Concept of infection
susceptible host
Tx of underlying risk, recognition of high-risk PTs, nutrition, mobilization, safe practices, isolation
Droplet precaution
clients who are known to have or suspected of having serious illnesses transmitted by particle droplets larger than 5 microns EX: M. Pneumoniae, Influenza, mumps, rubella, diphtheria, streptococcal pharyngitis
serosanguinous
clear or blood-tinged discharge commonly seen in surgical incisions
contact precautions
clients who are known to have or suspected of having serious illnesses that are easily transmitted by direct client contact or by contact with items in the client's environment EX: C. diff, shigella, hep. A
local infection
infection limited to a specific part of the body
systemic infection
infection that has spread and damaged different parts of the body
procedures and situations that affect likelihood of infection
1. Puncture wounds from contaminated needles or other sharps 2. Skin contact, which allows infectious fluids to enter through wounds and broken or damaged skin 3. Mucous membrane contact, which allows infectious fluids to enter through mucous membranes of the eyes, mouth, or nose. 4. Chemotherapy 5. The use of corticosteroids 6. Radiation therapy 7. Urinary catheterization 8. Respiratory care procedures such as ventilators 9. Surgical procedures are closely linked to HAIs
culture and sensitivity
A culture is a test to find germs (such as bacteria or a fungus) that can cause an infection --identifying the pathogen A sensitivity test checks to see what kind of medicine, such as an antibiotic, will work best to treat the illness or infection --drawn prior to antibiotic administration
diagnostics
CBC WBC >11.0mm3 (11 years and more adults) elevated B and T lymphocyte, neutrophil and monocyte indicative of bacterial or viral infection significant elevation of neutrophils - BACTERIAL infection elevation of neutrophil and basophil - PARASITIC infection Bands - immature neutrophils, greater than 6% of total neutrophils, indicate acute bacterial infection
compromised host - chronic disease and associated treatments
DM, cancer, hepatic disorders increase vulnerability to infecton medical therapy - antineoplastic, corticosteroids, antibiotics, presence of invasive devices (IV siste, catheter insertion, intubation)
Asymptomatic
No clinical evidence of disease, even with an invasion by microorganisms.
disease-specific isolation precautions (specific)
Provide precautions to protect against a specific disease. These precautions call for use of private rooms with special ventilation, sharing of rooms only with other clients infected with the same organism, and gowning to prevent gross soilage of clothes for specific infectious diseases
Category-specific Isolation Precautions: (Non-specific)
Strict isolation, Contact isolation, Respiratory isolation, Tuberculosis isolation, Enteric precautions, Drainage/Secretions precautions, and Blood/Body Fluid precautions
Describe the role of the nurse in obtaining or having specimens obtained prior to becoming antimicrobial treatment
The nurse is able to obtain the sample without an order. If they have a suspicion that the specimen will be ordered
disposal of soiled equipment and supplies
bagging linens lab specimens dishes blood pressure equipment disposable needles, syringes, and sharps disposable equipment and supplies nondisposable equipment and supplies
nutrition
a balanced diet enhances the health of all body tissues, helps keep the skin intact, and promotes the skin's ability to repel microorgs. adequate nutrition enables tissues to maintain and rebuild themselves and helps keep the immune system functioning well. in addition, because antibodies are proteins, inadequate nutrition can impair the body's ability to synthesize them, especially when protein reserves are depleted.
asepsis
absence of disease-causing microorganisms
Risk factors
age - infant immune system is immature elderly - changes take place in skin, respiratory tract, GI system, kidneys, and immune system that may predispose
bactericidal
an agent that destroys bacteria
susceptible host
an individual at increased risk for one or more reasons is more likely than others to acquire an infection
nonspecific defenses
anatomical and physiological barriers and the inflammatory response
broad spectrum antibiotics
antibiotic that acts against a wide range of disease-causing bacteria. A broad-spectrum antibiotic acts against both Gram-positive and Gram-negative bacteria,
portal of exit
break by hand hygiene, waste disposal, control of body fluids, PPE
antibiotics
broad spectrum peak and trough level monitor wbc monitor site of infection
C. diff vs MRSA
c. diff -Healthcare workers should follow isolation guidelines, which include the use of gloves and gowns when taking care of patients with C-diff. Keep in mind, hand sanitizers do not kill the C-diff bacteria. Always wash your hands with soap and water after patient care. MRSA - using standard precautions, such as gloves and gowns, when treating patients with MRSA. As always, hand washing is one of the best ways to prevent the spread of infections like MRSA.
reservoirs
can break by immunization, staff health, hygiene, environmental cleaning, food safety, disinfection sterilization
microorganism
can break first chain by identification and appropriate antibiotics
portal of entry
catheter care, hygiene, wound care, skin preparation, aseptic procedure, PPE
geographical location
cholera
narrow spectrum antibiotics
effective against specific families of bacteria
purulent
containing, consisting of pus
radiological examination
do not lead to confirmation of infection help visualize possibility of infection and/or its extend of infection
sleep
essential to maintaining health and renewing energy
Chain of infection
etiologic agent - microorganism - bacteria, fungi, protozoa, viruses, prions reservoir - source (where they thrive) - people, food, equipment, water (characteristic of/dependent on nutrients, O2, moist/dry, pH, temp.) EX: mouth, intestines, nose and skin in people portal of exit from reservoir (body fluids, skin, droplets) method of transmission - direct contact, ingestion, airborne, fomites portal of entry to the susceptible host - broken skin, GI tract, mucous membrane, respiratory tract susceptible host - immunosuppression, diabetes, immobility, age, surgery, cancer, normal flora suppression
stress
excessive stress predisposes people to infections. nature, number, and duration of stressors can influence susceptibility to infection. stressors elevate blood cortisone, and the prolonged elevation of blood cortisone decreases anti-inflammatory responses, depletes energy stores, leads to a state of exhaustion, and decreases resistance to infection.
fluid
fluid intake permits fluid output, which flushes out the bladder and urethra, removing microorgs that could cause infection
urine analysis
frequent urination pain or burning during urination cloudy, bloody, or foul-smelling urine
personal protective equipment
gloves gowns face masks eye wear
transmission route
hand hygiene, disinfection and sterilization, airflow control, food handling, PPE, isolation
specific defenses
immune system's process that begins when the body becomes sensitive to an antigen, and continues when antibodies are formed to contain or destroy the antigen
compromised host
immunodeficiency malnutrition - may cause increased metabolic rate, check albumin level and hemoglobin medication for the prevention of rejection of transplanted organs
infection process
incubation prodromal period acute phase or illness phase covalescence
CAUTI bundle
indwelling urinary catheters should be used in accordance with established evidence-based guidelines that address limiting their use and duration to those that are necessary for patient care aseptic technique securing the catheter to allow for unobstructed urine flow and drainage maintaining the urine collection system's sterility and replacing it when needed collecting urine samples selecting measures and monitoring compliance using evidence-based guidelines or best practices evaluating the effectiveness of infection prevention efforts.
nosocomial infections
infections that have been caught in a hospital and are potentially caused by organisms that are resistant to antibiotics. not present or incubating prior to the patient's being admitted to the hospital, but occurring within 72 hours after admittance to the hospital.
iatrogenic infections
infections transmitted during medical treatment and care --medication or physician
bacteriostatic
inhibiting growth or multiplication of bacteria
hygiene
intact skin and mucous membranes are one barrier against microorgs. entering the body. in addition, good oral care reduces likelihood of oral infection. regular bathing and shampooing removes microorgs. and dirt that can result in an infection
infection v2
invasion of body tissue by microorganisms with the potential to cause illness or disease moisture, warmth, nutrients, pH (stomach = 2), source of o2 (anaerobic or aerobic)
socioeconomic status
lack of preventive care or access to immunization
sanguinous exudate
large amount of RBCs that form a bright or dark red indicating new or old damage to capillaries
Illness stage
maximal impact of the infectious process occurs as pathogen proliferates and disseminates rapidly Toxic byproducts of microbial metabolism, cell lysis, immune response -- produce tissue damage and inflammation manifestations are more pronounced and specific to the infecting organism fever and chills may be significant alcoholic clients and older adults may respond to severe infection by becoming hypothermic PT often tachycardic and tachypneic because of increased metabolic demands local manifestations: redness, heat, swelling, pain, and impaired function ***Rapid multiplication, inflammatory and immune responses triggered, manifestation of the disease (local vs systemic)
pathogen
microorganism causing disease in healthy individuals
antifungal
monitor site of infection
indirect method of transmission
no human-to-human contact poor hand hygiene Vehicle: water, food, blood, plasma, fomites: glucose machine, surgical instruments, or dressing, clothing, bedding, sink Vector: mosquitoes, flies, mites, fleas, ticks, rodents, or dogs ingestion: fecal-oral transmission (through water and food, cholera, hep.A) inhalation (airborne transmission) - droplet (TB) or dust
antiviral
no treatment for viral infection
systemic manifestations of infection
nonspecific symptoms shared by other diseases if febrile - temp. > 100.4 F or 38 C Tachypnea: Resp >20 Tachycardia HR > 100bpm alcoholic and elderly may not develop temp. --hypothermic chills fever and shivering may be absent in eldery -- instead: altered mental status, disorientation, tachypnea chills, malaise, loss of energy, headache, loss of appetite, aching
covalescent stage
occurs when the infection is contained and the pathogen is eliminated affected tissues are repaired and manifestations resolve resolution of infection -- total elimination of pathogen from body without residual manifestations chronic disease, latency or carrier state may develop (host defenses eliminate infectious disease, but the organism continues to multiply on mucosal sites)
Who should get vaccinated for influenza
people who are at high risk of developing serious complications like pneumonia if they get sick with the flu. Includes: people who have certain medical conditions, including asthma, diabetes, and chronic lung disease. Pregnant women. People 65 years and older.
incubation period
period from exposure to first symptoms when the pathogens begins active replication but does not yet cause symptoms insufficient number to create disease -- NO recognizable symptoms Asymptomatic
immunization
pneumococcal is recommended for older adults who were last vaccinated more than 5 years previously and for individuals who are immunocompromised, or have risk factors such as chronic pulmonary, liver, or cardiac disease.
medical asepsis
procedures used to reduce number of microorganisms and prevent their spread hand washing and "no touch" dressing technique
colonization
process by which strains of microogranisms become resident flora, but do not cause disease
serous
producing or containing serum
environmental condition
sanitation condition crowded living conditions
isolation precaution = implementation of standard precaution
standard precautions - used in the care of all hospitalized individuals regardless of their diagnosis or possible infection status transmission-based precautions - used in addition to standard precautions for clients with known or suspected infections that are spread by contact or by airborne or droplet transmission
surgical asepsis
sterile technique procedure used to eliminate any microorganisms sterilization of surgical instruments
local manifestation of infection
swelling - edema pain erythema - redness warmth impaired function drainage: purulent - bacterial infection clear - viral infection, allergies
Prodromal period
symptoms begin to appear -- nonspecific/vague and include: general malaise, fever, myalgias (undetermined body ache), headache, and fatigue, low grade temp.
universal precautions
techniques to be used with all clients to decrease the risk of transmitting unidentified pathogens obstruct spread of bloodborne pathogens, microorganisms carried in blood and body fluids that are capable of infecting other individuals with serious and difficult to treat viral infections, EX: Hep. B, Hep. C and HIV
infection
the invasion of body tissue by microorganisms with the potential to cause illness or disease
virulence
the severity of the disease and how infectious they are organism must have disease-causing potential to cause an infection
antibiotic peak and trough level
to make sure the amount of medication in the patient's blood stream is still high enough to be therapeutic vancomycin and gentamycin
direct method of transmission
touching, biting, kissing, sexual intercourse (sneezing, coughing, sneezing, spitting, or talking can project droplets in the conjunctiva and mucous membranes of eyes, nose, and mouth if people are within 3 feet of each other human-to-human contact
isolation practices
use strict aseptic technique when performing any invasive procedure (inserting needle or catheter) and when changing surgical dressings
airborne precaution
used for clients who are known to have or suspected of having serious illnesses transmitted by airborne droplet nuclei smaller than 5 microns EX: measles, varicella, TB
