Unit 4: Ch. 10,22,28 Flashcards
1
Q
Define surgical asepsis
A
totally free of microorganisms, including spores
2
Q
Medical asepsis
A
- antimicrobial agent used
- containing
- handwashing
- PPE/ isolation
- clean technique **
3
Q
Surgical asepsis
A
- sterilization (physical and chemical)
- surgical hand antisepsis
4
Q
Sterile techniques
A
practices that avoid contaminating microbe-free items
5
Q
Autoclave
A
pressure steam sterilizer
6
Q
Principles of surgical asepsis
A
- sterile with sterile
- partially unwrapped packaging is considered unsterile
- if you question if its sterile, consider it unsterile
- longer the time = less sterile
- expiration dates
- once an item is open its only a matter of time before it is contaminated
- if item gets wet its contaminated
- coughing,sneezing, or excessive talking over a sterile field contaminates it
- dont reach over a sterile field
- below waist level is considered contaminated
7
Q
Sterile field
A
work area free of microorganisms
8
Q
Lipping
A
before use of a sterile solution, pour and discard small amount of liquid from the mouth of the container to wash away airbourne contaminators
9
Q
Mask
A
wear a mask if there is a risk for coughing or sneezing within a radius of 3 feet
10
Q
Particulate filter respirator
A
wear if there is a potential for acquiring diseases caused by droplet or airborne transmission
11
Q
Colonization
A
condition where microorganisms are present but there are no signs or symptoms
12
Q
Course of infectious diseases
A
- incubation period
- prodromal stage
- acute stage
- convalescent stage
- resolution
13
Q
Incubation period
A
infectious agents reproduces, but there are no signs or symptoms
14
Q
Prodromal stage
A
initial symptoms appear
15
Q
Acute stage
A
symptoms become severe and specific to the tissue or organ that is affected
16
Q
Convalescent stage
A
symptoms subside
17
Q
Resolution
A
pathogen is destroyed, health is restored
18
Q
When do we wear PPE?
A
Anytime you are exposed to bodily fluids
19
Q
Diseases that require isolation
A
- pulmonary TB
- measles (rubella)
- chicken pox (variscella)
- severe acute respiratory syndrome (SARS)
20
Q
Transmission based precaution
A
- isolation precautions
- airborne
- droplet
- contact
21
Q
Airborne
A
- private room
- negative air pressure
- 6 to 12 air changes per hour
22
Q
Airborne protection
A
- follow standard precautions
- door closed
- wear PPE
- N95 mask
23
Q
Airborne diseases
A
- pulmonary TB
- Measles
- chicken pox
- SARS
24
Q
Droplet
A
private room
within 3ft
ciughing sneezing etc
25
Droplet protection
- follow standard precautions
- leave door open or closed
- wear a mask
26
Droplet diseases
- influenza
- rubella
- strep pneumonia
- meningitis
- whooping cough
27
Contact
-private room or in a room with similarly infected patients
28
Contact protection
- standard precautions
- don gloves before entering
- handwashing
- avoid transporting the client
- have equipment exclusively for that specific pt
29
Reverse isolation
- use with patients who are immunocompromised
- standard precautions AND gown, gloves, mask
- limit visitor contact
- no sick visitors
- no fresh plants or flowers
- no raw or uncooked foods
30
Providing sensory stimulation
- move bed
- position pt so that they can look out the window
- encourage telephone calls
- converse with pt
- encourage activity
- offer wide choice of foods
31
Early signs of infection in older adults
change in behavior or mental status
32
Visitors in isolation rooms
- plan frequent social contact
- encourage visitors to come as often as policy allows
- visitors must follow infection control precautions
33
Types of drainage
- serous
- sanguineous
- serosanguineous
- purulent
34
Serous drainage
- mostly clear or slightly yellow
| - a bit thicker than water
35
Serosanguineous drainage
- thin and watery
| - pink in color
36
Sanguineous drainage
- fresh bloody exudate
| - bright red, thick
37
Purulent drainage
- thick with yellow,green, brown color
| - foul odor
38
What type of drainage is a sign of infection?
Purulent
39
Gauze dressing
- made of woven cloth fibers
| - ideal for covering fresh wounds that are likely to bleed or wounds that exude drainage
40
Transparent dressing
- clear acrylic film wound coverings
- allow nurses to assess wound without removing dressing
- commonly used to cover peripheral and central intravenous insertion sites
41
Hydrocolloid, hydrogel, and alginate dressings
-self adhesive, opaque, air and water occlusive
| keep wound moist
42
First intention healing
- primary intention
- wound edges are directly next to each other
- small amount of scar tissue
43
Second intention healing
- wound edges are widely separated
- more time consuming and and complex reparative process
- conspicuous scar
- wound care must be performed cautiously
44
Third intention healing
- wound edges are intentionally left widely separated and later brought together with some kind closure material
- broad, deep scar
- extensive drainage and tissue debris
45
TED hose
- compression stockings
- must have physician order
- remove every 8 hours
- apply after elevating legs for 15 minutes
46
Drains
tubes that provide a means for removing blood and drainage from a wound
47
Open drains
- flat flexible tubes that empty into a dressing
- use gravity or capillary action
- can be shortened by nurse
48
Closed drains
- tubes that terminate in a receptacle
- Jackson pratt (PV), hemovac
- use nonmechanical vacuum or negative pressure
49
Vacuum assisted closure (VAC)
- wound packed with foam filler and sealed with an occlusive dressing
- attached to a suction tube and pump
50
Factors that negatively impact healing
- compromised circulation
- infection
- purulent, bloody, or serous fluid accumulation
* KEY TO WOUND HEALING IS ADEQUATE BLOOD FLOW*
51
Pressure ulcer
- decubitus ulcer
| - wound caused by prolonged capillary compression that impairs circulation to the skin and underlying tissue
52
Pressure ulcer stage 1
- intact but reddened skin
| - skin that remains red when pressure is relieved
53
Pressure ulcer stage 2
pressure ulcer is red and accompanied by blistering or a skin tear
54
Pressure ulcer stage 3
- pressure ulcer has a shallow skin crater that extends to subcutaneous tissue
- may be accompanied by serous drainage or purulent drainage
55
Signs & symptoms of wound infection
- discharge
- redness
- odor
- hot to the touch
56
Actions for suspected wound dehiscence or evisceration
- position the client to the least strain to the open area
| - place sterile dressings moistened with normal saline
57
SALTT method
- size
- appearance
- location
- treatment
- tolerance
58
hyperendemic infections
infections that are highly infectious in all age groups
59
Open wound
one in which the surface of or the skin or mucous membrane
60
Closed wound
there is no opening in the skin or mucous membrane
61
Incision
clean separation of skin and tissue with smooth, even edges
62
Laceration
separation of skin and tissue in which the edges are torn and irregular
63
Abrasion
surface layers of skin are scraped away
64
Avulsion
stripping away of large areas of skin and underlying tissue, leaving cartilage and bone exposed
65
Ulceration
shallow crater in which the skin or the mucous membrane is missing
66
Puncture
opening of skin, underlying tissue or mucuos membrane caused by a narrow sharp pointed object
67
Contusion
injury to soft tissue underlying the skin from the force of contract with a hard object, sometimes called a bruise
68
Proliferation
period during which new cells fill and seal a wound
69
Integrity of skin and damaged tissue is restored by
- resolution
- regeneration
- scar formation
70
Slough
dead tissue on the wound
71
dehiscence
separation of wound edges
72
evisceration
wound separation with the protrusion of organs
73
montgomery straps
strips of tape with eyelets
74
debridement
removal of dead tissue
75
undermining
erosion of tissue from underneath intact skin
76
Normal white blood cell count
5000-10,000
77
Gauze
highly absorbent dressing
78
Temp for eye/ear irrigation
body temp
79
sharp debridement
removal of necrotic tissue with sterile scissors
80
enzymatic debridement
use of topically applied chemically substances that break down and liquify wound debris
81
autolytic debridement
painless, natural physiologic process that allows body enzymes to soften, liquify, and release devitalized tissue
82
10 microorganisms
- nonpathogens
- pathogens
- bacteria
- viruses
- fungi
- rickettsiae
- protozoans
- mycoplasmas
- helmiths
- prions
83
Virulence
how strong a bacteria or virus is
84
Means of transmission
- indirect contact
- direct contact
- vehicle
- vector
- airborne
- droplet
85
Antiseptics
inhibit the growth but do not kill microorganisms
| Ex: alcohol
86
Disinfectants
destroy active microorganisms but not spores
| Ex: bleach
87
Antimicrobial agents
chemicals that destroy or suppress the growth of infectious microorganisms
Ex: antiseptics, disinfectants, anti-infective drugs
88
Antibacterial
alter metabolic process of bacteria not viruses
89
Antiviral
control viral replication
90
Resident microorganisms
nonpathogens constantly present on the skin
91
transient microorganisms
pathogens picked up during brief contact with contaminated reservoirs
92
5 moments for hand hygiene
- before touching a patient
- before clean/aseptic procedure
- after body fluid exposure risk
- after touching a patient
- after touching patient surroundings
93
Surgical hand asepsis
- no jewelry/ watches
- antibacterial soap
- 2 to 6 minutes
- hands held above elbows
- orange sticks to clean fingernails
- friction with brush/sponge
- dry with sterile towels
- sterile gloves immediately after
94
Concurrent disinfection
keeping pt environment clean on a daily basis
95
Standard precautions
measures for reducing the risk of microorganism transmission
96
Standard precautions include:
- hand hygiene
| - PPE
97
N95
- individually fitted
| - can filter particles 1 micron with an efficiency of 95%
98
Powered air purifying respirator
-an alternative if a caregiver has not been fitted for an N95 or has facial hair
99
communicable disease
transmitted from one source to another by infectious bacteria or viral organisms
100
contagious disease
communicable disease that can spread rapidly among others, close proximity
101
community acquired infections
those that are not present or incubating prior to health care providers
102
wound
damaged skin or soft tissue
103
trauma
general term referring to injury
104
Wound repair process
- inflammation
- proliferation
- remodeling
105
inflammation
- lasts 2 to 5 days
- limit local damage
- remove injured cells and debris
- prepare wound for healing
106
Proliferation
- period during which new cells fill and seal a wound
- occurs 2 days to 3 weeks after inflammation phase
- characterized by the appearance of granulation tissue
107
remodeling
- period in which the wound undergoes changes and maturation
- may last 6 months to 2 years
108
granulation tissue
combo of new blood cells, fibroblasts, and epithelial cells
109
necrotic tissue
dry, brown, or black devitalized tissue
110
capillary action
movement of a liquid at the point of contact with a solid
111
sutures
knotted ties that hold incision together
112
staples
wide metal clips
113
Bandage
strip or roll of cloth wrapped around a body part
114
Binder
type of cloth generally applied to a particular body part like the abdomen or breast
115
Roller bandage principles
- elevate and support limb
- wrap from distal to proximal direction
- avoid gaps
- exert equal tension
- no wrinkles
- secure with metal clips
- check color and sensation of toes and fingers
- remove for hygiene and replace at least twice a day
116
mechanical debridement
physical removal of debris from nonhealing wounds
117
hydrotherapy
therapeutic use of water
118
irrigation
technique for flushing debris
119
wound irrigation
- before applying new dressing
- best when granulation tissue has formed
- surface tissue should be gently removed without disturbing healthy cells
120
eye irrigation
- flushes toxic chemical from eyes
| - displaces mucus or other drainage
121
ear irrigation
- removes debris from the ear
- contraindicated if eardrum is perforated
- direct solution towards the roof of the auditory canal
- afterwards loosley place a cotton ball
122
vaginal irrigation
- aka douche
- cleansing vaginal canal
- sometimes necessary to treat infection
123
primary goal for wound management
reapproximate the tissue to restore its integrity
124
Compresses
moist,warm, or cool cloths
125
aquathermia pad
an electrical heating or cooling device
126
soak
body part is submerged in fluid to provide warmth or to apply a medicated solution
127
pack
commercial device for applying moist heat
128
Therapeutic bath
those performed for other than hygiene purposes
129
Most common therapeutic bath
Sitz bath: soak of the perineal area
130
Decubitis ulcer
pressure ulcer
131
locations for pressure ulcers
- sacrum
- hips
- heels
- elbows
- shoulder blades
- back of head
