N200 Quiz 1 Chapter 28 Flashcards Preview

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Flashcards in N200 Quiz 1 Chapter 28 Deck (69):
1

_________ is the ability of a microorgnaism to produce disease. Microorganisms that cause disease in humans are ________.

Pathogenicity
pathogens

2

An ________ is an invasion of a susceptible host by pathogens or microorganisms resulting in disease. invasion and multiplication

Infection

3

What are the 5 causative agents of infection or pathogenicity?

Bacteria, viruses, fungi, protozoa, Rickettsia

4

What is the difference b/w colonization and infection?

Colonization: presence of growth of microorganisms within a host but do without tissue invasion or damage.
while an
Infection: Invasion of the body by pathogens or microorganisms that reproduce and MULTIPLY.

5

A ______ _______ are infectious agents that are capable of being transmitted to a client by direct or indirect contact thru a vehicle or vector or airborne routes.

Communicable agent

6

What are the 6 steps in the Chain of Infection?

1. infectious agent
2. Reservoir: Ie stethoscope, hands, anything w/ contact
3. Portal of Exit: bact wants to get out!!
4. Mode of Transmission: ex picked pimple, pus on hands
5. Portal of Entry: open wound on patient or surface
6. Host: person that is transmitting...

7

Normal Flora

bacteria which is a permanent resident. fights bad bacteria that entire GI tract.

8

How does a patient get c. diff?

antibiotics taking out normal flora.

9

________ are microorganisms that attach to the skin when a person has contact with another person or object during normal activities.

Transient Flora

10

What is a reservoir?

place where microorganisms survive, multiply, and await transfer to a susceptible host. Ex. hands, stethoscope, food

11

Name 6 common reservoirs for microorganisms and give an example of each.

1. Food: E coli
2. Oxygen: Staph & C-diff: anaerobic and aerobic
3. Water: turn into spore: ↑. think of mold, spores float in air.
4. Temperature (hot and cold): Legionella (grows in AC). Reason why operating rooms are cold (minimize bact growth).
5. pH: ↑ pH: urine =UTI. Higher alkaline in bladder, more susceptible bact is to growth. Void (urinate) flushes out microorganisms.
6. Light (grows in light and dark): bacteria under a dressing. Dark: why Physician orders dressing change. dressing is warm, moist, dark place where germs flourish

12

After micro-organisms find a site to grow and multiply, they need to find a __________ if they are to enter another host and cause disease.

port of exit

13

Virulence

Multiplication

14

Name 5 common portals of exit.

1. Skin and mucus membranes
2. Respiratory tract
3. Urinary tract
4. GI tract
5. Reproductive tract: VAGINAL secretions provide boundary to keep bugs out, maintain pH to deter bact.
Blood

15

True or False: All diseases employ the same mode of transmission.

False. Each disease has a specific mode of transmission.

16

True or False: the port of entry an organism uses to enter the body can be the same as the port of exit.

True.

17

________ to an infectious agent depends on the individual’s degree of resistance to pathogens.

Susceptibility

18

Name 5 Factors that affect susceptibility to a pathogen or infectious agent.

1. age
2. nutritional status
3. presence of chronic illness/disease
4. trauma
5. smoking

19

Course of infection depends on what 5 factors?

Pathogenicity (virulence) of the organism
Localized vs. Systemic:
Incubation period: maybe tired. occurs before you know you are sick. usually 48-72 hours
Prodromal Stage: starting to feel sick
Illness Stage
Convalescence

20

Describe the difference in temperature between systemic and localized infections.

systemic: fever >101.5 F
localized: may have fever

21

What are the bodies 3 defenses against infection?

1. Normal Flora
2. Body System Defenses
3. Inflammation

22

What 3 processes are included with inflammation (with regard to defense against infection)

1. Vascular and Cellular: review patho notes
2. Inflammatory exudate (pus)
3. Tissue repair

23

_______ IS HEALING SKIN

GRANULATION

24

_______ occur as a result of invasive procedures, antibiotic administration, the presence of multi-drug resistant organisms, and breaks in infection prevention, and controlled activities. Ex. blood draw, stick, temperature

Healthcare Associated Infections (HAI)

25

HAI are a result of what 4 activities?

1. invasive procedures
2. antibiotic administration
3. multi-drug resistant organisms
4. breaks in infection prevention, and controlled activities

26

What is an Iatrogenic infection? example?

HAI resulting from a diagnostic or therapeutic procedure.
Ex. MRSA

27

______ _____ are infections not occurring within one month of contact with health care.

Community Infections

28

What are 4 sites of HAI?

Urinary tract
Surgical or traumatic wounds
Respiratory tract
Bloodstream

29

Name several factors affecting susceptibility to infection.

Age
Heredity
Cultural Practices
Nutritional Status
Stress
Rest & Exercise
Immunization
Disease Processes
Occupation
Inadequate Defenses
Personal Habits
Environmental Factors
Medical Therapies
Clinical Presentation

30

Would result would you expect for the following lab tests to indicate presence of infection?
1. WBC Count
2. Sedimentation Rate
3. Iron Level
4. Blood Cultures/urinalysis
5. Wound, sputum, & throat cultures
6. Neutrophils
7. Lymphocytes
8. Monocytes
9. Eosinophils
10. Basophils

1. WBC: Increased in acute infection, decreased in certain viral or overwhelming infections
2. ESR: increase
3. Iron Level: Decreased in chronic infection
4. Blood Cultures/Urinalysis: positive for growth
5. Wound, sputum, & throat cultures: positive for growth
6 Neutrophils: Increased in acute suppurative (pus-forming) infection, decreased in overwhelming bacterial infection (older adult)
7. Lymphocytes: Increased in chronic bacterial and viral infection, decreased in sepsis
8. Monocytes: Increased in protozoan, rickettsial, and tuberculosis infections
9.Eosinophils: Increased in parasitic infection
10. Basophiils: Normal during infection

31

When performing a thorough nursing assessment, what steps can be performed to minimize infections in the acute care setting?

1. Identification & elimination of the organism
2. Support of the client’s defenses
3. Control ports of entry and exit
4. Avoid actions that transmit pathogens
5. Use Aseptic technique

32

What attributes are included in "Aseptic Technique"

Hand hygiene (CDC recommendations 2002b)
Soap (kills spores of c. diff) or alcohol based scrub (know when to use each)
Cleaning, disinfecting and sterilizing

33

What are the 5 most important health promotion techniques to minimize infection?

1. Prevention: #1
2. Nutrition
3. Hygiene
4. Immunization
5. Adequate Rest/ Regular Exercise

34

What 8 bedside activites or tools help prevent, control or reduce reservoirs?

1. Bathing: Use soap and water to remove drainage, dried secretions, or excess perspiration
2. Dressing Changes: Change dressings that become wet and/or soiled
3. Contaminated Sharps:Place all needles, safety needles, and needleless systems into puncture-proof containers
4. Contaminated Articles: Place tissues, soiled dressings, or soiled linen in fluid-resistant bags for proper disposal.
5. Bedside Unit: Keep table surfaces clean and dry
6. Bottled solutions (ensure sterility and toss 24 hours after opening)
7. Surgical Wounds: Keep drainage tubes and collection bags patent to prevent accumulation of serous fluid under the skin surface
8. Drainage Collection Containers: wear gloves, empty, never raise a drainage system.

35

What are the 5 types of isolation precautions?

1. Standard Precautions
2. Airborne Precautions: wear N95 respirator
3. Droplet Precautions: wear a surgical mask when within 3 feet of the patient
4. Contact Precautions
5. Protective Environment

36

Provide an example of each type of precaution:
1. Standard Precautions
2. Airborne Precautions
3. Droplet Precautions
4. Contact Precautions
5. Protective Environment

1. Standard Precautions: all patients
2. Airborne Precautions: pt with TB (in negative pressure room), protects you from pt
3. Droplet Precautions: pt w/ flu or bacteria that causes pneumonia (protects you from pt)
4. Contact Precautions: MRSA, VRE (protects you from pt)
5. Protective Environment immuno- compromised pts (protects pt from you)

37

What 7 considerations should occur regarding patients under isolation or with isolation precautions?

1. Psychological Implications
2. The environment
3. Personal protective equipment (PPE)
4. Removal of protective equipment
5. Specimen collection
6. Bagging ??
7. Transporting clients

38

1. What is the purpose of surgical asepsis?
2. When is it used?
3. describe skin prep on a client
4. What are the principles of surgical technique?

1. MAINTAIN STERILE FIELD/AREA
2. IV INSERTION, drawing LABS, DRESSING CHANGES, Operating room
3. Client preparation: SKIN PREP, CIRCULAR MOTION (FROM INSIDE -OUT)
4. use STERILE TOWEL, maintain 1 INCH BORDER, "maintain sterile to sterile" etc.

39

What are the 4 best defenses against the spread of infection?

1. Hand hygiene before and after all pt. contact
2. Proper use of supplies
3. Good aseptic technique
4. Critical Thinking

40

What are the "5 moments of hygiene"?

1. perform before touching a patient
2. before clean/aseptic procedures
3. ????
4. after touching patient
5.

41

If an infectious disease can be transmitted directly from one person to another, it is a:
A. Susceptible host.
B. Communicable disease.
C. Port of entry to a host.
D. Port of exit from the reservoir.

B. Communicable disease.

42

Which is the most likely means of transmitting infection between patients?
A. Exposure to another patient's cough
B. Sharing equipment among patients
C. Disposing of soiled linen in a shared linen bag
D. Contact with a health care worker's hands

D. Contact with a health care worker's hands

43

Identify the interval when a patient progresses from nonspecific signs to manifesting signs and symptoms specific to a type of infection.
A. Illness stage
B. Convalescence
C. Prodromal stage
D. Incubation period

C. Prodromal stage

44

Which of the following is the most effective way to break the chain of infection?
A. Hand hygiene
B. Wearing gloves
C. Placing patients in isolation
D. Providing private rooms for patients

A. Hand hygiene

45

A family member is providing care to a loved one who has an infected leg wound. What would you instruct the family member to do after providing care and handling contaminated equipment or organic material?
A. Wear gloves before eating or handling food.
B. Place any soiled materials into a bag and double bag it.
C. Have the family member check with the doctor about need for immunization.
D. Perform hand hygiene after care and/or handling contaminated equipment or material.

D. Perform hand hygiene after care and/or handling contaminated equipment or material.

46

A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention?
A. Provide a dark, quiet room to calm the patient.
B. Reduce the level of precautions to keep the patient from becoming angry.
C. Explain the reasons for isolation procedures and provide meaningful stimulation.
D. Limit family and other caregiver visits to reduce the risk of spreading the infection.

C. Explain the reasons for isolation procedures and provide meaningful stimulation.

47

The nurse wears a gown when:
A. The patient's hygiene is poor.
B. The nurse is assisting with medication administration.
C. The patient has acquired immunodeficiency syndrome (AIDS) or hepatitis.
D. Blood or body fluids may get on the nurse's clothing from a task that he or she plans to perform.

D. Blood or body fluids may get on the nurse's clothing from a task that he or she plans to perform.

48

The nurse has redressed a patient's wound and now plans to administer a medication to the patient. Which is the correct infection control procedure?
A. Leave the gloves on to administer the medication.
B. Remove gloves and administer the medication.
C. Remove gloves and perform hand hygiene before administering the medication.
D. Leave the medication on the bedside table to avoid having to remove gloves before leaving the patient's room.

C. Remove gloves and perform hand hygiene before administering the medication.

49

When a nurse is performing surgical hand asepsis, the nurse must keep hands:
A. Below elbows.
B. Above elbows.
C. At a 45-degree angle.
D. In a comfortable position.

B. Above elbows.

50

What is the best method to sterilize a straight urinary catheter and suction tube in the home setting?
A. Use an autoclave.
B. Use boiling water.
C. Use ethylene oxide gas.
D. Use chemicals for disinfection.

B. Use boiling water.

51

A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection?
A. It keeps an incontinent patient's skin dry.
B. It can get caught in the linens or equipment.
C. It obstructs the normal flushing action of urine flow.
D. It allows the patient to remain hydrated without having to urinate.

C. It obstructs the normal flushing action of urine flow.

52

Your ungloved hands come in contact with the drainage from your patient's wound. What is the correct method to clean your hands?
A. Wash them with soap and water.
B. Use an alcohol-based hand cleaner.
C. Rinse them and use the alcohol-based hand cleaner.
D. Wipe them with a paper towel.

A. Wash them with soap and water.

53

A patient's surgical wound has become swollen, red, and tender. You note that the patient has a new fever and leukocytosis. What is the best immediate intervention?
A. Notify the health care provider and use surgical technique to change the dressing.
B. Reassure the patient and recheck the wound later.
C. Notify the health care provider and support the patient's fluid and nutritional needs.
D. Alert the patient and caregivers to the presence of an infection to ensure care after discharge.

C. Notify the health care provider and support the patient's fluid and nutritional needs.

54

While preparing to do a sterile dressing change, a nurse accidentally sneezes over the sterile field that is on the over-the-bed table. Which of the following principles of surgical asepsis, if any, has the nurse violated?
A. When a sterile field comes in contact with a wet surface, the sterile field is contaminated by capillary action.
B. Fluid flows in the direction of gravity.
C. A sterile field becomes contaminated by prolonged exposure to air.
D. None of the principles were violated.

C. A sterile field becomes contaminated by prolonged exposure to air.

55

Interval between entrance of pathogen into body and appearance of first symptoms

Incubation Period

56

Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms.

Prodromal Stage

57

Interval when patient manifests signs and symptoms specific to type of infection.

Illness Stage

58

Interval when acute symptoms of infection disappear.

Convalescence

59

What are the bodies defense systems/processes to prevent disease:
1. skin
2. mouth
3. eye

1. Intact multilayered surface Provides barrier to microorganisms and antibacterial activity also sebum: Contains fatty acid that kills some bacteria
2. Intact multilayered mucosa Provides mechanical barrier to microorganisms also Saliva Washes away particles containing microorganisms
3. Tearing and blinking Provides mechanisms to reduce entry (blinking) or assist in washing away (tearing) particles containing pathogens, thus reducing dose of organisms

60

What are the bodies defense systems/processes to prevent disease:
4. respiratory tract
5. urinary tract
6.GI tract
7. vagina

4. Cilia lining upper airway, coated by mucus Traps inhaled microbes and sweeps them outward in mucus to be expectorated or swallowed also Macrophages Engulf and destroy microorganisms that reach alveoli of lung
5. Flushing action of urine flow Washes away microorganisms on lining of bladder and urethra also Intact multilayered epithelium Provides barrier to microorganisms

61

What are the bodies defense systems/processes to prevent disease:
6.GI tract
7. vagina

6. Acidity of gastric secretions Prevents retention of bacterial contents also Rapid peristalsis in small intestine
7. At puberty, normal flora causing vaginal secretions to achieve low pH Inhibit growth of many microorganisms

62

occurs when part of the patient's flora becomes altered and an overgrowth results (e.g., staphylococci, enterococci, yeasts, and streptococci).

Endogenous infection

63

absence of pathogenic (disease-producing) microorganisms.

Asepsis

64

What are two types of asepsis?

1. Medical asepsis, or clean technique, includes procedures for reducing the number of organisms present and preventing the transfer of organisms. Hand hygiene, barrier techniques, and routine environmental cleaning are examples of medical asepsis.
2. Surgical asepsis

65

If hands are not visibly soiled use an alcohol-based waterless antiseptic agent for routinely decontaminating hands in what situation?

a. Before, after, and between direct patient contact
b After contact with body fluids or excretions, mucous membranes, nonintact skin, or wound dressings
c When moving from a contaminated to a clean body site during patient care
d After contact with inanimate surfaces or objects in the patient's room
e Before caring for patients with severe neutropenia or other forms of severe immune suppression
f Before putting on sterile gloves and before inserting indwelling urinary catheters, peripheral vascular catheters, or other invasive devices
g After removing gloves

66

When do you wash hands?

1. When hands are visibly dirty, when soiled with blood or other body fluids, before eating, and after using the toilet, wash hands with water and either a nonantimicrobial or antimicrobial soap.
2. Wash hands if exposed to spore-forming organisms such as Clostridium difficile or Bacillus anthracis.

67

1. _____ is the removal of all soil
2. ______ describes a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects
3. ______ is the complete elimination or destruction of all microorganisms, including spores. Steam under pressure, ethylene oxide (ETO) gas, hydrogen peroxide plasma, and chemicals are the most common sterilizing agents.

Cleaning
Disinfection
Sterilization

68

1) covering your nose/mouth with a tissue when you cough and promptly disposing of the contaminated tissue
(2) placing a surgical mask on a patient if it does not compromise respiratory function or is applicable, which may not be feasible in pediatric populations
(3) hand hygiene after contact with contaminated respiratory secretions
(4) spatial separation greater than 3 feet from persons with respiratory infections

cough etiquette

69

__________ prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery. Surgical asepsis includes procedures used to eliminate all microorganisms, including pathogens and spores, from an object or area.

Surgical asepsis or sterile technique