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BSNC 3000 > Module 6 - Infection > Flashcards

Module 6 - Infection Flashcards

1
Q

External Risk Factors

A

operating room (ventilation, sterilization)
contaminated equipment
improper hand hygiene

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2
Q

Procedural Risk Factors

A

infection at remote site not treated prior to surgery
inappropriate antimicrobial prophylaxis & skin prep (shaving vs. clipping)
improper technique (sterile field, foreign bodies)
contaminated hardware

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3
Q

Patient Risk Factors

A

immunocompromised

diabetes

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4
Q

5 W’s of infection

A 
wind - lungs/GIT
water - urinary
wings - limbs/hardware/tubes/lines/drains
wound - incision
wonder drugs - corticosteroids
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5
Q

Types of antibiotics

A

naturally derived

synthetically derived

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6
Q

Antibiotics

A

drugs that kill bacteria

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7
Q

Antimicrobials

A

any drug that targets microbes other than bacteria

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8
Q

Antibiotic MOA

A

bacteriostatic or bactericidal

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9
Q

Bacteriostatic

A

slows bacterial growth

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10
Q

Bactericidal

A

kills bacteria

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11
Q

Narrow spectrum abx

A

work on a subset of bacteria

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12
Q

Broad spectrum abx

A

work on a range of bacteria

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13
Q

Beta-lactam drugs (cell wall inhibitors)

A

penicillins
cephalosporins
carbapenams
monobactams

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14
Q

Other cell wall inhibitors

A

vancomycin

bacitracin

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15
Q

Mechanisms of microbial resistance

A

1) decreased penetration
2) increased enzymatic degradation/modification
3) alteration of target site
4) increased efflux (removal)

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16
Q

Lactam drugs mechanism of resistance

A

beta-lactamase breaks down the lactam ring

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17
Q

Multidrug resistance

A

bacteria develop molecular pumps to actively remove antibiotics out of cell

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18
Q

VRE mechanism of resistance

A

alter peptidoglycan synthesis so that antibiotic does not bind

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19
Q

MRSA mechanism of resistance

A

uses altered PBP so B-lactam can’t bind

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20
Q

Factors promoting bacterial resistance

A

1) fast evolution
2) bacteria can share DNA
3) antibiotic overuse –> increase abx resistant strains

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21
Q

Nursing antibiotic stewardship

A

1) reduce need for abx –> hygiene, vaccines, safe sex
2) validate infections before beginning abx treatment
3) use abx exactly as prescribed –> complete entire regiment
4) patient reassessment within 48 hrs

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22
Q

How long after abx should a pt be reassessed?

A

48 hrs

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23
Q

Most common bacteria causing UTI

A

Uropathogenic e. coli

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24
Q

Uncomplicated UTI risk factors

A

female gender
older age
younger age

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25
Complicated UTI risk factors
indwelling catheters immunosuppression UTI abnormalities abx exposure
26
Mechanisms of UTI infection
1) fecal bacteria (ascending) 2) sexual contact 3) contaminted diaphram/birth control 4) can occur from the blood
27
Recurrent UTI MOA
once uropathogenic enter the urethra they can colonize the epithelium --> recurrent infection
28
Estrogen & Immunity
estrogen promotes production of glycogen lactobacilli digest glycogen --> lactic acid + bacteriocidal compounds lactic acid = reduce urethral pH bacteriocidal = kills bacteria
29
UTI Risk Factors
``` obstruction reflux congenital abnormalities female sex menopause urinary retention/urinary stasis neurologic abnormalities immunosuppression catheterization / cystoscopy inflammation/abrasion of urethral mucosa diabetes --> hyperglycemia prostate disorders ```
30
Factors causing urinary retention/stasis
diverticulitis bladder tumors contracture of bladder neck
31
Urine collection steps
collect adequate amount 10-20 cc PRIOR to abx therapy use a sterile container --> label use aseptic technique --> clean catch, foley catheter transport promptly to lab or fridge
32
Direct analysis of pathogen
phenotype genotype serotype
33
Indirect analysis of pathogen
serology --> look for specific antibodies made in response to infection
34
Microscopic tests
gram stain
35
Biochemical test
catalase enzyme
36
Growth conditions
O2 requirement of bacteria | aerobic vs. anaerobic
37
Elevated neutrophils
acute bacterial infection
38
Elevated lymphocytes
viral infection
39
Elevated eosinophils
allergic/parasitic infection
40
Elevated basophils
food allergy
41
Immature granulocytes
leukemia/lymphoma
42
Lab tests for UTi
Urine dipstick Microscopy Culture & Sensitivity
43
What does a urine dipstick measure
leukocyte esterase --> indicates WBC in urine | nitrites --> bacterial byproduct
44
Pyuria
presence of WBC in urine | >5-10
45
Hematuria
presence of blood in urine
46
How long does a C&S take
2-3 days
47
Systemic S/S of infection
fever hypotension fatigue
48
UTI Classification
upper vs. lower complicated vs. uncomplicated acute, chronic, recurrent
49
Upper UTI
kidneys | ureters
50
Lower UTI
bladder | urethra
51
Urinalysis components
``` colour specific gravity pH blood protein glucose nitrite leukocyte esterase bacteria WBC ```
52
Antibiotic patient education
``` take full dose, complete entire regimen may need to take with food (GI upset) may cause adverse fx follow prescription orders carefully report any adverse fx to your doctor ```
53
Common adverse fx of antibiotics
``` nausea/vomiting diarrhea rash urticaria photophobia fever chills ```
54
UTI Prevention
``` increase fluids (2L daily) void frequently (every 2-3 hrs) proper hygiene (wipe front to back) void after intercourse drink cranberry/blueberry juice ```
55
Immune defenses
``` washout phenomenon antibacterial enzymes antibodies (IgA) antiadherent fx of mucosal cells ureterovesicle junction (prevent reflux) bladder mucin layer (water barrier) prostate secretions normal bacterial flora of urethra ```
56
Washout phenomenon
urine sweeps away bacteria in the urethral tract
57
Urinary reflux
occurs when urine backflows from urethra --> bladder or bladder --> kidneys
58
What causes urinary reflux?
sudden increase in intra-abdominal pressure suddenly stopping urinary stream common in children
59
Routes of infection
ascending (most common) thru bloodstream fistula form intestine
60
S/S of lower UTI
``` pain burning on urination frequency urgency nocturia incontinence suprapubic/pelvic pain hematuria ```
61
S/S of upper UTI
``` flank pain (costovertebral palpation) chills fever N/V headache malaise painful urination ```
62
S/S of UTI in Older Adults
``` fatigue delirium sudden onset confusion altered sensorium anorexia new incontinence hyperventilation low grade fever ```
63
Urine characteristics
``` volume color concentration cloudiness odour ```
64
Strategies to reduce CAUTI
aseptic technique use smallest catheter possible secure catheter w/ tape to prevent movement/irritation inspect urine daily perineal care maintain closed system (foley catheter bag)
65
Normal PVR
50-100 mL
66
Types of urinary obstruction
functional | mechanical
67
Mechanical urinary obstruction
renal/ureteral calculi BPH pregnancy malformation of ureterovesical junction
68
Functional urinary obstruction
``` neurogenic bladder decreased voiding detrusor instability (anticholinergic drugs) constipation ```

BSNC 3000 (11 decks)

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