evolve addaptive quizzing chapter 29

guidelines to the patient to avoid contamination while performing the surgery are.....

*"I should inform the patient to avoid touching the sterile supplies and gown." *I should administer ordered analgesics half an hour before surgery begins if a patient is in pain." * "I should inform the patient to avoid sudden movements of any parts of the body covered by sterile drapes."

A registered nurse is teaching a student nurse about surgical hand asepsis. Which action of the student nurse can aggravate the risk for contracting an infection?

*Wearing a wristwatch to ensure accurate time for surgical hand asepsis *Maintaining a natural nail length of ½ inch long when performing surgical hand asepsis Rationale: Allergic skin reactions may occur as a result of the accumulation of scrubbing agents or glove powder under wristwatches. Therefore, the nurse should remove the wristwatch while performing hand asepsis. Longer nails can puncture gloves; therefore the nurse maintains a nail length of less than ¼ inch to ensure safety. Jewelry can cause the accumulation of scrubbing agents or glove powder. Therefore, the nurse should remove bracelets and rings while performing surgical hand asepsis. Artificial nails are known to harbor gram-negative microorganisms and fungi. Therefore, to avoid contamination, the nurse should remove artificial nails before performing surgical hand asepsis. Chipped and old nail polish retains microorganisms. Therefore, the nurse should remove chipped and old nail polish to prevent infections. p. 476

vehicle transmissions are transmitted through.....

IV fluids, food, and water. pg 445

Which pieces of equipment in the health care facility are considered noncritical items that should be disinfected?

Linens, stethoscopes and blood pressure cuffs p. 456

vectors are.....

Mosquitoes and flies. they can spread infection through external and internal transmission. pg 445

reservoirs of infection are....

Soiled dressings, body fluids, and urinary drainage bags

preparation of a sterile field.

Sterile gloves and a counter top surface

The nurse uses droplet precautions with a patient who is admitted to the infectious care unit. Which disease might a patient have?

Streptococcal pharyngitis Rationale: Streptococcal pharyngitis is a droplet infection caused by droplets larger than 5 microns. Therefore, the nurse should take droplet precautions. Measles is an airborne infection; therefore, the nurse should take airborne precautions. Herpes simplex and varicella-zoster are transmitted by direct contact; therefore, the nurse should take contact precautions. pg 459

Which factor increases the efficacy of disinfectants during the process of disinfection?

Temperature maintained at room temperature. Rationale: Disinfectants tend to work best at room temperature. Shortened exposure time decreases the efficacy of the disinfectants. The presence of pus and soap at the time of disinfection decreases the efficacy of disinfectants. p. 477

The nurse cares for a patient who has chickenpox. Which protection barriers should the nurse use? a. Mask b. Gloves c. Gowns d. Goggles e.N95 respirator

a. Mask e.N95 respirator Rationale: Airborne precautions should be taken while caring for patients with chicken pox. For this case, the nurse should use a mask and a N95 respirator. Gloves and gowns should be used while in direct contact with patients who are infected with multidrug resistant organisms, such as Clostridium difficile. Goggles should be worn while caring for patients with eye conditions such as conjunctivitis. p. 459

A registered nurse teaches nursing students about nonspecific defense systems of the body to protect against infections. Which defense systems act as good examples to prevent infections? a. Saliva b. Blinking c. Erythrocytes d. Macrophages e. Thrombocytes

a. Saliva b. Blinking d. Macrophages Rationale: Saliva, blinking, and macrophages are nonspecific body defense systems that help protect against infections. Saliva washes away particles containing microorganisms and reduces infection. Blinking reduces entry of particles containing pathogens, thus reducing the dose of organisms that cause infections. Macrophages engulf and destroy microorganisms that reach alveoli. Erythrocytes and thrombocytes are not associated with the body's defense systems. pg 447

A 30-year-old patient with a history of irritable bowel syndrome complains of diarrhea. The nurse finds that the patient is infected with Clostridium difficile and is on appropriate treatment. What could be the most likely reason for the patient's current complaints of diarrhea? a. The use of antibiotics b. Secondary viral infection c. Irritable bowel syndrome d. Aerobic bacteria

a. The use of antibiotics Rationale: The patient currently has diarrhea related to Clostridium difficile. Clostridium difficile is an organism that is increased in proportion to beneficial microorganisms by taking antibiotics. (The resulting diarrhea is known as antibiotic-induced diarrhea.) Therefore, the most likely reason for this particular patient's current complaints of diarrhea is the use of antibiotics. If a patient in a hospital setting acquires Clostridium difficile and has not been on antibiotics, the diarrhea is most likely due to cross contamination from another patient. A secondary viral infection could be a reason for diarrhea but not the most likely reason in this situation. Because the patient has a history of irritable bowel syndrome, which can cause diarrhea as well, it could also be a reason. However, Clostridium difficile is a more likely cause given that the patient is currently infected with it. Clostridium difficile is an anaerobic bacterium that thrives where little or no free oxygen is available. Aerobic bacteria require oxygen to survive and are not the cause of this patient's diarrhea. pp. 446-447, 460

A patient who underwent bariatric surgery complains of serous exudate at the site of surgery. The primary health care provider diagnoses the patient with a health care-associated infection. Which microorganisms can cause exogenous infections? a. Yeast b. Aspergillus c. Streptococcus d. Staphylococcus e. Clostridium tetani

b. Aspergillus e. Clostridium tetani Rationale: Microorganisms responsible for exogenous infections include Aspergillus and Clostridium tetani. Endogenous infections occur when the body's normal floras are altered. Yeast, streptococci,and staphylococci can cause endogenous infections. p. 448

Which patients are at a low risk of disease transmission? a. A patient with Ebola b. A patient with influenza c. A patient with pneumonia d. A patient with chickenpox e. A patient with viral meningitis

c. A patient with pneumonia e. A patient with viral meningitis Rationale: A patient with pneumonia and a patient with viral meningitis are at a low risk of disease transmission. A patient with Ebola, a patient with influenza, and a patient with chickenpox are at a high risk of disease transmission because these conditions can spread through direct contact. p. 443

While preparing to do a sterile dressing change, the nurse accidentally sneezes over the sterile field that is on the over-the-bed table. Which principles of surgical asepsis, if any, has the nurse violated? a. When a sterile field comes in contact with a wet surface, the sterile field is contaminated by capillary action. b. Fluid flows in the direction of gravity. c. A sterile field becomes contaminated by prolonged exposure to air. d. None of the principles were violated.

c. A sterile field becomes contaminated by prolonged exposure to air. Rationale: Avoid activities that create air currents, such as sneezing. When you sneeze, microorganisms travel through the air by droplets, contaminating the sterile field . Therefore, "a sterile field becomes contaminated by prolonged exposure to air" is the principle violated. The other two choices are correct but they do not describe the principle violated. p. 468

What major infections are caused by Escherichia coli? a. Hepatitis A b. Pneumonia c. Gastroenteritis d. Food poisoning e. Urinary tract infections

c. Gastroenteritis e. Urinary tract infections

The nurse assists a surgical technician in preparing a sterile field. Which action made by the nurse indicates a need for correction? a. Allowing the flap to lie flat on the table's surface b. Grasping the outer edge of the tip of the outermost flap c. Standing close to the sterile field while opening the last flap d. Opening the outermost flap of the sterile kit away from the body

c. Standing close to the sterile field while opening the last flap Rationale: While preparing a sterile field, the nurse should open the last flap while standing away to field as to avoid contamination. The flap should be allowed to lie flat on the table surface. The outer edge of the tip of the outermost flap should be grasped because the outer surface of the package is considered unsterile. The outermost flap of the sterile kit should be kept away from the body to prevent contamination. pp. 473, 474

exogenous infections come from:

microorganisms found outside the body such as salmonella, clostridium tetani, aspergillum

endogenous infections

occurs when part of the patient's flora becomes altered and an over growth results such as Staphylococci, enterococci, yeasts, and streptococci.

Which equipment is required for surgical hand asepsis?

paper facemask, protective eyewear, and surgical scrub sponges are required during surgical hand asepsis.