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FUNDAMENTALS OF NURSING PRACTICE > Module 04: Asepsis and Infection Control > Flashcards

Module 04: Asepsis and Infection Control Flashcards

1
Q

What are the nature of microorganisms in the human body?

A

Most microorganism are harmless and may even be beneficial.

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2
Q

These microorganisms are the collective vegetation in a given area.

A

Resident Flora

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3
Q

These are the microorganisms that are microbial species that can be cultured from body surfaces under certain circumstances.

A

Transient Flora

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4
Q

What are four (4) major microorganisms causing infections in humans?

A

(1) Bacteria
(2) Viruses
(3) Fungi
(4) Parasites

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5
Q

This is the growth of microorganisms in body tissues where they are not usually found.

A

Infection

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6
Q

This is the detectable alteration in normal tissue function.

A

Disease

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7
Q

This infections pertains to the one with no clinical evidence of disease.

A

Asymptomatic or Subclinical

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8
Q

This is the ability produce disease.

A

Pathogenicity

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9
Q

This can be transmitted to an individual.

A

Communicable Disease

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10
Q

These cause disease only in susceptible individuals.

A

Opportunistic Pathogens

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11
Q

This pertains to the freedom of disease-causing microorganisms.

A

Asepsis

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12
Q

What are the two (2) types of asepsis?

A

(1) Medical Asepsis
(2) Surgical Asepsis

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13
Q

This type of asepsis pertains to the practices intended to confine a specific microorganisms to a specific area.

A

Medical Asepsis

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14
Q

This type of asepsis pertains to the practices that intend to keep an area or object free from all microorganisms.

A

Surgical Asepsis

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15
Q

What are the four (4) types of infection?

A

(1) Colonization
(2) Local Infection
(3) Systematic Infection
(4) Bacteremia

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16
Q

This type of infection pertains to process by which strains of microorganisms become resident flora.

A

Colonization

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17
Q

This type of infection is limited to the specific part of the body where the microorganisms remain.

A

Local Infection

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18
Q

This type of infection pertains to when the microorganisms spread and damage different parts of the body.

A

Systematic Infection

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19
Q

This type of infection pertains to when the culture of the individual’s blood reveals microorganisms.

A

Bacteremia

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20
Q

These are infections that originate in any healthcare setting.

A

Healthcare-Associated Infections

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21
Q

This source of Healthcare-Associated Infections pertains to when the infection originates from the client themselves.

A

Endogenous

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22
Q

This source of Healthcare-Associated Infections pertains to when the infection originates from the hospital environment and hospital personnel.

A

Exogenous

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23
Q

According to the Centers for Disease Control and Prevention, this type of HAI pertains to the serious infection that occurs when microorganisms enter the bloodstream through a large catheter placed in a large vein.

A

Central Line-Associated Blood Stream Infections (CLABSI)

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24
Q

According to the Centers for Disease Control and Prevention, this type of HAI pertains to any infection involving any part of the urinary system (urethra, ureters, bladder or kidneys) acquired from the hospital?

A

Catheter-Associated Urinary Tract Infection (CAUTI)

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25
Q

According to the Centers for Disease Control and Prevention, this type of HAI pertains to an infection that occurs after surgery in the part of the body where the surgery took place.

A

Surgical Site Infection (SSI)

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26
Q

According to the Centers for Disease Control and Prevention, this type of HAI pertains to the lung infection that develops in a person on a machine used to help the client to breathe.

A

Ventilator Associated Pneumonia (VAP)

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27
Q

Explain the chain of infection.

A

(1) Etiologic Agent
(2) Reservoir
(3) Portal of Exit
(4) Mode of Transmission
(5) Portal of Entry
(6) Susceptible Host

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28
Q

What are the factors that can be considered as an etiologic agent?

A

(1) Numbers of organisms present
(2) Virulence and potency
(3) Ability to enter the host’s body
(4) Susceptibility of the host
(5) Ability to live in the host’s body

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29
Q

What are the factors that can be considered as a reservoir or the source of microorganisms?

A

(1) Humans or carriers
(2) Plants
(3) Animals
(4) Medical Equipment
(5) General Environment

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30
Q

This factors pertains to when an infectious agent may be transmitted from its natural reservoir to a susceptible host in different ways.

A

Chain of Infection or Modes of Transmission

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31
Q

What are the different types of Direct Modes of Transmission?

A

(1) Direct Contact
(2) Droplet Spread

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32
Q

What are the different types of Indirect Modes of Transmission?

A

(1) Airborne
(2) Vehicle-borne
(3) Vector-borne (mechanical or biologic)

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33
Q

This mode of transmission occurs through skin-to-skin contact, kissing, and sexual intercourse. Also refers to contact with soil or vegetation harboring infectious organisms.

A

Direct Contact

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34
Q

This mode of transmission pertains to the spray with relatively large, short-ranged aerosols produced by sneezing, coughing, or even talking. This can be classified as direct because the transmission is by direct spray over a few feet, before the droplet falls to the ground.

A

Droplet Spread

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35
Q

This mode of transmission occurs when infectious agents are carried by dust or droplet nuclei suspended in the air.

A

Airborne

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36
Q

What are the sizes of microorganisms transmitted through airborne?

A

5 microns in size

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37
Q

This mode of transmission is the indirect transmit of an infectious agent via food, water, biologic products (blood), and fomites (inanimate objects such as handkerchiefs, bedding or surgical scalpels).

A

Vehicle

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38
Q

This mode of transmission is when the infection is transferred via mosquitoes, fleas and ticks that may carry an infectious agent through purely mechanical means or may support growth or changes in the agent.

A

Vector

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39
Q

What are the different types of the portal of entry?

A

(1) Before an individual can become infected, microorganisms must enter the body.
(2) The skin is a barrier to infectious agents; however, any break in the skin can readily serve as a portal of entry.
(3) Medical interventions such as tubes, catheters, and surgical wounds are common portals of entry

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40
Q

This pertains to any individual who is at risk for infection.

A

Susceptible Host

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41
Q

This pertains to an individual who has increased risk and who for one or more reasons is more likely than others to acquire an infection.

A

Compromised Host

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42
Q

What are the different factors affecting a person’s susceptibility?

A

(1) Impairment of immune system
(2) Age (the very young or the very old);
(3) Clients receiving immune suppression treatment
(4) Immune deficiency conditions.

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43
Q

What are the different types of body defenses?

A

(1) Non specific
(2) Specific

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44
Q

This type of body defense protects the individual against all microorganisms?

A

Non specific Body Defense

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45
Q

This type of body defenses is directed against identifiable infectious agent.

A

Specific Body Defense

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46
Q

This type of non specific defense pertains to the first line of defense.

A

Intact Skin Mucous Membranes

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47
Q

What are the different types of intact skin mucous membranes?

A

(1) Skin Factors: Dryness of the skin, Resident bacteria and normal secretions that is slightly acidic
(2) Nasal Passages have cilia and moist mucous that trap MOs
(3) Oral Cavity that sheds epithelium to rid of mouth MOs, saliva has lactoferrin, lysozyme and IgA
(4) Eye is protected by tears to wash MOs
(5) GI tract have the high acidity of the stomach and resident flora of the colon
(6) Vagina has a pH that inhibits growth of MOs

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48
Q

This type of non specific defense is the local and nonspecific defensive response of the tissues to an injurious or infectious agent.

A

Inflammatory Response

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49
Q

The inflammatory response is characterized by what?

A

(1) Pain (dolor)
(2) Swelling (tumor)
(3) Redness (rubor)
(4) Heat (calor)
(5) Impaired function (functio laesa)

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50
Q

Infectious agents are classified as either:

A

(1) Physical Agents
(2) Chemical Agents
(3) Microorganisms

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51
Q

What are the three (3) Stages of inflammatory response?

A

(1) Vascular and cellular response
(2) Exudate Production
(3) Reparative Phase

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52
Q

Enumerate the vascular and cellular responses.

A

(1) Vasoconstriction at the site of injury
(2) Dilation of small blood vessels due to histamine release
(3) Hyperemia (increased blood supply) that leads to redness and heat
(4) Vascular permeability increases and release of chemical mediators (bradykinin, serotonin, prostaglandin) and histamine
(5) WBC, fluids and proteins leaks into the interstitial spaces leading to swelling and pain
(6) Pain is caused by pressure of accumulating fluid on nerve endings and irritating mediators
(7) Fluid pouring into joints will impair function
(8) Leukocytosis ensues (increase production of WBC from bone marrow)

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53
Q

Enumerate what happens when there is tissue injury caused by physical or chemical agent and pathogenic microorganism.

A

(1) Heat - Capillary Widening and increased blood flow
(2) Redness - Increased permeability and fluid release into tissues
(3) Swelling and Tenderness - Attraction of leukocytes and extravasation of leukocytes to site of injury
(4) Pain - Systematic response and fever and proliferation of leukocytes

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54
Q

This is produced consisting of fluid that escaped from blood vessels, dead phagocytes and dead tissue cells.

A

Exudate

55
Q

What are the steps of exudate production?

A

(1) Exudate is produced consisting of fluid that escaped from blood vessels, dead phagocytes and dead tissue cells
(2) Fibrinogen is converted to fibrin and thromboplastin and platelets from a network to wall off area
(3) Exudate is then cleared by lymphatic drainage

56
Q

Explain the reparative phase.

A

(1) Regeneration is the replacement of destroyed tissue cells by cells that are identical or similar in structure and function.
(2) When regeneration is not possible, repair occurs by scar formation.
(3) Damaged tissues are replaced with the connective tissue elements of collagen blood capillaries, lymphatics and other tissue bound substances.
(4) Granulation tissue. It is a fragile gelatinous tissue appearing pink or red because of the many newly formed capillaries.
(5) Later the tissue shrinks and a firmer tissue remains called cicatrix or scar.

57
Q

It is a fragile gelatinous tissue appearing pink or red because of the many newly formed capillaries.

A

Granulation tissue

58
Q

Later the tissue shrinks and a firmer tissue remains called __________.

A

Cicatrix or scar.

59
Q

These are the substances that induces a state of sensitivity or immune responses.

A

Antigen

60
Q

This type of antigen originates from the body.

A

Autoantigen

61
Q

What are the two (2) types of immune response?

A

(1) Antibody-Mediated Defense
(2) Cell-Mediated Defense

62
Q

This is also called humoral immunity as it resides in the B lymphocytes and mediated by antibodies produced by B cells

A

Antibody Mediated Defense

63
Q

These are also called immunoglobulins are part of the body’s plasma proteins. They defend primarily against bacterial and viral infections

A

Antibodies

64
Q

This antigen or antibody source are produced by the body in response to an antigen.

A

Active

Duration: Long

65
Q

This antigen or antibody source are formed in the presence of active infection in the body.

A

Active - Natural

Duration: Lifelong

66
Q

This antigen or antibody source are administered to stimulated antibody production.

A

Active - Artificial

Duration: Many years: need to be reinforced

67
Q

This antigen or antibody source are produced by another source, animal or human.

A

Passive

Duration: Short

68
Q

This antigen or antibody source are transferred naturally from an immune mother to her baby through her placenta or in the colostrum.

A

Passive - Natural

Duration: 6 months to 1 year

69
Q

This is an immune serum (antibody) are produced from an animal or another human injected.

A

Passive - Artificial

Duration: 2 to 3 weeks

70
Q

This is a serologic testing involves measurement of several hepatitis B virus (HBV)-specific antigens and antibodies. Different serologic “markers” or combinations of markers are used to identify different phases of HBV infection and to determine whether a patient has acute or chronic HBV infection, is immune to HBV as a result of prior infection or vaccination or is susceptible to infection.

A

HBV Serologic Test Interpretation

71
Q

This type of immunity occurs through the T cell system,

A

Cell-Mediated Defense

72
Q

What are the three (3) Types of Cell-Mediated Defense?

A

(1) Helper T cells
(2) Cytotoxic T cells
(3) Suppressor T cells

73
Q

What composes the nursing process?

A

(1) Assessment
(2) Diagnosis
(3) Planning
(4) Implementation
(5) Evaluation

74
Q

What composes the process of planning?

A

(1) Maintain or restore defenses
(2) Avoid the spread of infectious organisms
(3) Reduce or alleviate problems associated with the infection

75
Q

This is considered one of the most effective infection prevention measures.

A

Hand Hygiene

76
Q

These kill bacteria more effectively and more quickly than hand washing with soap and water.

A

Alcohol based hand rubs (foam or gel)

77
Q

What are the benefits of alcohol based hand rubs (foam or gel)?

A

(1) Kill bacteria more effectively and more quickly than hand washing with soap and water.
(2) Are less damaging to skin than repeated soap and water, resulting in less dryness and irritation.
(3) Require less time than hand washing with soap and water.
(4) Can be placed at the point of care in bottles or dispensers so they are more accessible.

78
Q

This is a chemical preparation used on skin or tissue.

A

Antiseptic

79
Q

This is a chemical preparation, such as phenol or iodine compounds used on inanimate objects.

A

Disinfectant

80
Q

This approach intends to destroys bacteria,

A

Bactericidal preparation

81
Q

This approach intends to prevent the growth and reproduction of some bacteria.

A

Bacteriostatic preparation

82
Q

This is known as the process that destroys all microorganisms, including spores and viruses.

A

Sterilization

83
Q

What are the four (4) approaches of sterilization?

A

(1) Moist heat
(2) Gas
(3) Boiling Water
(4) Radiation

84
Q

This approach on sterilization uses steam under pressure to attain temp higher than boiling point.

A

Moist heat

85
Q

This approach on sterilization uses ethylene oxide destroys Mos by interfering with metabolic process (toxic to humans).

A

Gas

86
Q

This approach on sterilization is the most practical and inexpensive, some spores and viruses are not killed. Min 15 mins for disinfection at home.

A

Boiling water

87
Q

This approach on sterilization uses ionizing (alpha, beta and x-ray) and non-ionizing (UV light) , rays do not penetrate deeply.

A

Radiation

88
Q

This is designed for all clients in hospital and designed to reduce risk of transmission of microorganisms from recognized and unrecognized sources.

A

Standard Precautions

89
Q

Standard Precautions apply to what?

A

These precautions apply to (a) blood; (b) all body fluids, excretions, and secretions except sweat; (c) nonintact (broken) skin; and (d) mucous membranes.

90
Q

What are the different standard precautions?

A

(1) Perform hand hygiene
(2) Use PPE if anticipating exposure to infectious material
(3) Follow respiratory hygiene/ cough etiquette
(4) Ensure appropriate patient placement
(5) Proper handling and cleaning of equipment and instruments
(6) Handle textiles and laundry carefully
(7) Follow safe injection practices
(8) Ensure healthcare worker safety

91
Q

What are the three (3) types of transmission based precautions?

A

(1) Airborne precaution
(2) Droplet precaution
(3) Contact precaution

92
Q

This type of transmission based precaution is used for clients known to have or suspected of having serious illnesses transmitted by airborne droplet nuclei smaller than 5 microns. Examples of such illnesses include measles (rubeola), varicella (including disseminated zoster), and tuberculosis.

A

Airborne precaution

93
Q

This type of transmission based precaution is used for clients known to have or suspected of having serious illnesses transmitted by particle droplets larger than 5 microns. Examples of such illnesses are diphtheria (pharyngeal); mycoplasma pneumonia; pertussis; mumps; rubella

A

Droplet Precaution

94
Q

This type of transmission based precaution is used for clients known to have or suspected of having serious illnesses easily trans- mitted by direct client contact or by contact with items in the client’s environment.

A

Contact precaution

95
Q

What are the standard precautions to take under airborne precautions?

A

(1) Place client in an airborne infection isolation room (AIIR). An AIIR is a private room that has negative air pressure, 6 to 12 air changes per hour, and either discharge of air to the outside or a filtration system for the room air.
(2) If a private room is not available, place client with another client who is infected with the same microorganism.
(3) Wear an N95 respirator mask when entering the room
(4) Susceptible individuals should not enter the room of a client who has rubeola (measles) or varicella (chickenpox). If they must enter, they should wear a respirator mask.
(5) Limit movement of the client outside the room to essential purposes. Place a surgical mask on the client during transport.

96
Q

What are the standard precautions to take under droplet precautions?

A

(1) Place client in private room.
(2) If a private room is not available, place client with another client who is infected with the same microorganism.
(3) Wear a mask if working within 1 m (3 ft) of the client.
(4) Limit movement of client outside the room to essential purposes. Place a surgical mask on the client while outside the room.

97
Q

This is a specific type of aseptic technique with a unique Theoretical and Clinical Practice Framework based upon the original concept of Key- Part and Key-Site Protection where staff identify and protect key parts and key sites (Rowley 2011)

A

Aseptic Non Touch Technique

98
Q

This is the critical part of equipment that comes into contact with a key site

A

Key Part

99
Q

This is the part of the body that is at risk of contamination if ANTT is not used e.g. wound, urethral meatus, insertion and access sites for medical devices.

A

Key Site

100
Q

What is the importance of identifying key sites and key parts?

A

The competency to identify the key parts of an equipment and key sites of the patient that need to be aseptic and protect them at all times. In this, the nurse can use basic precautions like hand cleaning and PPE, plus a combination of aseptic fields and non touch technique.

101
Q

Enumerate the principles of ANTT.

A

(1) A – Always ensure hands are decontaminated effectively prior to the procedure
(2) N – Never contaminate key parts of sterile materials/equipment or the patient’s susceptible key sites
(3) T – Touch non-key parts with confidence
(4) T –Take appropriate infection prevention and control precautions e.g. use of PPE, safe waste management

102
Q

What protects key parts?

A

(1) individually - micro critical aseptic fields
(2) together - large critical aseptic field

103
Q

Enumerate the steps of ANTT risk assessment.

A

(1) Does this procedure need the ANTT principles applied? Is a Standard or Surgical-ANTT required?
(a) Gain patient’s consent and explain procedure
(b) Draw curtains around patient or take to appropriate room
(2) Decontaminate hands
(3) Clean trolley/tray with appropriate detergent wipe
(a) Gather equipment including alcohol hand rub
(4) Create suitable working environment. If procedure is performed at the bedside ensure no cleaning or bed making are on-going within the area for at least 30 minutes. Ensure windows are closed and no fans are on
(5) Decontaminate hands
(6) Apply single use disposable apron
(7) If required open dressing pack/sterile drape
(8) Open and prepare all equipment on the tray/trolley. Keep all equipment within their packaging. Identify Key-Parts
(9) Decontaminate hands
(10) Apply gloves if required
(11) Perform procedure using ANTT
(12) Remove gloves and aprons and other Personal Protective Equipment (PPE)
(13) Dispose of waste
(14) Decontaminate hands
(15) Take patient back to the bedside if required and ensure patient is comfortable (16) Clean trolley/tray/environment
(17) Decontaminate hands

104
Q

What are some common microorganisms in the skin?

A

(1) Staphylococcus epidermidis
(2) Propionibacterium acnes
(3) Staphylococcus aureus
(4) Corynebacterium xeroxis
(5) Pityrosporum ovale (yeast)

105
Q

What are some common microorganisms in the nasal passages?

A

(1) Staphylococcus aureus
(2) Staphylococcus epidermidis

106
Q

What are some common microorganisms in the oropharynx or mouth?

A

(1) Streptococcus pneumoniae
(2) Streptococcus mutans
(3) Lactobacillus
(4) Bacteroides
(5) Actinomycoses

107
Q

What are some common microorganisms in the intestine?

A

(1) Bacteroides
(2) Fusobacterium
(3) Eubacterium
(4) Lactobacillus
(5) Streptococcus
(6) Enterobacteriaceae
(7) Shigella
(8) Escherichia coli

108
Q

What are some common microorganisms in the urethral orifice?

A

Staphylococcus epidermidis

109
Q

What are some common microorganisms in the urethra?

A

Proteus

110
Q

What are some common microorganisms in the vagina?

A

(1) Lactobacillus
(2) Bacteroides
(3) Clostridium
(4) Candida albicans

111
Q

What are the most common microorganisms in the urinary tract?

A

(1) Escherichia coli
(2) Enterococcus species
(3) Pseudomonas aeruginosa

112
Q

What are the causes for the most common microorganisms in the urinary tract?

A

(1) Improper catheterization techniques
(2) Contamination of closed drainage system
(3) Inadequate hand hygiene

113
Q

What are the most common microorganisms from surgical sites?

A

(1) Staphylococcus aureus (including methicillin resistant strains or MRSA)
(2) Enterococcus species (including vancomycin-resistant strains or VRE)
(3) Pseudomonas aeruginosa

114
Q

What are the causes of the most common microorganisms from surgical sites?

A

(1) Inadequate hand hygiene
(2) Improper dressing change technique

115
Q

What are the most common microorganisms in the blood stream?

A

(1) Coagulase-negative staphylococci
(2) Staphylococcus aureus
(3) Enterococcus species

116
Q

What are the causes of the most common microorganisms in the blood stream?

A

(1) Inadequate hand hygiene
(2) Improper intravenous fluid, tubing and site care technique

117
Q

What are the most common microorganisms from pneumonia?

A

(1) Staphylococcus aureus
(2) Pseudomonas aeruginosa
(3) Enterobacter species

118
Q

What are the causes of the most common microorganisms from pneumonia?

A

(1) Inadequate hand hygiene
(2) Improper suctioning technique

119
Q

What are the common infections in the respiratory tract?

A

(1) Parainfluenza virus (Mycobacterium tuberculosis)
(2) Staphylococcus aureus

120
Q

What are the common infections in the gastrointestinal tract?

A

(1) Hepatitis A Virus
(2) Salmonella Species
(3) C.difficile

121
Q

What are the common infections in the urinary tract?

A

(1) Escherichia coli
(2) Enterococci
(3) Pseudomonas aeruginosa

122
Q

What are the common infections in the reproductive tract?

A

(1) Neisseria gonorrhoeae
(2) Treponema pallidum
(3) Herpes Simplex virus type 2
(4) Hepatitis B Virus (HBV)

123
Q

What are the common infections in the blood?

A

(1) HBV
(2) HIV
(3) Staphylococcus aureus
(4) Staphylococcus epidermidis

124
Q

What are the common infections in the tissue?

A

(1) Staphylococcus aureus
(2) Escherichia coli
(3) Proteus species
(4) Streptococcus beta-hemolytic A or B

124
Q

What are the portals of exit of microorganisms in the respiratory tract?

A

(1) Nose or mouth through sneezing, coughing, breathing, or talking

125
Q

What are the portals of exit of microorganisms in the gastrointestinal tract?

A

(1) Mouth: Saliva or Vomitus
(2) Anus: Feces
(3) Ostomies: Feces

126
Q

What are the portals of exit of microorganisms in the urinary tract?

A

Urethral meatus and urinary diversion

127
Q

What are the portals of exit of microorganisms in the reproductive tract?

A

(1) Vagina: Vaginal discharge
(2) Urinary meatus: semen, and urine

128
Q

What are the portals of exit of microorganisms in the blood?

A

(1) Open wound
(2) Needle puncture site
(3) Any disruption of intact skin or mucous membrane surfaces

129
Q

What are the portals of exit of microorganisms in the tissue?

A

Drainage from a cut or wound

130
Q

This is known as the susceptibility to invasion and multiplication of pathogenic organisms, which may compromise health.

A

Risk for Infection

131
Q

What are the risk factors for risk for infection?

A

(1) Difficulty managing long-term invasive devices
(2) Difficulty managing wound care
(3) Dysfunctional gastrointestinal motility
(4) Exclusive formula feeding
(5) Impaired skin integrity
(6) Inadequate access to individual protective equipment
(7) Inadequate adherence to public health recommendations
(8) Inadequate environmental hygiene
(9) Inadequate health literacy
(10) Inadequate hygiene
(11) Inadequate knowledge to avoid exposure to pathogens
(12) Inadequate oral hygiene habits
(13) Inadequate vaccination
(14) Malnutrition
(15) Mixed breastfeeding
(16) Obesity
(17) Smoking
(18) Stasis of body fluid

132
Q

This is the susceptibility to invasion of pathogenic organisms at surgical site, which may compromise health.

A

Risk for surgical site infection

133
Q

What are the risk factors for risk for surgical site infection?

A

(1) Alcoholism
(2) Obesity
(3) Smoking

FUNDAMENTALS OF NURSING PRACTICE (13 decks)

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