Week 2 Infections Flashcards by Steven Singh

Chain of Infection

Infectious Agent
Reservoirs
Portal of Exit
Means of Transmission
Portal of Entry
Susceptible Host

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Colonization

Describes microbes present without host inference or interaction

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Infection

Indicates host interaction with the organism

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Disease

The infected host displays a decline in wellness caused by the infection

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Information Resouces

WHO
CDC
OSHA
Local Agencies
Hospital and facility infection control specialists and facility policies and procedures

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Isolation Precautions

Guidelines to prevent the transmission of microbes in hospitals

Standard precautions in all patients

Primary strategy for preventing HAIs

Transmission- Based Precautions are for Pt with known infections diseases spread by airborne, droplet or contact routes

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Elements of Standard Precautions

Hand hygiene
Use of gloves and other barriers
Needle sticks
Proper handling of patient care equipment and linen
Environmental control
Patient Placement

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Organisms of HAI Infection Potential

C diff
MRSA
VRE
Multi Drug resistant gram negative organisms
CAUTI
CLABSI
VAP

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Airborne Precautions

Hospitalized patient should be in negative pressure with the door closed, hcp should wear N95 resp mask at all times in the room

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Droplet Precautions

Wear a face mask but door remain open, transmission limited to close contact

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Contact Precautions

Use of barriers to prevent transmission, emphasize cautious technique because organisms are easily transmitted by contact between health worker and the PT

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Prevention of Infection

HAI bloodstream infections

Community acquired infections
- Community acquired pneumonia is treated with different antibiotics than hospital acquired pneumonia

Vaccination programs

Planning for pandemic

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Diarrheal Diseases

Transmission

Causes
Bacterial
Viral
Parasitic

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STIs Infections

Syphilis
Chlamydia Trachomatis
Neisseria Gonnorhea
HIV
Trichomoniasis
Herpes
HPV

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Nursing Process The Care of the Patient c STI Assessment

Protecting privacy and confidentiality

Communication needs to be culturally and emotionally sensitive and clarification is necessary

Patient Knowledge

Physical exam includes: rashes, lesions, drainage, inguinal nodes, genitalis, rectal, mouth and throat, women need abdominal and uterine exam

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Collaborative Problems and Potential Complications

Increased risk for ectopic pregnancy
Infertility
Transmission of infection
Neurosyphillis
Gennoccal Memingitis
Gonoccal Arthritis
Syphillis Aortitis
HIV related complications

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Interventions

Education about STDs and the spread of infection

Reducing Anxiety
Encourage to discuss anxieties and fears
Provide factual information and individualized education
Assistance in planning discussion with partners
Referral to social worker

Increasing Compliance
PT education
Referral to appropriate agencies

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Emerging Infectious Agents

West Nile
Legionnaires
Pertussis
Ebola
E. Coli
Hantavirus Pulmonary Syndrome

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Principles of Antimicrobial

Goal of therapy

Prevent and treat infection caused by pathogenic organisms

Drug Selection

Depends on organism causing infection
Severity of infection
Other Factors

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Beta Lactam Antibacterials

Penicillins
Cephalosporins
Carbapenems
Monobactams

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Penicillin

Safe, effective, widely used ATB

First ATB developed
- Had to be given parenterally
Destroyed by gastric acid
Injections were painful

Extensive use produced drug- resistant stains of Staphy

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Penicillin

Take on empty stomach 1 hour before or 2 hour before except Amoxicillin taken with meals

Indications for use
BActrial infections caused by susceptible organisms
More effective in gram + than gram - infections
Skin/ soft tissue, resp. GI, and GU infections
Incidents of resistance continue to increase

Contraindications
Hypersensitivity/ allergic reaction to any penecillin preparation
Potential exists for cross allergenicity with cephalosporins and carbapenems use to be avoided

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Penecillin Resistant Penicillins

Dicloxicillin
Naficillin
Oxacillin

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Aminopenecillins

Ampicillin
Amoxicillin
Pepercillin

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Penicillin Beta Lactamase Inhibitor Combinations

Ampillicin Sulbactam Pipercillin tazobactam

Cephalosporins

Derived from fungus Broad spectrum ATB goes against gram + and gram - Widely distributed into most body fluids and tissues Max conct in liver and kidneys Clinical Use Surgical Prophylaxis Infections Resp. Tract and urinary tract Skin, soft tissues Bones, joints Brain, spinal cord Contra in Previous anaphylatic reactions Cephalsporin allergy

Cefazolin

1st gen

2nd Generation

Cefotetan Cefoxitin Cefuroxime Ceftazidime

3rd Generation

Cetriaxone

4th Generation

Cefepime

5th Gen

Certaroline

Carbapenems

Broad Spectrum, bactericidal beta lactam anti microbials Inhibit synthesis of bacterial cell walls by binding with penicillin binding proteins

Imipenem Doripenem Ertapenem Meropenem

All are Carbapenems

Monobactams are active against bacteria

Gram - active against many strains that are antibody resistant Does NOT cause kidney damage or hearing loss Indications use for Urinary Tract, lower Respiratory, intra abdominal and gynecologic infections, septicemia

Examples of Monobactams

Aztreonam

Glycopeptide Antibiotic

Vancomycin Treats C diff

Side effects of Vancomycin

Hypotension SOB Dizziness Headache Chills Fever Chest Pain Red Man Syndrome c IV use

Introduction to Fungi

Include Yeasts and Molds Widely dispersed in environment Saprophytic: Feed on dead organic matter Parasitic- Feed on living organisms Larger and more complex than bacteria

Multicellular Organisms that form fuzzy coating on various surfaces can produce spores, which can persist indefinitely in the environment

Molds

Yeasts

Unicellular organisms Dermatophytes

Pathogens exist in

Soil, decaying plants Other environmental habitats Normal Flora ( candida albicans) Skin, mouth, GI tract, vagina

Dematophytes

Mild and Superficial Skin, hair, and nails: obtain nourishment from keratin Tinea Pedis- Athletes foot Tinea Captis- Ringworm

What are Mycoses?

Life threatening and systemic Mainly in immunosuppressed hosts More severe and invasive in immunocompromised

Why are serious fungal infections increasing?

HIV Use of immonosupressants Cancer, organ transplant patients Use of Indwelling caths Central Lines Prosthetic Devices Overuse of broad spectrum antibiotics

Name selected Fungal Infections

Aspergillosis Blastomycosis Candidasis Coccidiodmycosis Crytocossis Histoplasmosis Pneumocytosis Sporotrichosis

Fungal cells are similar to

Human cells Make sit difficult to develop effective antifungals

Where do antifungal medications target?

The cell membrane - Produce potentially serious toxicities and drug interactions Disrupt Structure and function of cell components Polyenes Azoles Echinocandins

Polyenes

Amphotericin B Nephrotoxic IV administered

Nystatin

Mycostatin Cream powder Ointment Suspension/Tablets oral thrush- candidasis

What is used for vaginal candidasis?

Fluconazole

Name the Azoles

Used PO, single dose, Parenteral Itraconazole Ketconzaloe Posaconazole Voriconazole

Echocandins include ?

Caspofungin Anidulafungin Micafungin Used IV

Other fungals include :

Griseofulvin Terbinafine Pyrimidine

Viral STDs

HIV HPV Herpes Hepatitis

Bacterial STDs

Syphilis Gonnorhea Chlymadia

Protozoal STD

Trichomonasis, crabs, pubic lice, scabies

Education on STDs

Decreasing the spread Safe Sex practices Abstinence Active infection- Have partner to be treated

Covid 19 Risk Factors

Age Obesity CV: HTN, CHF, CAD, cardiomyopathies Diabetes CKD COPD/TB/ Asthma Chronic Liver disease Cystic Fibrosis HIV/ Cancer/ Certain Meds ex ACEs and ARBs

Diagnostics

Labs Lymphophenia Neutrophillia Elevated AST and ALT Elevated Lactate Elevated CRP Elevated Ferritin Elevated D Dimer Elevated Prolactin Chest X ray and Chest CT -Unremarkable early in disease Bilateral air space consolidation

Chest Radiographs

Ground Glass Opacities See Xrays

Management and Treatment

Severe Clinical Presentation Present: Pneumonia ARDs Resp. Failure (Hypoxemic) Sepsis Septic Shock Cardiomyopathy and Arrythmias AKI Secondary Bacterial Infections HAIs -Due to prolonged hospital admission Treatment: Experimental corticosteroid use Supportive care includes: Treatment of PNA Trx hypoxemic respiratory failure/ ARDs -Mechanical Ventilation - Sepsis/ Shock/ Multiorgan failure - Affects of HAIs - Thromboembolism

Week 2 Infections Flashcards

(61 cards)