Fundamentals: Infection control (ch. 39)

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_____ infectious agents attach to skin when in contact with something contaminated. Readily transmitted.

Transient

______ microorganisms attach to the skin when a person has contact with another person or object during normal activities.

Transient

When hands are visibly soiled or contaminated with blood or body fluids, wash them with

either a nonantimicrobial or an antimicrobial soap and water.

An DECREASE in normal Lymphocyte values (20%-40%) would indicate:

sepsis

Decreased values of normal Lymphocytes (below 20%) would indicate:

sepsis

Airborne:

smaller than 5 microns- these patients need a negative pressure room, need N95 mask

An infection will develop when ______.

the individual becomes susceptible to the strength and number of microorganisms

Transmission based precautions

Tier Two

The presence of infectious microorganism growth in cultures of blood or urine is an indication of :

infection

Signs and symptoms of Systemic Infection:

-fever -increased pulse and respiration -loss of energy -anorexia -enlarged lymph nodes

________ is the most effective way to break the chain of infection (CDC, 2008a; WHO, 2009).

Hand hygiene

Microorganism, causing the disease (infectious agent), include:

-Bacteria-staph -Viruses-hepatitis, HIV -Fungi-candida -Protozoa-worms, ticks

Which type of personal protective equipment are staff required to wear when caring for a pediatric patient who is placed into airborne precautions for confirmed chicken pox/herpes zoster? Select all that apply. -Disposable gown -N 95 respirator mask -Face shield or goggles -Surgical mask -Gloves

-Disposable gown -N 95 respirator mask -Gloves (The organism is dispersed into the air and is light enough to stay afloat for long periods of time. Wearing protective covering and the filtration mask or hood prevents the staff from breathing in the infected air particles.)

A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection? Select all that apply. -It allows migration of organisms into the bladder. -The insertion procedure is not done under sterile conditions. -It obstructs the normal flushing action of urine flow. -It keeps an incontinent patient's skin dry. -The outer surface of the catheter is not considered sterile.

-It allows migration of organisms into the bladder. -It obstructs the normal flushing action of urine flow. (The presence of a catheter in the urethra breaches the natural defenses of the body. Reflux of microorganisms up the catheter lumen from the drainage bag or backflow of urine in the tubing increases the risk for infection. The indwelling catheter should always be placed under sterile conditions.)

Which of the following actions by the nurse comply with core principles of surgical asepsis? Select all that apply. -Set up sterile field before patient and other staff come to the operating suite. -Keep the sterile field in view at all times. -Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated. -Only health care personnel within the sterile field must wear personal protective equipment. -The sterile gown must be put on before the surgical scrub is performed.

-Keep the sterile field in view at all times. -Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated. (Keeping the sterile field in view at all times confirms that no contamination has occurred. The outer 2.5-cm (1-inch) of the sterile field is the most likely place for accidental contamination. The sterile table should be set up after the patient and staff are in the room to prevent a higher risk of contamination of the sterile field by air current. All surgical personnel will be wearing protective personal equipment in the surgical suite, not just those within the sterile field. The sterile gown and gloves are donned after the surgical scrub.)

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Streptococcus (beta-hemolytic group B) organisms

-Organism: Bacteria -Major Reservoir: Adult genitalia -Major Infection/disease: Urinary tract infection, wound infection, postpartum sepsis, neonatal sepsis

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Mycobacterium tuberculosis

-Organism: Bacteria -Major Reservoir: Droplet nuclei from lungs, larynx -Major Infection/disease: Tuberculosis

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Neisseria gonorrhoeae

-Organism: Bacteria -Major Reservoir: GU tract, rectum, mouth -Major Infection/disease: Gonorrhea, pelvic inflammatory disease, infectious arthritis, conjunctivitis

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Streptococcus (beta-hemolytic group A) organisms

-Organism: Bacteria -Major Reservoir: Oropharynx, skin, perianal area -Major Infection/disease: "Strep throat", rheumatic fever, scarlet fever, impetigo, wound infection

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Staphylococcus epidermidis

-Organism: Bacteria -Major Reservoir: Skin -Major Infection/disease: Wound infection, bacteremia

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it causes: Staphylococcus aureus

-Organism: Bacteria -Major Reservoir: Skin, hair, anterior nares, mouth -Major Infection/disease: Wound infection, pneumonia, food poisoning, cellulitis

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Rickettsia rickettsii

-Organism: Bacteria -Major Reservoir: Wood tick -Major Infection/disease: Rocky Mountain spotted fever

For this pathogen list the type of organism, it's major reservoir(s), and major infections/diseases it causes: Escherichia coli

-Organism: Bacteria -Major Reservoir: colon -Major Infection/disease: Gastroenteritis, urinary tract infection

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Candida albicans

-Organism: Fungi -Major Reservoir: Mouth, skin, colon, genital tract -Major Infection/disease: Candidiasis, pneumonia, sepsis

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Aspergillus organisms

-Organism: Fungi -Major Reservoir: Soil, dust, mouth, skin, colon, genital tract -Major Infection/disease: Aspergillosis, pneumonia, sepsis

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Plasmodium falciparum

-Organism: Protozoa -Major Reservoir: Blood -Major Infection/disease: Malaria

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Hepatitis B virus

-Organism: Virus -Major Reservoir: Blood and certain body fluids, sexual contact -Major Infection/disease: Hepatitis B

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Hepatitis C virus

-Organism: Virus -Major Reservoir: Blood and certain body fluids, sexual contact -Major Infection/disease: Hepatitis C

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Human immunodeficiency virus (HIV)

-Organism: Virus -Major Reservoir: Blood, semen, vaginal secretions, sexual contact -Major Infection/disease: Acquired immunodeficiency syndrome (AIDS)

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Hepatitis A virus

-Organism: Virus -Major Reservoir: Feces -Major Infection/disease: Hepatitis A

For this pathogen, list the type of organism, it's major reservoir(s), and major infections/diseases it cause: Herpes simplex virus (type 1)

-Organism: Virus -Major Reservoir: Lesions of mouth or skin, saliva, genitalia -Major Infection/disease: Cold sores, aseptic meningitis, STD, herpetic whitlow

Which of these statements are true regarding disinfection and cleaning? Select all that apply. -Proper cleaning requires mechanical removal of all soil from an object or area. -General environmental cleaning is an example of medical asepsis. -When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound. -Cleaning in a direction from the least to the most contaminated area helps reduce infections. -Disinfecting and sterilizing medical devices and equipment involve the same procedures.

-Proper cleaning requires mechanical removal of all soil from an object or area. -General environmental cleaning is an example of medical asepsis. -Cleaning in a direction from the least to the most contaminated area helps reduce infections. (Environmental surfaces (e.g., bedside table) potentially can contribute to cross-transmission by contamination of health care personnel from hand contact with contaminated surfaces, medical equipment, or patients. Cleaning from the least to the most contaminated area of a wound prevents recontamination of the cleaned area.)

Signs and symptoms of Localized Infection:

-Redness/erythema -Swelling/edema -Pain or tenderness -Warmth at site -Possible loss of function of affected area

How does stress affect risk for infection?

-Stress prolonged or intense stress results in elevated cortisone levels and decreased resistance to infection. -Increases glucose levels and decreases anti-inflammatory responses.

What does it mean when a patient is diagnosed with a multidrug-resistant organism in his or her surgical wound? Select all that apply. -There is more than one organism in the wound that is causing the infection. -The antibiotics the patient has received are not strong enough to kill the organism. -The patient will need more than one type of antibiotic to kill the organism. -The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively. -There are no longer any antibiotic options available to treat the patient's infection.

-The antibiotics the patient has received are not strong enough to kill the organism. -The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively. (Multidrug-resistant organisms are bacteria that have become resistant to certain antibiotics, and these antibiotics can no longer be used to control or kill the bacteria.)

Localized infections: a specific area is infected, wound, pain, redness, warmth, tenderness. Systemic infections: an infection affecting the entire body instead of one organ, can be fatal. How can nursing help control spread of infection??

-Use standard precautions, appropriate PPE, and hand hygiene when assessing the wound. The use of these precautions and hand hygiene blocks the spread of infection to other sites or other patients for localized. -The nurse is responsible for properly administering antibiotics, monitoring the response to drug therapy, using proper hand hygiene, and standard precautions. Supportive therapy includes providing adequate nutrition and rest to bolster defenses of the body against the infectious process. The course of care for the patient often has additional effects on body systems affected by the infection.

Portals of exit include sites such as:

-blood -skin and mucous membranes (breakdown allows exit) -respiratory tract (sneezing/cough) -genitourinary (GU) tract -gastrointestinal (GI) tract -transplacental (mother to fetus) -Reproductive tract

To thrive organisms require (survival needs):

-proper environment - food -oxygen -water, temperature -pH -light.

Resident skin microorganisms are not virulent. However, these skin microorganisms can cause serious infection when:

-surgery or other invasive procedures allow them to enter deep tissues or -when a patient is severely immunocompromised (has an impaired immune system).

Normal Adult Basophil count:

0.5%-1.5%

Normal Adult Eosinophil count:

1%-4%

What is the correct order of steps for removal of protective barriers after leaving an isolation room? -1. Remove gloves. -2. Perform hand hygiene. -3. Remove eyewear or goggles. -4. Untie top and then bottom mask strings and remove from face. -5. Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.

1, 3, 5, 4, 2 (This sequence ensures that the risk of contamination to other surfaces or health care personnel is minimized.)

Respiratory hygiene/cough etiquette:

1. Have patients cover the nose/mouth when coughing or sneezing 2. use tissues to contain respiratory secretions and dispose in nearest waste container 3. perform hand hygiene after contacting respiratory secretions and contaminated objects/materials; 4. contain respiratory secretions with procedure or surgical mask 5. spatial separation of at least 3 feet away from others if coughing.

Many measures that control Portals of Exit/Entry:

1. Maintaining the integrity of skin and mucous membranes reduces the chances of microorganisms reaching a host. 2. Keep a patient's skin well lubricated by using lotion as appropriate. Patients who are immobilized and debilitated are particularly susceptible to skin breakdown. 3. Do not position patients on tubes or objects that cause breaks in the skin. 4. It is important to turn and position patients before their skin becomes reddened. 5. Frequent oral hygiene prevents drying of mucous membranes. 6. A water-soluble ointment keeps the patient's lips well lubricated. 7. Wear clean gloves if there is a chance of contact with any blood or body fluids and perform hand hygiene after providing care. 8. Be sure to bag contaminated items (e.g., linen) appropriately.

When should you perform hand hygiene? (Standard precautions for use with ALL PATIENTS)

1. Perform hand hygiene before, after, and between direct contact with patients. (Examples of between-contact activities are cleaning hands after a patient care activity, moving to a non-patient care activity, and cleaning hands again before returning to perform patient contact.) 2. Perform hand hygiene after contact with blood, body fluids, mucous membranes, nonintact skin, secretions, excretions, or wound dressings; after contact with inanimate surfaces or articles in a patient room; and immediately after gloves are removed. 3. Wear gloves when touching blood, body fluids, secretions, excretions, nonintact skin, mucous membranes, or contaminated items or surfaces is likely. Remove gloves and perform hand hygiene between patient care encountersPerform hand hygiene before, after, and between direct contact with patients. (Examples of between-contact activities are cleaning hands after a patient care activity, moving to a non-patient care activity, and cleaning hands again before returning to perform patient contact.) 4. When hands are visibly soiled or contaminated with blood or body fluids, wash them with either a nonantimicrobial or an antimicrobial soap and water. 5. When hands are not visibly soiled or contaminated with blood or body fluids, use an alcohol-based, waterless antiseptic agent to perform hand hygiene (WHO, 2009). 6. Wash hands with nonantimicrobial soap and water if contact with spores (e.g., Clostridium difficile) is likely to have occurred. 7. Do not wear artificial fingernails or extenders if duties include direct contact with patients at high risk for infection and associated adverse outcomes. 8. Wear gloves when touching blood, body fluids, secretions, excretions, nonintact skin, mucous membranes, or contaminated items or surfaces is likely. 9. Remove gloves and perform hand hygiene between patient care encounters and when going from a contaminated to a clean body site.

Human reservoirs are divided into two types:

1. Those with acute or symptomatic disease 2. Those who show no signs of disease but are carriers of it

What are lab tests used to screen for infection?

1. WBC count 2. Erythrocyte sedimentation rate 3. Iron level 4. Cultures of urine and blood 5. Cultures and gram stain of wound, sputum, and throat 6. Differential count: -Neutrophils -Lymphocytes -Monocytes -Eosinophils -Basophils

The potential for microorganisms or parasites to cause disease depends on:

1. number of microorganisms present 2. their virulence, or ability to produce disease 3. their ability to enter and survive in a host 4. the susceptibility of the host.

Normal Adult Monocyte count:

2%-8%

Normal Adult Lymphocyte count:

20-40%

Microorganisms can live only in certain temperature ranges. Each species of bacteria has a specific temperature at which it grows best. The ideal temperature for most human pathogens is:

20° to 43° C (68° to 109° F)

A patient's surgical wound has become swollen, red, and tender. You note that the patient has a new fever, purulent wound drainage, and leukocytosis. Which interventions would be appropriate and in what order? 1. Notify the health care provider of the patient's status. 2. Reassure the patient and recheck the wound later. 3. Support the patient's fluid and nutritional needs. 4. Use aseptic technique to change the dressing.

4, 2, 1, 3 (The first three interventions require more immediate attention to the signs of suspected infection; supporting the patient's wound healing and hydration is important but can be addressed after action is taken to address early signs of infection.)

Most human pathogens prefer a pH level of:

5-7

Most microorganisms prefer an environment within a pH range of _____.

5.0 to 7.0

Normal Adult Values for White blood cell (WBC) count:

5000-10,000/mm3

Normal Adult Values for Neutrophils:

55-70%

Most human pathogens prefer temperatures that are:

68-109 degrees F

Measles, chickenpox (varicella), disseminated varicella zoster, pulmonary or laryngeal tuberculosis would require what kind of precautions?

AIRBORNE PRECAUTIONS (droplet nuclei smaller than 5 microns): -Private room -negative-pressure airflow of at least 6 to 12 exchanges per hour via high-efficiency particulate air (HEPA) filtration -mask or respiratory protection device -N95 respirator (depending on condition)

What transmission-based precautions would you use for a patient with Measles?

What transmission-based precautions would you use for a patient with chickenpox (varicella)?

What transmission-based precautions would you use for a patient with disseminated varicella zoster?

What transmission-based precautions would you use for a patient with pulmonary or laryngeal tuberculosis?

host produces own antibodies upon exposure

Active (secondary immunity)

An adult White blood cell (WBC) count value greater than 5,000-10,000 is an indication of

Acute infection

Which organism causes more infections in humans? Aerobic or Anaerobic?

Aerobic

______ bacteria require oxygen for survival and for multiplication sufficient to cause disease.

Aerobic

Pathogens that require oxygen to survive such as staph and strep are _____.

Aerobic (MOST COMMON TYPE IN HUMANS)

-smaller droplets, remain in air for long (measles, chickpox, TB) -Place in private room with negative pressure or place in room with client with same microorganism. -Wear special respiratory mask, N95 -Respirator mask/mask client if transport needed

Airborne (Tier Two)

Droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing or carried on dust particles.

Airborne mode of Transmission

Focus on diseases that are transmitted by smaller droplets, which remain in the air for longer periods of time. This requires a specially equipped room with a negative air flow referred to as an airborne infection isolation room. Air is not returned to the inside ventilation system but is filtered through a high-efficiency particulate air (HEPA) filter and exhausted directly to the outside. All health care personnel wear an N95 respirator every time they enter the room.

Airborne precautions

What kind of patients would require a protective environment? (Private room; positive airflow with 12 or more air exchanges per hour; HEPA filtration for incoming air; mask to be worn by patient when out of room during times of construction in area)

Allogeneic hematopoietic stem cell transplant patients

_______ typically cause infections deep within the pleural cavity, in a joint, or in a deep sinus tract.

Anaerobes

Pathogens that survive on little to no oxygen such as C. Difficile are _____.

Anaerobic

______ bacteria thrive where little or no free oxygen is available.

Anaerobic

An example of an anaerobic organism is _______, an organism that is part of the normal flora of the human colon but can cause infection if displaced into the bloodstream or surrounding tissue following surgery or injury.

Bacteroides fragilis

_____ Values remain normal during infection.

Basophils (0.5-1.5%)

Some bacteria assume a form, called a spore, which is resistant to drying, and can live on inanimate surfaces for long periods of time. A common spore-forming bacterium is _____, an organism that causes antibiotic-induced diarrhea.

C. difficile

_____ is the national public health agency concerned with prevention and control of disease.

CDC

What transmission-based precautions would you use for a patient with Colonization or infection with multidrug-resistant organisms such as VRE and MRSA, Clostridium difficile, shigella, and other enteric pathogens?

CONTACT PRECAUTIONS (direct patient or environmental contact): -Private room or cohort patients (see agency policy) -gloves -gowns -(Patients may leave their room for procedures or therapy if infectious material is contained or covered, placed in a clean gown, and if hands are cleaned.)

What transmission-based precautions would you use for a patient with Scabies?

What transmission-based precautions would you use for a patient with herpes simplex?

What transmission-based precautions would you use for a patient with major wound infections?

What transmission-based precautions would you use for a patient with respiratory syncytial virus in infants, young children, or immunocompromised adults?

What transmission-based precautions would you use for a patient with varicella zoster (disseminated)?

What transmission-based precautions would you use for an immunocompromised adult?

What transmission-based precautions would you use for a patient with meningococcal pneumonia or sepsis? pneumonic plague

DROPLET PRECAUTIONS (droplets larger than 5 microns; being within 3 feet of the patient): -Private room or cohort patients; -mask or respirator required (depending on condition) (refer to agency policy)

What transmission-based precautions would you use for: Colonization or infection with multidrug-resistant organisms such as VRE and MRSA, Clostridium difficile, shigella, and other enteric pathogens; major wound infections; herpes simplex; scabies; varicella zoster (disseminated); respiratory syncytial virus in infants, young children, or immunocompromised adults

Increased values of normal Lymphocytes (above 40%) would indicate:

Chronic bacterial and viral infection

Microorganisms require nourishment. Some such as ________, the microbe that causes gas gangrene, thrive on organic matter.

Clostridium perfringens

______ is the presence and growth of microorganisms within a host but without tissue invasion or damage.

Colonization

microorganism present and grows but without tissue invasion or damage

Colonization

If an infectious disease can be transmitted directly from one person to another, it is termed a _______.

Communicable disease

Used for direct and indirect contact with patients and their environment. Direct contact refers to the care and handling of contaminated body fluids. Contact precautions require a gown and gloves. An example includes blood or other body fluids from an infected patient that enter the health care worker's body through direct contact with compromised skin or mucous membranes. Indirect contact involves the transfer of an infectious agent through a contaminated intermediate object such as contaminated instruments or hands of health care workers. The health care worker may transmit microorganisms from one patient site to another if hand hygiene is not performed between patients

Contact precautions

•VRE = Vancomycin-resistant enterococci, C-diff, MRSA •Use Standard and contact precautions •Use equipment assigned to that room only •Isolation until 3 negative cultures taken 1 week apart

Contact precautions

After elimination instruct women to clean the rectum and perineum by wiping from the urinary meatus toward the rectum. Cleaning in a direction from the least to the most contaminated area helps reduce GU infections. Meticulous and frequent perineal care is especially important in older-adult women who wear disposable incontinence pads. These are all examples of

Control of Portals of Exit/Entry

Interval when acute symptoms of infection disappear. (Length of recovery depends on severity of infection and patient's host resistance; recovery may take several days to months.)

Convalescence

A normal Iron level (80-180 in men, 60-160 in women) is ____ in a chronic infection.

DECREASED

The normal White blood cell (WBC) count value (5,000-10,000) is _____ in certain viral or overwhelming infections.

DECREASED

Diphtheria (pharyngeal), rubella, streptococcal pharyngitis, pneumonia or scarlet fever in infants and young children, pertussis, mumps, Mycoplasma pneumonia, meningococcal pneumonia or sepsis, pneumonic plague would all require what kind of precautions?

What transmission-based precautions would you use for a patient with Diphtheria (pharyngeal)?

What transmission-based precautions would you use for a patient with Mycoplasma pneumonia?

bacteria that naturally reside in a closed system. Disease occurs when the client's own flora are altered and an overgrowth results or when normal bacterial flora enter a sterile body area.

Endogenous

What transmission-based precautions would you use for a patient with mumps?

What transmission-based precautions would you use for a patient with pertussis?

What transmission-based precautions would you use for a patient with pneumonia or scarlet fever in infants and young children?

What transmission-based precautions would you use for a patient with pneumonic plague?

What transmission-based precautions would you use for a patient with rubella?

What transmission-based precautions would you use for a patient with streptococcal pharyngitis?

Person-to-person (fecal, oral) physical contact between source and susceptible host (e.g., touching patient feces and then touching your inner mouth or consuming contaminated food)

Direct Contact mode of Transmission

-particle droplets > 5 microns (large), -Influenza, mycoplasma pneumonia, pertussis, mumps -Private room, or with same DX -Wear mask if working within 3 feet -Move client outside of room only for essential purposes, and place mask on client

Droplet (Tier Two)

Large particles that travel up to 3 feet during coughing, sneezing, or talking and come in contact with susceptible host

Droplet mode of Transmission

Focus on diseases that are transmitted by large droplets (greater than 5 microns) expelled into the air and by being within 3 feet of a patient. Droplet precautions require the wearing of a surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated-care equipment. An example is a patient with influenza.

Droplet precautions

A patient is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Which type of isolation precaution is most appropriate for this patient? -Reverse isolation -Droplet precautions -Standard precautions -Contact precautions

Droplet precautions and Contact precautions (The patient has a multidrug resistant organism within his respiratory tract that has become pathogenic. The route of transmission for this type of condition is respiratory; thus whenever the patient coughs or sneezes, organisms are sprayed into the air and then drop onto surfaces in the room. In addition to gown and gloves, a mask must also be worn.)

The normal Erythrocyte sedimentation rate value (men=15, women=20) is ___ in the presence of inflammatory process.

ELEVATED (indicates infection)

Some viruses such as ______ are transmitted through direct contact with the blood or body fluids of a person who is sick with Ebola. However, droplets (e.g., splashes or sprays) of respiratory or other secretions from a person who is sick with _____ could also be infectious. Therefore certain precautions (called standard, contact, and droplet precautions) are recommended for use in health care settings to prevent the transmission of the virus from patients who are sick with ____ to health care personnel and other patients or family members.

Ebola virus, Ebola

emptying urinary drainage bags are examples of

Eliminating reservoirs of infection

What is the protective environment?

Environment where allogeneic hematopoietic stem cell transplant patients need. Private room with positive airflow with 12 or more exchanges, HEPA filtration for incoming air, mask worn by patient if leaving the room.

Microorganisms require nourishment. Some such as _______ consume undigested foodstuff in the bowel. Carbon dioxide and inorganic material such as soil provide nourishment for other organisms.

Escherichia coli

HAIs microorganisms are external to host (outside the client), not normal flora.

Exogenous

A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention? -Provide a dark, quiet room to calm the patient. -Reduce the level of precautions to keep the patient from becoming angry. -Explain the reasons for isolation procedures and provide meaningful stimulation. -Limit family and other caregiver visits to reduce the risk of spreading the infection.

Explain the reasons for isolation procedures and provide meaningful stimulation. (Patients on isolation precautions may interpret the needed restrictions as a sign of rejection by the health care worker.)

______ is an example of a communicable disease that can be asymptomatic. It is most efficiently transmitted through the direct passage of blood into the skin from a percutaneous exposure, even if the source patient is asymptomatic.

HCV (Hepatitis C virus-major cause of liver cancer/liver disease)

What is the most effective way to control transmission of infection? -Isolation precautions -Identifying the infectious agent -Hand hygiene practices -Vaccinations

Hand hygiene practices (Hands contaminated with transient bacteria are a primary source for transmission of infection.)

The normal White blood cell (WBC) count value (5,000-10,000) is _____ when there is an acute infection.

INCREASED

An Erythrocyte sedimentation rate value elevated higher than 15 (for men) or higher than 20 (for women) would indicate:

INFECTION/INFLAMMATION (Elevated in presence of inflammatory process)

direct result from invasive diagnostic or therapeutic procedures

Iatrogenic

Interval when patient manifests signs and symptoms specific to type of infection. For example, strep throat is manifested by sore throat, pain, and swelling; mumps is manifested by high fever, parotid and salivary gland swelling.

Illness Stage

Client manifest signs and symptoms specific to infection. Sore throat, pain, and swelling due to step throat. Or mumps manifested by high fever, parotid and salivary gland swelling.

Illness stage

directed towards a specific infectious agent

Immunity (secondary)

Interval between entrance of pathogen into body and appearance of first symptoms (e.g., chickenpox, 14 to 16 days after exposure; common cold, 1 to 2 days; influenza, 1 to 4 days; measles, 10 to 12 days; mumps, 16 to 18 days; Ebola 2 to 21 days

Incubation Period

Personal contact of susceptible host with contaminated inanimate object (e.g., needles or sharp objects, dressings, environment)

Indirect Contact mode of Transmission

Invasion of host by pathogen resulting in disease

Infection

Bedside Unit • Keep table surfaces clean and dry.