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1

Name the components of the chain of infection

Infectious agent
reservoir
portal of exit
mode of transmission
portal of entry
host

2

What is a microorganism?

infection or etiological agent

3

4 factors microorganisms depend on to cause disease

1. sufficient # of organism
2. virulence (strength & type of organism)
3. entry & survival in host
4. Susceptibility of host

4

Nosocomial

= health-care associated infections (MRSA)

5

Reservior

place where pathogens are stored

6

What do pathogens need to survive?

Food; O2 levels (aerobic vs anaerobic); H2O; temp; pH; and little light.

7

What can be portals of exit?

Body openings (mouth, rectum, urethra, etc.)
Breaks in skin or mucous membranes

8

4 modes of transporation

1. contact
direct (touching, kissing)
indirect (stethoscope, door handle)
droplet (lands on surface)
2. Air
3. Vehicles (IV fluids, water)
4. Vectors --> animals/ insects (Lymes disease, West Nile

9

List ways to reduce transmission

1. Hand Hygiene
2. Don't share equipment
3. Careful w/ soiled items
4. PPE

10

Moments for Hand hygiene

b/f touching pt
b/f cleaning/ aseptic procedure
After body fluid exposure
After touching pt
After touching pt’s surroundings

11

Host

Can enhance resistance
Degree of resistance to a pathogen.
Resistance increased by immunizations & exposure to disease.

12

Portal of entry

Body openings (mouth, rectum, urethra, etc.)
Breaks in skin or mucous membranes
The more devices, the more portals

13

Defenses to prevent infection

Normal Flora
Body defense mechanisms – skin, tears, cilia, urine, stomach acid, etc. Drink H2O (flush system out!)
Inflammation = protective vascular rxn
S+S = redness, pain, heat, and swelling
Immune system

14

Inflammatory response

1. Vascular and cellular responses
2. Inflammatory exudate
3. Tissue repair

15

Serous exudate

Clean

16

sanguineous exudate

Blood

17

Purulent exudate

pus

18

Medical Asepsis

Clean technique

19

Asepsis

the absence of bacteria, viruses, & other microorganisms.

20

Which of the following nursing measures is appropriate in breaking a link in the chain of infection?
A. Cover mouth and nose when sneezing.
B. Place contaminated linens in a paper bag.
C. Use personal protective equipment (PPE) sparingly.
D. Wear gloves at all times.

A. Cover mouth and nose when sneezing.

21

The nurse has just admitted a patient to rule out Alzheimer’s disease. The patient is confused and spitting on everyone who enters the room. What should the nurse do?
A. Wait an hour until the patient calms down, and then use gloves when touching the patient.
B. Use gloves, a mask, a face shield, and a gown when entering the room to perform the initial assessment.
C. Administer a sedative, and then perform the assessment after the patient is asleep; no precautions would be needed.
D. Realize that isolation equipment might further confuse the patient and avoid using a face mask and shield, but use gown and gloves.

B. Use gloves, a mask, a face shield, and a gown when entering the room to perform the initial assessment.

22

If an infectious disease can be transmitted directly from one person to another, it is called which of the following?
A. A susceptible host
B. A communicable disease
C. A portal of entry to a host
D. A portal of exit from the reservoir

B. A communicable disease

23

A patient who has been admitted to your unit has been identified as being colonized by (is a carrier of) methicillin-resistant Staphylococcus aureus (MRSA). Which measure should be taken to prevent the spread of MRSA to other patients on the unit?
A. Place the patient in a single or a private room, and place the patient on contact precautions.
B. Standard precautions and routine practices only are indicated for the patient.
C. Place the patient in a room with another patient on isolation for Clostridium difficile.
D. Place the patient in a single room.

a. Place the patient in a single or a private room, and place the patient on contact precautions.

24

When should a gown be worn?
A. If the patient’s hygiene is poor.
B. If the patient has acquired immune deficiency syndrome or hepatitis.
C. If the nurse is assisting with medication administration.
D. If blood or body fluids may get on the nurse’s clothing from a task the nurse plans to perform.

D. If blood or body fluids may get on the nurse’s clothing from a task the nurse plans to perform.

25

Which of the following statements reflects the current trend in the directives from the Centers for Disease Control and Prevention for minimizing the risks of infection?
A. Discard all dressings into red bags.
B. Do not recap bottles of solutions to minimize the risk of contamination.
C. Recap syringes or break needles off before discarding them into sharps containers.
D. Keep all drainage tubing below the level of the waist or site of insertion.

D. Keep all drainage tubing below the level of the waist or site of insertion.

26

Which of the following laboratory tests will show elevated results if a bacterial infection is present?
A. Basophils
B. White blood cell count
C. Iron level
D. Eosinophils

B. White blood cell count

27

What is the single most effective method by which the nurse can break the chain of infection?
A. Give all patients antibiotics.
B. Wear gloves when caring for all patients.
C. Wash hands between procedures and patients.
D. Make sure housekeeping staff are using the right chemicals.

C. Wash hands between procedures and patients.

28

Before the nurse washes the hands when leaving an isolation room, what is the last clothing item that the nurse removes?
A. Mask
B. Gown
C. Goggles
D. Head cover

C. Goggles

29

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

B. Explain the isolation procedures, and provide meaningful stimulation.

30

To remove a glove that is contaminated what should the nurse do first?
A. Rinse the glove before removing it to minimize contamination.
B. Pull the glove off the back of the hand until it slides off the entire hand and discard it.
C. Grasp the outside of the cuff or palm of the glove and pull it away from the hand without touching the wrist or fingers.
D. Put the thumb inside the wrist to slide the glove over the hand with minimal touching of the hand by the other gloved hand.

C. Grasp the outside of the cuff or palm of the glove and pull it away from the hand without touching the wrist or fingers.

31

The mode of Transmission for Hep A is
A. direct & indirect contact
B. Droplet transmission
C. Airborne Transmission
D. Vectorborne Transmission

A. direct & indirect contact

32

The mode of Transmission for Hep A is
A. direct & indirect contact
B. Droplet transmission
C. Airborne Transmission
D. Vectorborne Transmission

A. direct & indirect contact

33

Describe incubation period

Interval b/w entrance of pathogen & 1st appearance of symptoms

34

Prodromal Stage

Interval from onset of NON-specific S&S to specific symptoms
- may be more capable of spreading disease to others

35

Illness Stage

Pt manifests S&S specific to infection

36

Convalescence

Acute symptoms disappear
body tries to replenish itself
On route to homeostasis

37

Increased WBC

acute infection, neoplasm, allergy neoplasm, immunosuppression

38

Decreased WBC

certain viral infections
Overwhelming infections

39

Increased ESR

inflammatory process, acute/ chronic infection, tissue necrosis, infarction

40

Decreased Iron

Chronic infection

41

Elevated C-reactive protein

acute inflammatory process

42

Cultures in Urine and blood

Presence of infectious microorganism

43

WBC's on gram stain

Presence of infectious microorganism

44

A. Increased Neutrophils
B Decreased Neutrophils

A. acute suppurative infection
B. Overwhelming Bacterial Infection (older adults)

45

A. Increased Lymphocytes
B. Decreased Lymphocytes

A. Chronic bacterial & viral infections
B. sepsis

46

Increased Monocytes

Protozoal, rickettsial, & TB infections

47

Increased Eosinophils

Parasitic infection

48

Basophils

Normal during infection

49

Airborne Precautions (Diseases)

Measles, chicken pox, disseminated zoster, TB

50

Droplet Precautions (Diseases)

diptheria, rubella, influenza, mumps, pertussis, Meningcoccal pneumonia, sepsis

51

Contact precautions (Diseases)

Drug-resistant organisms, C. difficile, major wound infections, gastrointestinal, respiratory, skin infections