 18

Which diseases use Enteric Precautions?

Answer 18

Infectious diarrhea

• Clostridium difficile
• gastroenteritis
• rotavirus
• norovirus
• hepatitis A & E

Question 19

What type of room does a client on transmission-based precautions get?

Answer 19

Preferably put all clients with an infectious disease in their own private room to prevent cross-infection.

Clients with the same exact infectious disease can be roomed together. It is sometimes referred to as “room like with like”.

Question 20

Where do needles go after being used?

Answer 20

In a sharps container/puncture-resistant container designated for needles.

Question 21

What can the nurse use to prevent needle sticks?

Answer 21

Needleless devices.

Question 22

What type of bag does hazardous waste and blood go into?

Answer 22

A biohazardous waste bag.

Question 23

What are the most common nosocomial infections?

Answer 23

1. C diff. - clostridium difficile
2. VRE - vancomycin-resistant enterococci
3. MRSA - methicillin-resistant staph aureus
4. CRE - carbapenem-resistant Enterobacteriaceae

Question 24

When is the N95 / particulate respirator removed?

Answer 24

Outside of the client’s room after their door has been closed.

Question 25

What does the client **wear** when leaving the room when they are on airborne precautions?

Answer 25

A surgical mask.

Question 26

What is a **sterile field**?

Answer 26

An **area that is kept sterile** in order to prepare for a procedure on the client.

Question 27

What **distance of the border** of a sterile field is **_NOT_** considered sterile?

Answer 27

The outer 1 inch (2 cm).

Question 28

What are the **steps** to apply sterile gloves?

Answer 28

1. Wash hands 2. Open package 3. Lift glove by cuff 4. Apply glove 5. Lift other glove 6. Apply 2nd glove 7. Do not touch the outside of the gloves

Question 29

What are the **steps** to take off dirty gloves?

Answer 29

1. Pinch glove at top 2. Peel glove off inside out 3. Put fingers under the glove 4. Peel glove off inside out into other glove 5. Throw in trash 6. Wash hands

Question 30

What are **neutropenic precautions**?

Answer 30

Also called "protective isolation": **The client is at risk of getting an infection and needs to be in a private room:** * no fresh fruits or flowers in room * freshwater for drinking at least every 1 hour * avoid ill people * meticulous hand hygiene and wear gloves * no live vaccines * wash teeth gently and floss gently * wear a mask in crowded areas or when leaving room * avoid invasive procedures * fruits and vegetables need to be washed and cooked before eating * no salad bars * assess for signs and symptoms of infection: *WBC count and temperature*

Question 31

What types of **clients** are on neutropenic precautions?

Answer 31

**Immunosuppressed** * AIDS * burns * organ transplants / stem cell transplants * on immunosuppression meds * cancer / on chemotherapy

Question 32

In what **order** is personal protective equipment put on?

Answer 32

1. gown 2. mask 3. goggles 4. gloves ## Footnote The easiest way to remember is to put your hands over your head and start from the bottom up.

Question 33

In what **order** is personal protective equipment taken off?

Answer 33

1. gloves 2. goggles 3. gown 4. mask OR 1. take off gown and gloves at same time 2. goggles 3. mask

Question 34

When is personal protective equipment **removed**?

Answer 34

At the doorway before leaving the room. ## Footnote If the client is on airborne precautions, take the PPE off in the anteroom. The anteroom is a small room between the client's main room and the hallway.

Question 35

What is **medical asepsis**?

Answer 35

A procedure that is considered clean and **clean gloves and clean technique is used**.

Question 36

What are some common **procedures** that use medical asepsis?

Answer 36

* NG tube insertion * enema * removing old dressing * opening sterile supplies

Question 37

What is **surgical asepsis**?

Answer 37

A procedure that is considered sterile and **sterile gloves and sterile technique is used**.

Question 38

What are some common **procedures** that use surgical asepsis?

Answer 38

* foley insertion * trach suctioning * wound care * IV insertion (clean gloves are used, but the area stays sterile) * CVAD/PICC dressing change

Question 39

What is the **teaching** to prevent an infectious disease from spreading at home?

Answer 39

* wash all bedding, pillowcases, and towels in hot water * dry on the hot setting in the dryer * frequent handwashing

Question 40

What is the easiest way to quickly master safety and infection control for the NCLEX-RN, including emergencies and precautions?

Answer 40

Brainscape's [NCLEX-RN (3) Safety & Infection Control](https://www.brainscape.com/learn/nclex-rn?utm_source=crosslink&utm_medium=in-app&utm_campaign=in-app) Flashcards ## Footnote These flashcards offer a targeted selection of over 3,000 NCLEX flashcards based on the latest NCLEX-RN Test Plan!