Nursing 102: Infection Control and HIPAA: (Content towards Quiz 1)

What federal law gives patients more control over their health information?

HIPAA

What activity is a major component of patient and worker protection in infection control?

Hand hygiene

What are the elements of respiratory hygiene?

Have patients cover their nose or mouth when sneezing or coughing; use tissues to contain respiratory secretions and dispose of in nearest waste container; perform hand hygiene after contact with respiratory secretions and contaminated objects or materials; contain respiratory secretions with the procedure or surgical mask; sit at least 3 feet away from others if coughing.

Infections people get while they are receiving health care for another condition.

Healthcare-associated infections

Medical asepsis

also known as "clean technique" is aimed at controlling the number of microorganisms and is used for all clinical patient care activities.

Surgical asepsis

also known as the "sterile technique" is aimed at removing all microorganisms and is used for all invasive sterile procedures.

Describe the prone position

- (Rarely used) laying face down in the horizontal plane ( face to one side ) - flat pillow under abdomen below the diaphragm - Considered the first line of therapy for critically ill patients with severe acute respiratory distress syndrome (ARDS)

What can be done to assist patients with altered or limited mobility?

- Adapt a different approach to care based on the individuals needs - Provide different interventions that maximize the patient's activity level while keeping the patient safe.

What are the types of transmission-based precautions?

- Airborne Precautions (Droplets <5 μm) - Droplet Precautions (Droplets >5 μm; being within 3 feet of the patient) - Contact Precautions (Direct patient or environmental contact) - Protective environment (Allogeneic hematopoietic stem cell transplants)

How do physiological influences on body alignment and mobility affect the older adult?

- Decalcification of bones and degenerative joint changes Degeneration of nerve cells and a decrease in neurotransmitters - a thinning of vertebral disks - shortening of the spinal column and onset of kyphosis with the spinal column compression occurs. - Bone density decreases and becomes brittle. - Cartilage becomes rigid and fragile, and there Is a loss of resilience and elasticity of ligaments. - Muscle mass and tone reduction in mobility impairment attributable to reduced range of motion and pain in joints, reduced muscle strength, and increased risk for bone fracture

When ambulating or transferring a patient to a chair, what should the nurse do to prevent orthostatic hypotension?

- Implement interventions - Mobilize the patient as soon as possible (as the physical condition allows ) even if it is just dangling legs from the bedside or moving to a chair - (this maintains muscle tone and increases venous return, helping to stabilize blood pressure ) - Assess with safe patient handling algorithm if immobile and up for the first time in a while

Describe Sims/Lateral Recumbent Position.

- Lateral on the side with the major portion of body weight on the dependent hip and shoulder with one leg bent. (Same as sims but with one leg bent)

Describe the side-laying position

- Lateral on the side with the major portion of body weight on the dependent hip and shoulder.

when to use Hand rolls

- for patients who's arms are paralyzed or who are unconscious - rotation on 2 hours then off 2 hours

Describe Semi-Fowler's position

- known as the sitting position - the head of the bed is angled between 30 and 45 degrees

Describe Fowler's position

- known as the sitting position - the head of the bed is angled between 60 and 90 degrees

Altered mobility can impact the patient by causing what?

-Major physiological, psychological, and social effects. - postural and muscular damage to circulation, motion, and sensation.

Describe the supine position

-rest on the back/horizontal plane - body parts in the same location as good standing alignment - optional to use a pillow under the knee for comfort

Describe the assessment criteria considered for the safe transferring of patients

1. Identify the patient using at least two identifiers 2. identify the height and weight of pt from the medical record. 3. Review the medical history for falls or fear of falling 4. Assess the previous mode of transferring to bed or chair if possible 5. Review medical records for any previous disabilities that could affect mobility/movement. 6. Assess patient and family caregiver health literacy. 7. Assess the patient's cognitive status, including ability to follow verbal instructions, short-term memory, and recognition of physical deficits and limitations to movement.

Orthostatic hypotension includes a blood pressure drop greater than ______

20 mmHg in systolic pressure or 10 mmHg in Diastolic pressure

disabaility

Negative aspects to a person's health condition and social or physical limitations.

What does standard PPE consist of?

Gloves Gowns Shoe covers Head covers Masks Respirators Eye protection Face shields Goggles

What are some strategies of infection prevention and measures to reduce reservoirs of infection and break the chain of infection?

Bathing with soap and water to remove visible silage Proper disposal of soiled items; Proper PPE Vaccinations

Standard precautions must be used in what situations?

Blood All body fluids Secretions Excretions Non-intact skin Mucous membranes

In regards to the chain of infection, what is a way to stop germs from spreading?

By interrupting this chain at any link.

Droplet precautions require what PPE?

Gloves Gown Mask or respirator

Privacy gives the patient the right to keep personal information from being _____________.

Disclosed

True or false: Confidentiality keeps the patient's personal information protected once it is disclosed to another hospital.

False: Keeps the patient personal protected once it is disclosed in a healthcare setting

What do both of the following statements describe? Cognitive, social, physical, and emotional ability to carry on the normal activities of life. An individual's ability to perform the normal daily activities required to meet basic needs; fulfill usually roles in the family, workplace, and community; and maintain health and well-being.

Functional ability

In the following situations should you wash your hands with soap and water or with alcohol-based hand rub? • Before, after, and between direct patient contact (e.g., taking a pulse, lifting a patient) • Before putting on sterile gloves and before inserting invasive devices such as a peripheral vascular catheter or urinary catheter • After contact with body fluids or excretions, mucous membranes, nonintact skin, and wound dressings (even if gloves are worn) • When moving from a contaminated to a clean body site during care • After contact with surfaces or objects in the patient's room (e.g., overbed table, IV pump) • After removing gloves

In all listed, alcohol-based hand rub can be used for routine contamination if hands are not visibly dirty.

What does a fever and a warm incision likely indicate?

Infection

Droplet precautions must be used in what situations?

Influenza Mumps Respiratory Diseases Adenovirus Group A streptococcus Neisseria meningitides Pertussis Rhinovirus Mycoplasma pneumonia Diphtheria Pneumonic plague Rubella Respiratory syncytial virus

Airborne precautions must be used in what situations?

Mycobacterium Tuberculosis Varicella (chickenpox) Measles Disseminated herpes zoster Rubeola

What can be done to take precaution against latex allergies?

Keep the powder from the gloves away from patients because the powder acts as a carrier for the _______ protein. Do not snap gloves on and off. • Identify patients who are _____sensitive. The operating room (OR) needs to be labeled ____ free to prevent personnel from bringing rubber products (e.g., wristbands, chart labels) into the room. • Develop programs to educate health care workers in the care of _______-sensitive patients.

Contact precautions must be used in what situations?

Major wound infections Multi-drug resistant bacteria (VRE or MRSA) Diarrhea (Clostridium Difficile) Shingella Herpes simplex Scabies Varicella zoster(disseminated) Respiratory syncytial virus

An abnormal drop in blood pressure when a person sits or stands up ( or moves rapidly from horizontal to vertical.

Orthostatic hypotension

The following list of factors are those that contribute to what? Aging Poor nutrition Infection Exposure to toxicants Chronic health issues Immunocompromised

Patient susceptibility to infection

impairment

Physical abnormality that underlines the limitations and os caused by some type of disease process

why correct positioning of the patient is crucial

Potter, prevents injury to nurse and patient, prevents pressure sores, prevents nerve damage

The following statement is describing what? Evidence-based information about body alignment, balance, gravity, and friction.

Principals of proper body mechanics

Airborne precautions require what PPE?

Private room Negative pressure with 6-12 air exchanges/hr VIA HEPA filtration Mask & respirator N95

Contact precautions require what PPE?

Private room - door can be open Gloves Gown- if giving direct care Handwashing Disposable supplies Dedicated equipment

The following phrases are connected to what kind of considerations that should be taken for what sort of care? -Disrupts normal social relationships with visitors and caregivers. - Imposes barriers to the expression of a patient's identity and normal interpersonal relationships -Affects the delivery of quality care -Rushed care or showing a lack of interest in a patient's needs

Psychosocial considerations for a patient in isolation.

The following are associated with what? Hand hygiene. Maintaining a safe, clean, hygienic hospital environment. Screening and categorizing patients into cohorts. Public health surveillance. Antibiotic stewardship. Following patient safety guidelines.

Strategies to Prevent Healthcare-Associated Infections

The following list of preventions are interventions that can be taken to prevent what? Hand hygiene. Maintaining a safe, clean, hygienic hospital environment. Screening and categorizing patients into cohorts. Public health surveillance. Antibiotic stewardship. Following patient safety guidelines.

Strategies to Prevent Healthcare-Associated Infections

When are the following assistive devices/methods used? clean gloves:

reduces the spread of microorganism

The following list of preventions are interventions that can be taken to maintain what? Steer Clear of Earshot. Keep Information Out of Eyesight. Whatever You Do, Don't Gossip. Know Who You're Talking To. Pay Attention in Training. Don't Treat Conflicts of Interest. Conclusion.

The confidentiality of electronic and written health records

The following statement correctly describes which link of infection? Statement: This could be via someone's hands, on an object, through the air or through bodily fluid contact. 1.) Mode of transmission 2.) Susceptible host 3.) Portal of entry 4.) Portal of exit

The correct answer is 1.)

The following statement correctly describes which link of infection? Statement: This could be landing on a mucous membrane, being breathed in, entering via a wound, or a tube such as a catheter. 1.) Susceptible host 2.) Portal of entry 3.) Reservoir 4.) Portal of exit

The correct answer is 2.)

The following statement correctly describes which link of infection? Statement: is vulnerable to infection 1.) Infectious agent or pathogen 2.) Portal of entry 3.) Susceptible host 4.) Portal of exit

The correct answer is 3.)

The following definition correctly describes which link of infection? Definition: A true pathogen that causes disease in virtually any susceptible host. (Bacteria, Viruses, Fungi, Parasite) A.) Infectious agent B.) Susceptible host C.) Reservoir D.) Mode of Entry

The correct answer is A.)

The nurse is teaching a class of junior high school students about infection control through effective hand washing. Which statement made by a student indicates the need for further teaching? AA "Hand sanitizer works just as well as washing with soap and water." BB "If I sing the song "Happy Birthday" twice through while scrubbing my hands, that should be long enough." CC "I need to read the label on the hand sanitizer to be sure that it's at least 60% alcohol." DD "We should all wash our hands before eating lunch every day."

The correct answer is AA.)

The following definition correctly describes which link of infection? Definition: source of infection where the microorganism can live and thrive. A.) Mode of transmission B.) Reservoir C.) Susceptible host D.) Mode of Entry

The correct answer is B.)

What does HIPAA stand for? AA.) Health Independent Privacy and Accessibility Act of 1997 BB.) Health Insurance Portability and Accountability Act of 1996 CC.) Human Independent Protection and Accessibility Act of 1995 DD.) Hospital Insurance Preservation and Answerability Act of 1994

The correct answer is BB.)

The correct order for the six links of infection is: A.) - susceptible host. - portal of exit - mode of transmission - reservoir - portal of entry B.) - susceptible host. - reservoir - portal of exit - the infectious agent - portal of entry - mode of transmission C.) - the infectious agent - reservoir - portal of exit - mode of transmission - portal of entry - susceptible host. D.) - the infectious agent - portal of entry - mode of transmission - susceptible host. - reservoir - portal of exit

The correct answer is C.)

When is the use of alcohol- based hand rubs not recommended? AA.) Before and after patient care BB.) When entering and exiting a patients room CC.) When hands are visibly soiled DD.) After moving a patient in bed

The correct answer is CC.)

The following statement correctly describes which link of infection? Statement: in the case of a person with flu, this would include coughing and sneezing. A.) Mode of transmission B.) Susceptible host C.) Portal of entry D.) Portal of exit

The correct answer is D.)

After patient teaching, the patient is able to verbalize that which occurrence can delay wound healing after surgery? AA.) Adequate arterial blood flow to the wound BB.) Supplemental oxygen therapy CC.) A healthy diet DD.) An increased hospital stay

The correct answer is DD.)

PHI is an acronym for: E.) Protected Health Information F.) Private Health Information G.) Protected Health Insurance H.) Private Hospital Information

The correct answer is E.)

PHI gives patients access to which of the following: E.) Access to keep and alter medical records F.) Rights to view and amend medical records G.) Access to Keep medical records H.) Rights to Amend medical records

The correct answer is F.)

What is the purpose of the Privacy care rule for HIPAA? E.) To keep patients' information private. F.) To keep information from being shared unnecessarily. G.) To limit information to specific purposes to decrease the likelihood of any PHI from being unnecessarily used or viewed. H.) To protect patient personal information once is disclosed.

The correct answer is G.)

A 3-year-old girl with flu-like symptoms is at home playing with cars. She coughs into her hands and then continues to race the cars around the playroom. Her father who is unvaccinated cleans up the cars after the child goes down for a nap. After touching the cars, He picks a booger with the same hand. The portal of entry is represented by: H.) The hand-to-nose contact I.) The 3-year-old-girl J.) The coughed on car K.) The unvaccinated father

The correct answer is H.)

A 3-year-old girl with flu-like symptoms is at home playing with cars. She coughs into her hands and then continues to race the cars around the playroom. Her father who is unvaccinated cleans up the cars after the child goes down for a nap. After touching the cars, He picks a booger with the same hand. The mode of transmission is represented by: H.) The 3-year-old-girl I.) The hand-to-nose contact J.) The unvaccinated father K.) The coughed on car

The correct answer is I.)

A 3-year-old girl with flu-like symptoms is at home playing with cars. She coughs into her hands and then continues to race the cars around the playroom. Her father who is unvaccinated cleans up the cars after the child goes down for a nap. After touching the cars, He picks a booger with the same hand. The reservoir is represented by: H.) The hand-to-nose contact I.) The 3-year-old-girl J.) The coughed on car K.) The unvaccinated father

The correct answer is J.)

A 3-year-old girl with flu-like symptoms is at home playing with cars. She coughs into her hands and then continues to race the cars around the playroom. Her father who is unvaccinated cleans up the cars after the child goes down for a nap. After touching the cars, He picks a booger with the same hand. The portal of exit is represented by: H.) The 3-year-old-girl I.) The hand-to-nose contact J.) The unvaccinated father K.) The coughed on car

The correct answer is K.)

A patient is under airborne precautions for TB. The nurse is going to implement which of the following interventions for the patient? L.) Use hand hygiene and masks for entering/exiting and in the room with the patient. M.) Prevent visitors from entering the room. N.) Help to ensure adequate social interaction and support. O.) Communicate with the patient over the call light whenever possible.

The correct answer is L.)

A patient is in contact isolation for a bacterial infection. The nurse is going to implement which of the following interventions for the patient? L.) Prevent visitors from entering the room. M.) Use PPE equipment only when knowingly coming into contact with pathogens. N.) Help to ensure adequate social interaction and support. O.) Communicate with the patient over the call light whenever possible.

The correct answer is N.)

Which of the following can a nurse do to help an older adult who deals with limited mobility? (pay attention to lowercase/uppercase/multi-letter options) a.) Understand the normal/more common challenges one faces. b.) Understand the normal/more common changes to provide appropriate care. c.) Understand the normal/more common changes to provide appropriate care and help with adaptation to change. d.) Help the patient to push through their challenges.

The correct answer is c.)

Reason to use hand rolls

To maintain the thumb in slight adduction and in opposition to the fingers

The______ of _______ ________ varies from person to person and with in the same person at different times.

scope of functional ability

When to use trochanter roll

Useful with patients who have lost the ability to move their lower extremities

How to/ how long to perform hand washing? (Time, temp, friction)

With vigorous, brief rubbing together of all surfaces of lathered hands followed by rinsing under a stream of warm water for 15 seconds.

full function

a positive or neutral interaction between a persons health condition and ability to perform social or physical activities

What risks place the patient at high risk for acquiring infection?

age, pre-existing illness/chronic illness, stress, presence of disease

Healthcare-associated infection include

central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Infections may also occur at surgery sites, known as surgical site infections.

When are the following assistive devices/methods used? pillows, friction reducing device/slide sheet or tube:

repositioning device reduces friction as patient is moved up in bed, prevents friction from contact of skin with board

When are the following assistive devices/methods used? Hand rolls and splints

reduces extension of fingers and abduction of thumb, maintains thumb slightly adducted and in opposition to fingers

When are the following assistive devices/methods used? trochanter roll:

ensures proper alignment, prevents external rotation of hips, which contributes to muscle contractures

To prevent pressure ulcers, how often should immobilized patients be repositioned:

every 2 hours to help with blood flow and prevention of pressure ulcers

the scope of functional ability can range from ________ ______ to ______.

full function to disability

Patients with what type of mobility will have voluntary or involuntary movements that could affect activity level?

limited or altered

Is an infection at a wound site likely to be systemic or localized?

localized

When are the following assistive devices used? therapeutic boots or splints:

maintains feet in dorsiflexion, prevents plantar flexion contractures or foot drop

Dizziness, pallor, tachycardia, fainting, and nausea are all symptoms of what

orthostatic hypotension

When are the following assistive devices/methods used? sandbags:

provides stability and prevents muscle contractures

The six links of infection include :

the infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

Active range of motion is used when

the patient is able to independently move each joint through the range of motion unassisted.

Passive range of motion is used when

the patient is unable to move independently and the nurse moves each joint through range of motion

Body alignment refers to

the positioning of the joints, tendons, ligaments, and muscles while standing, sitting, and lying.

Reason to use trochanter roll

to prevent external rotation of the hips when in supine position

Diminished sensory can cause issue with agility and alight meant affecting the older adults mobility: true or false

true

With the application of standard precautions (Tier One), when should clean non-sterile gloves be worn?

when touching blood, body fluids, secretions, excretions, nonintact skin, mucous membranes, or contaminated items or surfaces. Remove and dispose of gloves and perform hand hygiene between patient care encounters and when going from a contaminated to a clean body site. when your anticipated patient interaction is likely to involve contact with blood or body fluids.