Kinns Chapter 27 Infection Control
Which of the following procedures require the use of disposable gloves. 1. Assisting with a vaginal examination 2. Performing a routine urinalysis 3. Measuring a patient's temperature, pulse, and respirations 4. Performing a patient interview 5. Drawing blood from a 6-year-old child
1. Assisting with a vaginal examination 2. Performing a routine urinalysis 3. Drawing blood from a 6-year-old child
List five different bodily fluids that have been identified as potentially infectious by the CDC.
1. Cerebrospinal fluid (CSF); synovial, pleural, pericardial, peritoneal, mucous, and amniotic fluids 2. Liquid or semiliquid blood 3. Vaginal and seminal secretions 4. Saliva in dental procedures 5. Body fluid visibly contaminated with blood
List the chain of infection in order.
1. Infectious Agent 2. Reservoir Host 3. Portal of exit 4. Mode of transmission 5. Portal of entry 6. Susceptible host
Name the ways the body naturally defends itself from infection.
1. Intact Skin 2. Mucous membranes 3. Cilia hairlike projections line the respiratory tract and move in coordinated upward motion to trap foreign substances 4. Sneezing/coughing 5. Secretions 6. Neutral pH
Describe the five conditions needed for microorganisms to grow.
1. Nutrients-Carbs, proteins, and fats 2. Moisture 3. Temperature- many flourish at body temp 4. Oxygen- some require O2 to grow, others don't 5. Neutral pH
Identify four safety rules that should be followed in the ambulatory care setting to comply with Osher's environmental protection guidelines.
1. Observe warning labels on biohazard containers and equipment. 2. Minimize splashing or spraying of potentially infectious materials. Blood that splatters onto open areas of the skin or mucous membranes is a proven mode of transmission of HBV. 3. Bandage any breaks or lesions on your hands before gloving. 4. If exposed body surfaces, such as the eyes, come in contact with body fluids, flush with water and/or scrub with soap and water as soon as possible using an eye wash unit.
Describe three things the medical assistant can do to promote environmental protection of the office
1. Observe warning labels on biohazard containers and equipment. 2. Minimize splashing, spraying, and spattering of drops of potentially infectious materials. Splattering of blood onto skin or mucous membranes is a proven mode of transmission of HBV. 3. Bandage any breaks or lesions on the hands before gloving.
List the five groups of infectious organisms
1. Viruses 2. Bacteria 3. Protozoa 4. Fungi 5. Rickettsiae
Describe the procedure for proper hand washing.
1.Remove all jewelry except your wristwatch, which should be pulled up above your wrist or removed, and a plain gold wedding ring. 2.Turn on the faucet with a paper towel and regulate the water temperature to lukewarm. 3.Allow your hands to become wet, apply soap, and lather using a circular motion with friction while keeping your fingertips pointed downward. Rub well between your fingers. If this is the first hand washing of the day, thoroughly inspect the area under each fingernail and clean with a nail brush or an orange stick. 4.Rinse well, holding your hands so that the water flows from your wrists downward to your fingertips. 5.Wet your hands again and repeat the scrubbing procedure using a vigorous, circular motion over the wrists and hands for at least 1 to 2 minutes. 6.Rinse your hands a second time, keeping your fingers lower than your wrists. 7.Dry your hands with paper towels. Do not touch the paper towel dispenser as you get the towels. 8.If the faucets are not foot operated, turn off the water faucet with the paper towel. 9.After you finish drying your hands and turning off the faucets, discard the used towels in a bio-hazardous waste container. 10.Apply a water-based antibacterial hand lotion to prevent chapped or dry skin.
Sanitization
A cleansing process that reduces the number of microorganisms to a safe level as dictated by the public health guidelines
Antigen
A foreign substance that causes the production of a specific antibody
Disinfectant
A liquid chemical that is capable of eliminating many or all pathogens but is not effective against bacterial spores
Latent
A persistent infection in which the symptoms cycle through periods of relapse and remission
Interferon
A protein formed when a cell is exposed to a virus; the protein blocks viral action on the cell and protects against viral invasion
Urticaria
A skin eruption that creates inflamed wheals; hives
Palliative
A substance that relieves or alleviates the symptoms of a disease without curing the disease
Spores
A thick-walled, dormant form of bacteria that is very resistant to disinfection measures
List four types of infection.
Acute infection, chronic, latent, slow.
Germicides
Agents that destroy pathogenic organisms
Permeable
Allowing a substance to pass or soak through
Anaphylaxis
An exaggerated hypersensitivity reaction that in severe cases leads to vascular collapse, bronchospasm, and shock
Candidiasis
An infection caused by a yeast that typically affects the vaginal mucosa and skin
Chronic
An infection that persists for a long period, sometimes for life
Vector
Animals or insects (ex. ticks) that transmit the causative organisms of disease
Tinea
Any fungal skin disease that results in scaling, itching, and inflammation
Transient Bacteria
Bacteria temporarily living in or on a certain body part, such as the hands
Resident Bacteria
Bacteria that live in or on a certain part of the body; such as the skin or mucosa
List five groups of infectious organisms.
Bacteria, fungi, viruses, protozas, rickettsia
Potentially infectious fluids are:
Blood, semen, vaginal sectetion
Inflammatory Process`
Bodies second line of defense against infection - responses that destroy and remove pathogenic organisms and their byproducts, or limits the extent of damage caused by the invading pathogen. Includes erythema, edema, pain and heat. Causes an increase in white blood cells.
CDC stands for ___.
Center for Disease Control
List three potentially infectious fluids.
Cerebrospinal Fluid (CSF) Synovial Pleural Pericardial Peritoneal Mucous Amniotic Fluids Blood Vaginal Seminal Secretions Saliva
List three types of bacteria and describe their shapes.
Cocci - sphere Bacilli - rod Spirilla - spiral anaphylaxis response
Fomite
Contaminated, nonliving objects (ex. examination room equipment) that can transmit infectious organisms
Pus formation
Destroyed pathogens, cells, and WBCs collect in the area and form a thick, white substance.
Sterilization
Destruction of all microorganisms
Surgical Asepsis
Destruction of organisms before the enter the body
Name a symptom of sign of latex allergy.
Difficulty breathing
List the signs and symptoms of inflammation.
Edema Erythema Pain Heat
True/False Viruses are susceptible to antibiotics.
False
True/False Viruses may be treated with antibiotics.
False
Integumentary System
First line of defense against pathogenic invasion. (mechanical barrier to infection)
Hepatitis A can be _____.
Food borne
Sterile
Free of all microorganisms, pathogenic and non-pathogenic
Name the two factors required for proper hand washing.
Friction and running water
List several items that should be included in the OSHA Exposure plan.
Housekeeping, PPE, vaccinations, post-exposure, training, medical surveillance, record keeping.
Explain the difference between cell-mediated immunity and humoral immunity.
Humoral immunity creates specific antibodies to combat antigens Cell-mediated immunity attacks the source of the infection at the cellular level.
Rosa is concerned that she may be allergic to latex. For what signs and symptoms should she look when she puts on latex gloves? Is Rosa's employer required to supply her with latex-free gloves if she does have a latex allergy? Why or why not?
Hypersensitivity reactions to latex gloves or the powder that lines them may be localized, causing urticaria, dermatitis, conjunctivitis, and rhinitis; they also may be systemic reactions, manifesting as asthmatic reactions or an anaphylactic response. Osher's guidelines require healthcare workers to wear gloves. If an employee is allergic to latex, the employer must provide the proper gloves to enable the person to perform his or her job duties.
Septicemia
If the body is too weak or the number of pathogens is too great, the bloodstream.
Enlarged lymph nodes
If the pathogenic invasion is too great for localized control, the infection may collect in the body's lymph nodes.
Antibody
Immunoglobulins produced by the immune system in response to bacteria, viruses, and other antigenic substances
Opportunistic infections
Infections caused by a normally non-pathogenic organism in a host whose resistance has been decreased
The first link in the chain of infection is:
Infectious Agent
Anaerobes
Live without oxygen
OSHA stands for
Occupational Safety and Health Administration
The relief of symptoms is called ___.
Palliative Treatment
Hereditary
Pertaining to a characteristic, condition, or disease transmitted from parent to offspring on the DNA chain
Pathogenic
Pertaining to a disease-causing microorganism
Autoimmune
Pertaining to a disturbance in the immune system in which the body reacts against its own tissue
Acute
Rapid onset of symptoms but last relatively short time
Medical Asepsis
Removal of disease-causing organisms or destruction of the organisms after they leave the body
Aerobes
Require oxygen to grow
For proper handwashing, you need:
Running water and friction
Rhinitis means ____.
Runny nose
_____________ is the cleansing process that reduces the number of microorganisms to a safe level as dictated in public health guidelines.
Sanitation
__________ is the cleansing process that decreases the number of microorganisms to a safe level as dictated in public health guidelines.
Sanitization
Contaminated
Soiled with pathogens or infectious material, non-sterile.
List several barriers or types of personal protective equipment that are commonly used in physicians' offices.
Specialized clothing, latex gloves, face masks, protective glasses, laboratory coats, and mouthpieces.
Coccie bacteria are ____.
Spherical-shaped
Instruments in surgery are ____.
Sterile
Antiseptic
Substances that inhibit the growth of microorganisms on living tissues
Parenteral
The injection or introduction of substances into the body by any route other than the digestive tract
Remission
The partial or complete disappearance of the clinical and subjective characteristics of a chronic or malignant disease
Pyemia
The presence of pus-forming organisms in the blood
Disinfection
The process of killing pathogenic organisms or rendering them inactive
Relapse
The recurrence of the symptoms of a disease after apparent recovery
Describe the impact of the inflammatory response on the body's ability to defend itself against infection.
Through the inflammatory response, the body prevents the invasion of microorganisms after trauma or limits the number of these invaders. This process has four classic symptoms: erythema, pain, edema, and heat. When cellular damage occurs, inflammatory mediators are released, which cause blood vessels to dilate and become permeable and chemotaxis to occur; this brings more WBCs to the site.
Coagulate
To form clots
Hand Sanitation should be performed after gloves have been removed.
True
True/False two factors needed for proper hand washing are friction and running water.
True
True/False Hand washing must be performed after taking off gloves.
True
When removing contaminated gloves, ____.
Turn inside out one over the other
Hypersensitivity to latex products may include the following symptoms:
Urticaria, Dermatitis, conjunctivitis, rhinitis,
Explain the five major areas included in the OSHA compliance guidelines.
a. Barrier protection devices b. Environmental protection c. Housekeeping controls d. Hepatitis B immunizations e. Postexposure follow-up
Rosa is explaining the signs and symptoms of inflammation to a patient. List the four classic symptoms.
a. Erythema b. Edema c. Pain d. Heat
List six common errors of disinfection.
a. Instruments are not thoroughly sanitized, and attached organic matter inhibits or prevents the action of the disinfectant. No chemical can kill unless it reaches all instrument surfaces; therefore, complete sanitization is absolutely necessary. b. Sanitized instruments are not dried, and the moisture on the instruments dilutes the disinfectant solution beyond the effective concentration. c. A solution is left in an open container, and evaporation changes its concentration. d. Solutions are not changed after the recommended period for use has expired. e. Solutions are not prepared properly or not mixed properly before use. f. The manufacturer's recommended temperature for use and storage is not maintained.
Employers with workers who are at risk for occupational exposure to blood or other infectious materials must implement an Occupational Safety and Health Administration (OSHA) Exposure Control Plan that details employee protection procedures. List seven items that should be included in the plan.
a. PPE b. Training c. Medical surveillance d. Hepatitis B vaccination e. Record keeping for workplace injuries f. Labeling hazardous materials g. Engineering controls
Rosa is helping to update the OSHA Exposure Control Plan in her office. She wants to include a policy for wearing gloves. List six different times gloves should be worn.
a. When touching a patient's blood and body fluids, mucous membranes, or skin that is not intact. b. When handling items and surfaces contaminated with blood and body fluids. c. When performing venipuncture, finger sticks, injections, and other vascular procedures. d. When cleaning. e. When handling, processing, and disposing of all specimens of blood and body fluids. f. When decontaminating spills of blood or other body fluids.
Define nosocomial
acquired or occurring in a hospital
Define Antibody
an immunoglobulin produced by the immune system in response to invading bacteria, viruses, or other antigenic substances.
Rosa is helping to update the OSHA Exposure Control Plan in her office. She wants to include a policy for wearing gloves. All of the following are times gloves should be worn EXCEPT: a. When touching a patient's blood and body fluids, mucous membranes, or skin that is not intact. b. Handling items and surfaces contaminated with blood and body fluids. c. While taking a patient's medical history d. Performing venipuncture, finger sticks, injections, and other vascular procedures. e. Cleaning f. Handling, processing, and disposing of all specimens of blood and body fluids g. Decontaminating spills of blood or other body fluids.
c. While taking a patient's medical history
Inflammation mediators that are released at the site of cellular damage perform which of the following functions? a. Increase blood flow to the site b. Increase the permeability of blood vessel walls c. Cause more red blood cells (RBCs) to be attracted to the site of injury d. Both A and B e. All are correct
d. Both A and B
Which of the following are potentially infectious fluids? a. Synovial b. Pleural c. cerebrospinal fluid (CSF) d. mucous e. Blood f. Peritoneal g. amniotic fluids h. human tissue i. All of the above
i. All of the above
Rhinitis
inflammation of the mucous membranes of the nose
Viruses form a substance called ____.
interferon
A/an ________________ infection is usually acquired during hospitalization or in a healthcare setting.
nosocomial
The most important step in achieving asepsis is:
washing hands
While performing venipuncture, Rosa receives an accidental needlestick. Describe the postexposure instructions and follow-up procedures.
• The employee should immediately wash or flush the exposed area. • The employee should immediately report the incident to the supervisor. • The employee should receive a confidential medical evaluation. The physician caring for the exposed employee must receive written details regarding the exposure incident including the route and circumstances surrounding the incident. All documentation related to the exposure must remain confidential, not disclosed to any individual without the employee's express written permission, and kept for at least the duration of the worker's employment plus 30 years. • An incident report must be filed that documents the details surrounding the exposure incident, the route or type of exposure, and the identity, if known, of the source individual. The source individual is the person, living or dead, whose blood or potentially infectious material was the source of the occupational exposure. • The source individual, if known, is immediately screened for HBV and HIV. State law determines whether the employee may be told the results of the source individual's tests. • The exposed employee is tested for HBV and HIV if consent is given. If the employee refuses the tests but blood is drawn, the sample must be stored 90 days for the worker to decide whether screening is wanted. • If the employee has not been vaccinated against HBV, vaccination is offered. • The employee must receive a copy of the healthcare provider's written opinion within 15 days of completion of the evaluation. • The employee must receive health counseling regarding the risk of illness or other adverse outcomes of exposure and the potential for as well as consequences of transmission of the disease to family, patients, and others.
Rosa realizes that her patient needs to be educated about proper asepsis. However, in a busy office, the staff does not have a lot of extra time. What can Rosa do during her time with the patient to educate the person properly about aseptic techniques?
• While hand washing, explain to the patient that this routine is part of daily hygiene and is particularly important for patients who are very young or old or who seem to get sick frequently. Discuss with the patient that hands should be washed before and after meals; after sneezing, coughing, or nose blowing; after using the bathroom; before and after changing a dressing; and after changing an infant's diaper. • Explain to the patient how using disposable tissues to cover the nose and mouth when coughing or sneezing reduces the possibility of transmitting illness between household members. • Discuss proper ways of disposing of used tissues, especially when a member of the household is suspected of having a communicable disease. • Instruct the patient about the differences between sterile and clean dressings and bandages. Show him or her step by step how to change a dressing properly and then how to dispose of the contaminated items. • Set up an information table in the waiting room with take-home pamphlets and literature. • Mail a periodic newsletter to patients about infection control, especially during flu season. • Demonstrate and explain aseptic procedures to patients and/or family members, inviting them to participate.