chap 24 prep u

The correct sequence of the stages of infection are...

(1) incubation period, (2) prodromal stage, (3) full stage of illness, and (4) convalescent period.

A nurse is caring for four clients. Which client has the highest risk of infection?

An older male with an enlarged prostate can have urine trapped in the bladder leading to urinary tract infections. A toddler with a benign heart murmur is developmental in nature and does not place them at an increased risk of infection. Pregnancy can alter immunity; however, this is not the highest risk. Scoliosis has no impact on infection.

Contact precautions are used for what 4 types of diseases?

Contact precautions are used for clients who are infected or colonized by a microorganism that spreads by direct or indirect contact, such as MRSA, vancomycin-resistant enterococci (VRE), or vancomycin-intermediate Staphylococcus aureus (VISA).

Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)?

Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact.Direct client contact between a VRE-positive client and another client without handwashing carries a significant risk of infection, especially when contact includes body fluids.

A nurse has put on personal protective equipment (PPE) to perform the dressing change of a client's surgical wound. While the nurse is cleansing the incision, the client begins bleeding and blood hits the nurse's wrist, running down under the cuff of her glove. What is the nurse's best action?

If the nurse is accidentally exposed to blood, it is necessary to stop the task and immediately follow facility protocol for exposure, including reporting the exposure. It would be unsafe to proceed with the dressing change before addressing the exposure. Applying new gloves does not eliminate the exposure.

first trimester

Infection with rubella during the ____ is of great concern, as it frequently leads to congenital rubella syndrome. The later in the pregnancy that a woman develops rubella, a reaction is less likely and typically less severe. A reaction is also less likely during the postpartum interval.

The nurse is caring for a pediatric client who became very ill after being in a day care where a number of other children are sick with the same condition. How will the nurse document this condition? Select all that apply.

Infections disease, communicable disease, and contagious disease describe this type of illness. A noncommunicable disease is caused by food or environmental toxin. Health care-associated infections are acquired within a healthcare facility.

The nurse is caring for an older adult client in a long-term care facility who has been previously alert and oriented. The client has become agitated and disoriented to time and place. The client is afebrile. What action by the nurse may assist with the determination of a causative factor in the client's condition?

Many older clients do not mount a febrile response to infection, and increasing agitation or confusion in response to infection may be dismissed as normal signs of aging. It is likely the client may have developed a urinary tract infection, which is a common cause of change in mental status in older adults. Hypertension generally does not cause a change in orientation or agitation, and the client with hypertension may not display any symptoms at all. Psychosis or delirium does not usually develop for no reason in a client who has been previously alert and oriented. Hunger does not result in behavior that is disoriented or agitated.

When preparing a sterile field, the nurse notes that bottle of sterile saline was opened 48 hours ago and is half full. What should the nurse do?

Once a bottle of sterile saline is open, the contents must be used within 24 hours of opening. Lipping the opening of the bottle is appropriate, but contents in the bottle are expired.

A 12-year-old is being hospitalized for pneumonia. The nurse receives the client's culture and sensitivity report on her tracheal aspirate. The client is infected with a strain of Streptococcus pneumoniae, which is particularly prone to cause infections, also referred to as what?

Pathogenicity is an organism's ability to cause infection

A nurse is caring for a client, age 4 years, who is being treated for osteomyelitis in his left femur. He is on a 28-day course of IV vancomycin to be administered daily at 1300. Today is day 3 of treatment, and the pharmacist asks the nurse to draw a peak vancomycin level. What would be the most appropriate time to draw this blood?

Peak levels are drawn shortly after the drug is administered. The best choice is 1500 because it closely follows the time of infusion, which is when the drug concentration would be highest.

The student nurse asks the nursing instructor to explain why stress can increase the risk of infection. The instructor explains:

Physical or emotional stress causes the body to release cortisol, which can increase the risk of infection by suppressing the immune response. Cortisol increases the level of serum glucose, providing a good medium for bacterial growth.

Nurses working in bed management are assigning clients from the emergency room to semiprivate rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards?

Reactive airway disease and exacerbation of COPD are both medical diagnoses and not communicable conditions. Clients with these conditions can room together. C. difficile requires contact isolation and is contagious. Diabetic ketoacidosis is considered a medical diagnosis and requires standard precautions.

The nurse planning to insert an indwelling urinary catheter into a client should utilize which technique?

Surgical asepsis, also known as sterile technique, is utilized to keep objects and areas free from microorganisms when performing surgery and procedures such as insertion of an indwelling urinary catheter or IV catheter.

First line of defense

The ___ against infection is intact skin and mucous membranes covering body cavities.

incubation period

The ___ is the interval between the pathogen's invasion of the body and the appearance of symptoms of infection. During this stage, the organisms are growing and multiplying. The length of incubation may vary.

convalescent period

The ____ is the recovery period from the infection. ____ may vary according to the severity of the infection and the client's general condition. The signs and symptoms disappear, and the person returns to a healthy state.

The nurse is assessing a client admitted from a long-term facility. Which assessment finding could indicate an increased risk for infection? Select all that apply.

The client is at risk for infection related to a break in skin integrity which allows an entry way for pathogens. The client is also at risk for infection because of the indwelling urethral catheter as well as because of the ineffective cough, which creates an inability to clear secretions.

Which client would the nurse consider the most infectious?

The client is most infectious during the prodromal stage of the illness. Early signs and symptoms of disease are present, but these are often vague and nonspecific, ranging from fatigue and malaise to a low-grade fever. This period lasts from several hours to several days. During this phase, the client often is unaware of being contagious. As a result, the infection spreads.

The nurse is caring for a client who requires droplet precautions. Which statement made by the client would indicate further teaching is required?

The client on droplet precautions should only leave the room when necessary and wear a mask. The nurse should limit the client's movement outside the room. Visitors should remain 3 feet (1 meter) from the client. Anything that enters the isolation room should remain until discharge.

Which client should the nurse determine is at greatest risk for vancomycin-resistant enterococci (VRE) infection?

The nurse should determine that the client receiving chemotherapy is the client at greatest risk for VRE infection due to having a compromised immune system from the chemotherapy. Other risk factors for VRE include recent abdominal or chest surgery, presence of urinary or central IV catheter, prolonged antibiotic use (especially with vancomycin), and lengthy hospital stays (especially in an ICU).

A nurse is caring for a client who is diagnosed with tuberculosis. Which nursing intervention promotes infection control based on nursing practice standards for safety?

The nurse would use airborne precautions, not droplet precautions when caring for a client diagnosed with tuberculosis.

full stage

The presence of specific signs and symptoms indicates the ___ of illness. The type of infection determines the length of the illness and the severity of the manifestations.

The nurse is caring for a client who is hospitalized and has an indwelling urethral catheter. Which finding would most likely indicate the client has developed an infection?

Urine culture is positive for vancomycin-resistant enterococci (VRE). Infections result from pathogens that produce illness after invading body tissues and organs. The client with the indwelling urethral catheter is at risk for developing an infection. The finding that would most likely indicate an infection would be a positive result. Nausea and vomiting, a fever, and dark yellow urine with sediment are possible signs of an infection, but each of these findings alone does not confirm an infection.

A nurse is providing care to a client who has Salmonella food poisoning. The nurse understands that this pathogen was transmitted by which mechanism?

Vehicle transmission involves the transfer of microorganisms by way of vehicles or contaminated items that transmit pathogens; for example, food can carry Salmonella. Direct contact transmission involves body surface-to-body surface contact causing the physical transfer of organisms between an infected or colonized person and an infected host. Droplet transmission occurs when mucous membranes of the nose, mouth, or conjunctiva are exposed to secretions of an infected person who is coughing, sneezing, or talking. Airborne transmission occurs when fine particles are suspended in the air for a long time or when dust particles contain pathogens.

Why would you do a c- section?

Viral diseases such as chickenpox or herpes simplex, acquired from the birth canal or from an infected sibling, can cause severe widespread disease.

Helminths

___ are infectious worms that may or may not be microscopic. They include roundworms, tapeworms, and flukes.

Rickettsiae

___ are microorganisms that resemble bacteria but cannot survive outside of another living species. They are responsible for Lyme disease.

Influenza

___ is transmitted through droplets; therefore droplet contact precautions are appropriate.

e.coli

___ residing in the intestinal tract is typical normal flora. Escherichia coli in the urinary tract is indicative of a urinary tract infection. Shigella germs are a common cause of severe diarrhea and are contagious. Shigella in the urinary tract is indicative of a urinary tract infection.

Two common factors that increase a persons risk of becoming infected with C difficle are...

are age greater than 65 and current or recent use of antibiotics.

Ringworm is caused by ...

by a fungal infection. Fungi include yeasts and molds, which cause infections in the skin, mucous membranes, hair, and nails.

Exudate

fluid, such as pus, that leaks out of an infected wound

A normal white blood cell count is...

is 5,000 to 10,000 cells/mm3.

Cardinal signs of infection include

redness (heat), swelling, pain, and loss of function. As leukocytes and neutrophils enter the area, exudate made up of fluid, cells, and inflammatory by-products may be released by the wound. Warmth and heat at the site versus coolness are a sign of infection.

N95 respirators are used...

when caring for clients in airborne precautions