Chapter 24: Asepsis and Infection Control

An older adult client has been receiving care in a two-bed room that he has shared with another older, male client for the past several days. Two days ago, the client's roommate developed diarrhea that was characteristic of Clostridium difficile. This morning, the client himself was awakened early by similar diarrhea. The client may have developed which type of infection?

Exogenous healthcare-associated The client's suspected infection originated with another person (exogenous) and was contracted in the hospital (healthcare-associated). It was not the result of his treatment (iatrogenic) and C. difficile is not an antibiotic-resistant microorganism. Endogenous infections originate from within the organism and are not attributed to an external or environmental factor.

The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by infection control practice standards for hand hygiene?

Since it is not soiled and it was just an intervention, Decontaminate hands using an alcohol-based hand rub.

When is it necessary for the nurse to implement the observable personal protective equipement (PPE) intervention? Providing care to a client in isolation Feeding a client known to spit food Double-bagging biohazardous materials Suctioning a tracheostomy

Suctioning a tracheostomy

The nurse performs hand hygiene using soap and water before and after providing client care. Which nursing action is performed correctly according to the procedure?

The nurse washes at least 1 in (2.5 cm) above the area of contamination if present. The nurse must wash at last 1 in (2.5 cm) above the area of contamination to properly performed hand hygiene. The nurse should use warm to hot water to wash hands. The amount of liquid soap varies depending on the concentration of the soap. The nurse rinses with water flowing toward the fingertips.

The nurse is caring for a client who has an infection spread by respiratory droplets and is under droplet precautions. Which precautions should the nurse take?

Use a mask when within 3 ft (1 m) of the client. For droplet precautions, the nurse will need to make sure the client is in a private room or shares a room with a person who is infected with the same microorganism. Full isolation precautions are not required for this client as this limits visitors which is not necessary. The nurse will use a mask when working within 3 ft (1 m) of the client. Washing hands upon entering the room will not prevent a visitor from being at risk for droplet transmission as this mode of transmission is not by touching. Using a gown is not necessary when caring for a client on droplet precautions as droplets are airborne.

The nurse is initiating isolation precautions for a client who has chronic Clostridium difficile infection. What should the nurse be sure to include with these precautions?

be sure that there are gloves of various sizes and gowns for use

What is the normal amount of WBCs?

normal value is 5,000 to 10,000/mm3

iatrogenic is

relating to illness caused by medical examination or treatment.

A nurse has finished giving care to a client who has a communicable respiratory infection. In which order should the personal protective equipment (PPE) be removed? 1. Gloves 2. Respirator 3. Gown 4. Goggles

1, 4, 3, 2

The nurse is assisting a client with a history of vancomycin resistant enterococcus (VRE). What precaution should the nurse implement? contact precautions standard precautions airborne precautions droplet precautions

Contact precautions VRE is transmitted via contact. The nurse caring for a client with VRE should implement contact precautions which is wearing a gown and gloves while in the client's room. Droplet precautions include wearing a surgical mask while in the room. Special masks for airborne precautions are used for, but are not limited to: measles, severe acute respiratory syndrome (SARS), varicella (chickenpox), and mycobacterium tuberculosis. Standard precautions are used with all clients. 615

The nurse is providing care for a client with varicella. What action should the nurse perform? Ensure the client is housed in a negative pressure room. Wear a surgical mask at all times when in the client's room. Teach visitors to maintain a distance of 3 feet (1 meter) from the client . Perform hand hygiene with soap and water rather than alcohol handrub.

Ensure the client is housed in a negative pressure room. (Varicella is an airborne disease requiring a negative air flow room. Airborne diseases such as varicella require an N95 mask to protect noninfected persons; a surgical mask is insufficient. Staff and visitors must use personal protective equipment but do not need to maintain a rigid buffer zone. Unless visibly soiled, hand hygiene can safely be performed with alcohol-based handrubs.)

The nurse is providing discharge education for a client with diabetes. Which symptom(s) of foot ulcer infection should the client report to the health care provider? Select all that apply. Inside edges of the ulcer appear to be drawing together Pain with redness and swelling Purulent or malodorous drainage Scabs forming over the ulcer Localized heat

Pain with redness and swelling Localized heat Purulent or malodorous drainage Signs of infection of the client's foot ulcer that the nurse includes in discharge teaching include redness, swelling, and pain; localized heat; and purulent or malodorous drainage. If the inside edges of the ulcer appear to be drawing together and/or if scabs are forming over the ulcer, the ulcer is likely to be healing. 600

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? The nurse notes the client's urine is dark yellow with sediment. The client reports nausea and vomiting. Urine culture is positive for vancomycin-resistant enterococci (VRE). The unlicensed assistive personnel (UAP) documents the client's oral temperature as 99°F (37.22°C)

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 in charge of care for a client who has methicillin-resistant Staphylococcus aureus(MRSA). Which guideline is accurate for using transmission-based precautions when caring for this client? Place the client in a private room that has monitored negative air pressure. Wear gloves whenever entering the client's room. Use respiratory protection when entering the room. Keep visitors 3 feet (1 m) from the client.

Wear gloves whenever entering the client's room.

A nurse is caring for a child who is hospitalized for diphtheria. Which guideline would be appropriate when caring for this client? Wear personal protective equipment (PPE) when entering the room for all interactions that may involve contact with the client. Ensure that hard surfaces in the room are disinfected at least once per day. Place client in a private room that has monitored negative air pressure. Use a private room with the door closed at all times.

Wear personal protective equipment (PPE) when entering the room

A nurse is caring for four clients. Which client has the highest risk of infection? older male with an enlarged prostate young woman with a history of scoliosis toddler with a benign heart murmur woman in second trimester of pregnancy

older male with an enlarged prostate 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.

A nurse has collected the blood, urine, and stool specimens of a client with meningococcal meningitis. Which precaution should the nurse take when transporting the specimens? place each of the three sealed specimens in a separate paper bag swab the outside of each specimen container with alcohol prior to transport place the specimens into plastic biohazard bags wear gloves and a gown when transporting the specimen

place the specimens into plastic biohazard bags

A nurse is caring for a 55-year-old postoperative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? endotracheal tube urinary catheter Salem sump nasogastric tube PICC line

urinary catheter