Asepsis

Antibody-Mediated Defenses

humoral (or circulating) immunity because the defenses reside ultimately in the B lymphocytes and are mediated by antibodies produced by B cells.

Systemic Infection:

if a microorganism spreads and damages different parts of the body, this is an internal infection.

Fungi

include yeast and molds. *candida albicans is a yeast considered to be normal flora in the human vagina*

Carrier State

one who is infected but free from disease. This may also exist in individuals with a clinically recognizable disease such as dogs with rabies. The carrier state may be: -short duration (temporary or transient carrier) -long duration (chronic carrier)

Blood-borne Pathogens

organisms in blood

Endogenous Source

nosocomial infections can originate from the clients themselves. *Most nosocomial infections appear to have endogenous sources*

Cell-Mediated Defenses:

occur through the T cell system. On exposure to an antigen, the lymphoid tissues release large numbers of activate T cells into the lymph system.

Respiratory hygiene/Cough etiquette:

that calls for covering the mouth and nose when sneezing or coughing, proper disposal of tissues, and separating potentially infected individuals from others by at least 1 m (3ft) or having them wear a surgical mask.

Pathogenicity

the ability to produce disease. *a pathogen is a microorganism that causes disease*

Sepsis

the condition in which acute organ dysfunction occurs secondary to infection.

Susceptibility

the degree to which an individual can be affected, the liklihood of an organism causing an infection in that person.

Latrogenic Infections

the direct result of diagnostic or therapeutic procedures. Ex: iatrogenic infection is bacteremia that results from an IV infusion line.

Etiologic Agent or microorganism:

the extent to which any microorganism is capable of producing an infectious process depends on: -the number of microorganisms present -the virulence and potency of the microorganisms (pathogenicity) -the ability of the microorganisms to enter the body -the susceptibility of the host -the ability of the microorganisms to live in the host's body

Evalutation:

the final step, compare client's response with expected outcomes.

Disinfecting and Sterilizing

the first links in the chain of infection, the etiologic agent and the reservoir, are interrupted by the use of *antiseptics* (agents that inhibit the growth of some microorganism) and *disinfectants* (agents that destroy pathogens other than spores) and by sterilization.

Laboratory Data:

the following would present an infection: -Elevated leukocyte (WBC) count (4,500-11,000/mL is normal) -Increases in specific types of leukocytes as revealed in the differential WBC count. Specific WBC are increased or decreased in certain infections. -Elevated erythrocyte sedimentation rate (ESR). Red Blood cells normally settle slowly, but the rate increases in the presence of an inflammatory process. Urine, blood, sputum, or other drainage cultures (laboratory cultivation of microorganism in a special growth medium) that indicate the presence of pathogenic microorganisms

Asepsis

the freedom from disease causing micro-organisms. To decrease the possibility of transferring microorganisms from one place to another this technique is used.

Infection

the growth of microorganisms in body tissue where they are not usually found. *such microorganism is called an infectious agent*

Inflammatory Response characterized by 5 signs and 3 stages:

*3 stages:* -First Stage (vascular and cellular response) -Second Stage (exudate production) -Third Stage (reparative phase) *5 signs* 1-pain 2-swelling 3-redness 4-heat 5-impaired function of the part (if the injury is severe) *commonly words with the suffix -itis describe an inflammatory response EX: appendicitis means inflammation of the appendix*

Hand Hygiene

*most important in every setting. It is considered one of the most effective infection prevention measures.* -vigorous hand washing under a stream of water for 15-20 seconds using granular soap, soap filled sheets, or liquid soap at the beginning of the nurse's shift, when hands are visibly soiled, and after using the toilet -Antimicrobial soaps are used in high risk areas. CDC recommends to use antimicrobial hand hygiene agents: -when there are known multiple resistant bacteria -before invasive procedures -in special care units, such as nurseries and ICU -before caring for severely immunocompromised clients *if the nurse develops dermatitis, the client may be at higher risk b/c hand washing is does not decrease bacterial counts on skin with dermatitis. The nurse is also at higher risk because the normal skin barrier has been broken.*

Factors increasing susceptibility to infection:

*one of the most important factors is host susceptibility, which is affected by age, heredity, level of stress, nutritional status, current medical therapy, and preexisting disease processes* -heredity influences the development of infection in that some people have a genetic susceptibility to certain infections -Stress elevates blood cortisone. Prolonged elevation of blood cortisol decreases anti-inflammatory responses, depletes energy stores, leads to a state of exhaustion, and decreases resistance to infection. -Resistance to infection depends on adequate nutritional status. B/c antibodies are proteins, the ability to synthesize antibodies may be impaired by inadequate nutrition, especially when protein reserves are depleted. -Medical therapies predispose a person to infection. Example: radiation treatments for cancer destroy not only cancer cells but also some normal cells -Diagnostic Procedures may also predispose the client to an infection, especially when the skin is broken or sterile body cavities are penetrated during the procedure. -Any disease that lessens the body's defenses against infection places the client at risk. EX: chronic pulmonary disease, which impairs ciliary action and weakens the mucous barrier; peripheral vascular disease. *DM is a major underlying disease vascular status and increased serum glucose levels increase susceptibility*.

Collaborative Nursing Diagnosis:

-*potential complication for infection*:fever -*imbalanced nutrition: less than body requirements* if the client is too ill to eat adequately -*acute pain* if the client is experiencing tissue damage and discomfort -*impaired social interaction or social isolation* if the client is required to be separated from other during a contagious episode -*anxiety* if the client is apprehensive regarding changes in life activities resulting from the infection or its treatment such as absence from work or inability to perform usual functions.

Psychosocial Needs of Isolated Clients:

-*sensory deprivations* : occurs when the environment lacks normal stimuli for the client, for example, communication with others. Signs include: -boredom -inactivity -slowness of thought -daydreaming -increased sleeping -though disorganization -anxiety -hallucinations -panic -*decreased self esteem r/t feelings of inferiority.*

Measures can reduce a person's susceptibility:

-Hygiene -Nutrition -Fluid -Sleep -Stress -Immunizations

Infectious Process:

-Incubation Stage (between entrance of pathogen and appearance of first S&S) -Prodromal Stage (capable of spreading to other people, general, non-specific S&S) -Illness Stage (specific S&S for type of illness/infection) -Convalescence Stage (acute S&S disappear, time of recovery. Based on severity)

Anatomic and Physiological Barriers:

-Intact skin and mucous membranes are the body's first line of defense against microorganisms. *Unless the kin and mucosa become broken, they are effective barrier against bacteria.* -Fungi can live on the skin, but *CANNOT* penetrate it. -The dryness of the skin is also a deterrent to bacteria. -Resident bacteria also prevents other bacteria from multiplying -Normal secretions make the skin slightly acidic; a acidity also inhibits bacterial growth -Nasal passage defensive mechanism: air follows the tortuous route of passage, it comes in contact with moist mucous membranes and cilia. *These trap microorganisms, dust, and foreign materials.* -Lungs have alveolar macrophages (phagocytes) that ingest microorganisms, dead cells, and foreign particles. -The eye is protected from infection by tears, which continually wash microorganisms away and contain inhibiting lysozyme. -High acidity of the stomach normally prevents microbial growth.

Two types of asepsic techniques:

-Medical -Surgical

Considerations for older adults and infections:

-Nutrition is often poor in older adults. Certain components especially adequate protein, are necessary to build up and maintain the immune system -DM, which occurs more frequently in older adults, increases the risk of infection and delayed healing by causing an alteration in nutrition and impaired peripheral circulation, which decrease oxygen transport to the tissues. -The immune system reacts slowly to the introduction of antigens, allowing the antigen to reproduce itself several times before it is recognized by the immune system. T-cell effectiveness is often decreased due to immaturity. -The normal inflammatory response is delayed. Atypical symptoms such as confusion, and disorientation, agitation, incontinence, falls, lethargy, and general fatigue are often seen first.

Acute and Chronic infection:

-acute infection: generally appear suddenly or last a short time. -chronic infection: may occur slowly, over a very long period, and may last months or years.

Principles of surgical asespsis:

-all objects used in a sterile field must be sterile -sterile objects become unsterile when touched by unsterile objects -sterile objects that are out of sight or below the waist or table level are considered unsterile -sterile objects can become unsterile by prolonged exposure to airborne microorganism -fluids flow in the direction of gravity -moisture that passes through a sterile object draws microorganism from unsterile surface by capillary action -the edges of a sterile field are considered unsterile -the skin cannot be sterilized and is unsterile -conscientiousness, alertness, and honesty are essential qualities in maintaining asepsis technique.

Proper use of alcohol based products:

-apply a palmful of product into cupped hand, enough to cover all surfaces of both hands -rub palms against palms -interlace fingers palms into palms -rub palms to back of hands -rub all surfaces of each finger with opposite hands -*continue until product is dry-about 20 to 30 seconds*

Four major categories of microorganisms that cause infection in humans:

-bacteria -fungi -viruses -parasites

First Stage (vascular and cellular response)

-blood vessels at the site of injury constrict. -followed by dilation of small blood vessels (occurring as a result of histamine released by the injured tissue) thus, more blood flows to the area. This is referred to as *hyperemia* and is responsible for the characteristic signs of *redness and heat* -vascular permeability increases at the site with dilation of the vessels in response to cell death, the release of chemical mediators and the release of histamine -fluid protein and leukocytes leak into the interstitial spaces, and the signs of *inflammation*-swelling (edema) and pain-appear. -*pain* is caused by the pressure of accumulating fluid on nerve endings and the irritating chemical mediators. -in response to the exit of leukocytes from the blood, the bone marrow produces large numbers of leukocytes and releases them into the blood stream this is called *leukocytosis*

Order to *REMOVE* PPE:

-gloves -perform hand hygiene -remove protective eye wear -remove gown when preparing to leave the room -remove mask (*do not touch front of the mask*) -perform hand hygiene again

Order to *PUT ON* PPE:

-hand hygiene -gown -face mask -(apply eye wear if called for) -apply clean gloves

Planning:

-maintain or restore defenses -avoid the spread of infectious organisms -reduce or alleviate problems associated with the infection *Nursing strategies to meet these goals include:* -using meticulous medical and surgical aseptic techniques to prevent the spread of potentially infectious microorganisms -implementing measures to support the defenses of a susceptible host -teaching clients about protective measures to prevent infections and the spread of infectious agents when an infection is present

Applying Sterile Gloves:

-perform hand hygiene -place package of gloves on a clean, dry, surface -open the outer package without contaminating the gloves or the inner package -remove the inner package from the outer package -put the first glove on the dominate hand -put second glove on nondominant hand -remove and dispose of used gloves

Injurious Agents:

-physical agents (include mechanical objects causing trauma to tissues, excessive heat or cold, and radiation) -chemical agents (include external irritants such as strong acids, alkalis, poisons, and irritating gases) -Internal Irritants (substances manufactured within the body such as excessive hydrochloric acid in the stomach)

Body Defenses Against Infection:

-specific (immune) defenses: are directed against identifiable bacteria, viruses, fungi, or other infectious agents -nonspecific defenses: protect the person against all microorganism, regardless of prior exposure. *anatomic and physiological barriers and the inflammatory response*

Isolation guidelines two-tier approach:

-standard precautions -transmission based precautions

Steps to follow after exposure to bloodborne pathogens:

-test for the source of Hebp B, C, and HIV when feasible consent is given *Hep B and C spread most commonly through needle sticks*

Assessing:

-the nurse obtains the client's history -conducts the physical assessment -gathers laboratory data

Consider the following when disinfecting articles:

-the type and number of infectious organisms. Some microorganisms are readily destroyed, whereas others require longer contact with the disinfectant -the recommended concentration of the disinfectant and the duration of contact -the presence of soap. some disinfectants are ineffective in the presence of soap or detergent -the presence of organic materials. the presence of saliva, blood, pus, or excretions can readily inactivate many disinfectants. -the surface areas to be treated. The disinfecting agent must come into contact with all surfaces and areas.

CDC promotes alcohol based hand rubs because:

-they kill bacteria more effectively and more quickly than hand washing with soap and water -they are less damaging to skin than soap and water, resulting in less dryness and irritation -they require less time than hand washing with soad and water -bottle/dispensers can be placed at the point of care so they are more accessible

Isolation Practices:

-use strict aseptic technique when performing any invasive procedure and when changing surgical dressings -change IV tubing and solution containers according to hospital policies *every 48-72 hours* -check all sterile supplies for expiration date and intact packaging -prevent urinary infections by maintaining a closed urinary drainage system with a *downhill flow of urine*. Keep the drainage bag and spout off the floor. -Implement measures to prevent impaired skin integrity and to prevent accumulation of secretions in the lungs (ex: have client move, cough, and breathe deeply at least every 2 hours)

Nosocomial Infections can be prevented by:

-using proper hand hygiene -environmental controls -sterile technique -identification and management of clients at risk for infections

Microorganisms vary in:

-virulence (their ability to produce disease) -severity of the diseases they produce -degree of communicability

Chain of infection:

6 links make up the chain. -the etiologic agent or microorganism -reservoir (where the organism naturally resides) -portal of exit from the reservoir -a method (mode of transmission) -portal of entry into a host -the susceptibility of the host

Disinfecting

A disinfectant is a chemical preparation, such as phenol or iodine compounds, used on inanimate objects. disinfectants are frequently caustic and toxic to tissues. It is a more concentrated solution. Both antiseptics and disinfectants are said to have bactericidal or bacteriostatic properties.

Diagnosing

Risk for infection, the state in which an individual is at increased risk for being invaded by pathogenic microorganisms. Identify risk factors such as: -inadequate primary defense such as *broken skin, traumatized tissue, decreased ciliary action, statis of body fluids, change in pH of secretions, or altered peristalsis. -inadequate secondary defenses such a leuopenia, immunosuppression, decreased hemoglobin, or suppressed inflammatory response.

Physical Assessment:

S&S of an infection vary according to the body area involved. Commonly the skin and mucous membranes are involved in a *local infectious process*, resulting in the following: -localized swelling -localized redness -pain or tenderness with palpation or movement -palpable heat at the infected area -loss of function of the body part affected, depending on the site and extent of involvement S&S of a *systemic infection* include: -fever -increased pulse and respiratory rate if the fever is high -malaise and loss of energy -anorexia and, in some situations, nausea and vomiting -enlargement and tenderness of lymph nodes that drain the area of infection

Compromised Host

a client whose normal defenses have been lowered by treatments or illnesses. This person has an increased risk. For one or more reasons is more likely than others to acquire an infection. *Examples of compromised host or client*: -having skin impairments, such as severe dermatitis or major burns, which cannot be effectively covered with dressings.

Disease

a detectable alteration in normal tissue function.

Inflammation:

a local and nonspecific defensive response of the tissues to an injurious or infectious agent. It is an adaptive mechanism that: -destroys or dilutes the injurious agent -prevents further spread of the injury -promotes the repair of damaged tissue

Opportunistic Pathogen

a pathogen that only causes disease in a susceptible individual.

Carrier

a person or animal reservoir of a specific infectious agent that usually doesn't manifest any clinical sign of disease.

Antigen

a substance that induces a state of sensitivity or immune responsiveness (immunity)

Method of Transmission:

after a microorganism leaves it source or reservoir; it requires a means of transmission to reach another person or host through a receptive portal entry. *3 Mechanisms are: direct transmission, indirect transmission, airborne transmission.*

Antiseptic

agents that inhibit the growth of some microorganisms. An antiseptic is a chemical preparation used on skin or tissue.

Personal Protective Equipment (PPE)

all health care providers must provide PPE (clean or sterile gloves, gowns, masks, and protective eyewear) according to the risk of exposure to potentially infective materials.

Antibodies

also called immunoglobulins, are part of the body's plasma proteins. The antibody-mediated responses defend primarily against the extracellular phases of bacterial and viral infections.

Surgical Asepsis

also known as sterile technique. Refers to those practices that keep an area or object free of all microorganisms; it includes practices that destroy all microorganisms and spores. *it is used for all procedures involving sterile areas of the body.* *an object is sterile only when it is free of ALL microorganism*

Susceptible Host:

any person who is at risk for infection. Impairment of the body's natural defenses and a number of other factors can affect susceptibility to infection. Examples are: -age *(the very young and the very old)* -clients receiving immune suppression treatment for cancer -chronic illnesses -following a successful organ transplant -immune deficiency conditions

Contact Precautions

are used for clients known to have or suspected of having serious illnesses easily transmitted by direct client contact or by contact with items in the client's environment. *Examples of contact illnesses*: -GI infections -Respiratory infections -skin infections -wound infections or colonization with muti-drug resistant bacteria. *MRSA requires contact precautions. More Americans die from MRSA than AIDS each year.* Special contact precautions are used for vancomycin-resistant enterococci (VRE) infections. CDC recommends use of antibacterial soap for hand washing and no sharing of equipment among clients with and without VRE.

Airborne Precautions

are used for clients known to have or suspected of having serious illnesses transmitted by airborne droplet nuclei smaller than 5 microns. *Examples of airborne diseases*: -measles (rubeola) -varicella (including disseminated zoster) -TB *Guidelines*: -place client in airborne infection isolation room (AIIR), it is a private room that has negative air pressure,6-12 air changes per hours -wear N95 mask -place surgical mask on the client during transport

Transmission bases Precautions:

are used to protect the nurse and others from acquiring the infectious organism. These precautions are used in addition to SP when those precautions do not completely block the chain of infection and the infections are spread in one of three ways by airborne or droplet transmission or by contact. Transmission based precautions may be used singly or in combination.

Portal of Entry to the Susceptible Host:

before a person is infected, microorganisms must enter the body. The skin is a barrier to infectious agents; however any break in the skin can readily serve as a portal of entry. *Often, microorganisms enter the body of the host by the same route they used to leave the source*

Portal of Exit from Reservoir

before an infection can establish itself in a host, the microorganisms must leave the reservoir. Examples: -Respiratory Tract (nose or mouth through sneezing, coughing, breathing, or talking) -GI Tract (mouth: saliva, vomitus, Anus: feces, Ostomies: feces) -Urinary Tract (urethral meatus and urinary diversion) -Reproductive Tract (Vagina: vaginal discharge, Urinary meatus: semen, urine) -Blood (open wound, needle puncture site, any disruption of intact skin or mucous membrane surfaces) -Tissue (drainage from a cut or wound)

Indirect Transmission

can be either vehicle borne or vector borne. -Vehicle-borne Transmission: a vehicle is any substance that serves as infectious agent into a susceptible host through a suitable portal of entry. *Fomites (inanimate materials or objects), such as handkerchiefs, toys, soiled clothes, cooking, or eating utensils, and surgical instruments or dressings can act as vehicles. Water, food, serum, blood, and plasma.* -Vector-borne Transmission: a vector is an animal or flying or crawling insect that serves as an intermediate means of transporting the infectious agent. Transmission may occur by injecting salivary fluid during biting or by depositing feces or other materials on the skin through the bite wound or a traumatized skin area.

True Pathogen:

causes disease or infection in a healthy individual.

Nosocomial Infections:

classified as infections that originate in the hospital. This is a subgroup if *health care-associated infections (HAIs)-those that originate in any health care setting* Not all are preventable or iratrogenic.

Disease that requires combination of contact and transmission based precautions:

clients infected with the coronavirus that causes severe acute respiratory syndrome (SARS-CoV), standard including eye protection, contact and airborne precautions are indicated.

Viruses

consist primarily of nucleic acid and therefore must enter living cells in order to reproduce. *Common viruses include: rhinovirus (causes the common cold), hepatitis, herpes, and human immunodeficiency virus)*

Granulation Tissue:

damaged tissues are replaced with the connective tissue elements of collagen, blood capillaries, lymphatics, and other tissue bound substances. It is a fragile, gelatinous tissue, appearing pink or red b/c of the many newly formed capillaries. Later in the process, the tissue shrinks (the capillaries are constricted, even obliterated) and the collagen fibers contract, so that firmer fibrous tissue remains.

Nursing History:

during nursing history, the nurse assesses: -the degree to which a client is at risk of developing an infection *(to identify this, the nurse reviews the client's chart and structures the nursing interview to collect data regarding the factors influecning the development of infection, especially exsisting disease processes. history of recurrent infections, current mediccations, and therapeutic measures, current emotional stressors, nutrional status, and history of immunizations)* -any client complaints suggesting the presence of an infection

Medical Asepsis:

includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth, and transmission of microorganisms. *objects are referred to as clean (absence of almost all microorganisms) or dirty (soiled, contaminated), which means likely to have microorganisms, which may cause an infection.

Communicable Disease

infectious agent being able to be transmitted to an individual by direct or indirect contact or as a airborne infection.

Specific Defenses:

involve the immune system. The immune response has 2 components: -antibody mediated defenses -cell mediated defenses

Direct Transmission:

involves immediate and direct transfer of microorganisms from person to person through touching, biting, kissing, or sexual intercourse. *Droplet spread is also a form of direct transmission but can only occur if the source and the host are within 1m (3 ft) of each other*

Sterile Field

is a microorganism free area. Nurses often establish a sterile field by using the innermost side of a sterile wrapper or by using a sterile drape.

Local Infection:

is limited to the specific part of the body where the microorganisms remain.

Parasites

live on other living organisms. *examples are: protozoa (such as the one that causes malaria), helminths (worms), and arthropods (mites, fleas, ticks)

Sterile Gloves

may be applied by the open or closed method. -*open method*: most frequently used outside the operating room because the closed method requires that the nurses wear a sterile gown

Airborne Transmission:

may involve droplets or dust. The material is transmitted by air currents to a suitable portal of entry, usually the respiratory tract, of another person. *Droplet nuclei, the residue of evaporated droplets emitted by an infected host such a someone with TB, can remain in the air for long periods.*

Exogenous Source

microorganisms that cause infection which stem from the hospital environment and hospital personnel.

Disease Specific Isolation Precautions:

provide precautions for specific diseases. These precautions delineate use of private rooms with special ventilation, having the client share a room with other clients infected with the same organism, and gowning to prevent from soilage of clothes for specific infectious diseases.

Isolation

refers to measures designed to prevent the spread of infections or potentially infectious microorganisms to health personnel, clients, and visitors.

Standard Precaution (SP) or Universal Precautions (UP)

reflecting their applicability in all client care situations. Health care professionals use SP when providing care to all clients. Used in the care of all hospitalized individuals regardless of their diagnosis or possible infection status. Used in any situation involving blood, all body fluids, excretions, and secretions except sweat (whether or not blood is present or visible), nonintact skin, and mucous membranes. *SP includes:* -hand hygiene -use of PPE (which include gloves, gowns, eyewear, and masks) -safe injection practices -safe handling of potentially contaminated equipment or surfaces in the client environment -respiratory hygiene/cough etiquette

Exudate Production:

second stage of inflammation, the inflammatory exudate, is produced, consisting of fluid that escaped from the blood vessels, dead phagocytic cells, and dead tissue cells and products that they release.

Occupational Exposure

skin, eye, mucous membrane or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties

Reservoir

sources of microorganisms. Common sources include: -other humans *(most common source of infection)* -the client's own microorganisms -plants -animals -general environment -food -water -feces

Steriling

sterilization is a process that destroys all microorganisms, including spores and viruses. Four commonly used methods of sterilizations are: *moist heat* (to steralize with moist heat, such as with an autoclave, steam under pressure is used because it attains temperatures higher than the boiling point. *gas* (ethylene oxide gas destroys microorganisms by interfering with their metabolic processes. effective against spores. Its advantages are food penetration and effectiveness for heat sensitive items. Its major disadvantage is its toxicity to human) *boiling water* (the most practical and inexpensive method for sterilizing in the home. The main disadvantage is that spores and some viruses are not killed by this method. Boiling a minimum of 15 minutes is advised for disinfection of articles in the home.) *radiation* (both ionizing (such as alpha, beta, and x rays) and nonionizing (UV light) radiation are used for disinfection and sterilization. The main drawback to UV light is that the rays do not penetrate deeply.

Hand Hygiene Importance:

the hands of personnel are a common vehicle for the spread of microorganisms. Insufficient hand hygiene is thus an important factor contributing to the spread of nosocomial microorganisms.

Active Immunity

the host *PRODUCES* antibodies in response to natural antigens (infectious microorganisms) or artificial antigens (vaccines). B Cells are activated when they recognize the antigen. Natural Duration: LIFELONG Artificial Duration: many years: the immunity must be reinforced by booster

Passive (acquired) Immunity

the host *RECEIVES* natural (from a nursing mother) or artificial (from an injection of immune serum) antibodies produced by another source. Natural Duration: 6 months - 1 year Artificial Duration: 2-3 weeks

Bacteria

the most common infection-causing microorgansims. *can be transported through air, water, food, soil, body tissues, and inanimate objects*

Implementing:

the nurse implements strategies to prevent infection. If infection cannot be prevented, the nurse's goal is to *prevent the spread of the infection within and between individuals, and to treat the existing infection* Nursing activities are those that *interfere with the chain of infection to prevent and control transmission of infectious organisms, and that promote care of the infected client*

Colonization:

the process by which strains of microorganisms become resident flora. In this state, the microorganism may grow and multiply but *DO NOT* cause a disease.

Autoantigen

the proteins originate in a person's own body.

Regeneration:

the replacement of destroyed tissue cells by cells that are identical or similar in structure and function. When regeneration is not possible, repair occurs by fibrous (scar) tissue formation.

Reparative Phase:

third stage of the inflammatory response involves the repair of injured tissues by regeneration or replacement with fibrous tissue (scar) formation. Regeneration and Granulation tissue can be found during this phase.

Leukocyte levels increase during inflammation:

to 20,000 from the normal values being 4500-11000

Hand washing with soap and water may be inadequate:

to sufficiently remove pathogens, particularly because health care personnel tend to not wash thoroughly. After the initial hand washing, CDC recommends the use of alcohol based antiseptic hand rubs before and after each direct client contact.

Category Specific Isolation precautions:

use 7 categories: -strict isolation -contact isolation -respiratory isolation -TB isolation -enteric precautions -drainage/secretions precautions -blood/body fluid precautions

Droplet Precautions

used for clients known to have or suspected of having serious illnesses transmitted by particle droplets larger than 5 microns. *Examples of droplet diseases*: -diphtheria (pharyngeal) -mycoplasma pneumonia -pertussis -mumps -rubella -steptococcal pharyngitis -pneumonia -scarlet fevever in infants -pneumonic plague *Guidelines*: -place client in private room -wear a mask 1 m (3ft) of the client -place surgical mask during transportation

Bacteremia

when a culture of the person's blood reveals microorganisms.

Septicemia

when bacteremia results in systemic infection. This has become more common over time.

Asymptomatic or subclinical:

when the microorganism produces no clinical evidence of disease.

Gloves

worn for 3 reasons. -protect the hands when the nurse is likely to handle any body substances -reduce the likelihood of nurses transmitting their own endogenous microorganisms to individuals receiving care. -reduce the chance that the nurse's hands will transmit microorganisms from one client or an object to another client. *Nitrile gloves are preferable for clinical procedures that require manual dexterity and/or will involve more than brief client contact.*

Face Masks

worn to reduce the risk for transmission of organisms by the droplet contact and airborne routes and by splatters of body substances. CDC recommends mask to be worn when: -those close to the client if the infection is transmitted by large particle aerosols (droplets). (They travel short distances) -by all individuals entering the room if the infection is transmitted by small particle aerosols. *Single Use disposable surgical masks*: are effective for use while the nurse provides care to most clients but should be changed if they become soiled or wet.

Gowns:

worn when the nurse's uniform is likely to be soiled. -*Steril gowns* may be indicated when the nurse changes the dressings of a client with extensive wounds (burns) -*Singe Use Gown technique* is the usual practice in hospitals.