Concept of infection

susceptible host

Tx of underlying risk, recognition of high-risk PTs, nutrition, mobilization, safe practices, isolation

Droplet precaution

clients who are known to have or suspected of having serious illnesses transmitted by particle droplets larger than 5 microns EX: M. Pneumoniae, Influenza, mumps, rubella, diphtheria, streptococcal pharyngitis

serosanguinous

clear or blood-tinged discharge commonly seen in surgical incisions

contact precautions

clients who are known to have or suspected of having serious illnesses that are easily transmitted by direct client contact or by contact with items in the client's environment EX: C. diff, shigella, hep. A

local infection

infection limited to a specific part of the body

systemic infection

infection that has spread and damaged different parts of the body

procedures and situations that affect likelihood of infection

1. Puncture wounds from contaminated needles or other sharps 2. Skin contact, which allows infectious fluids to enter through wounds and broken or damaged skin 3. Mucous membrane contact, which allows infectious fluids to enter through mucous membranes of the eyes, mouth, or nose. 4. Chemotherapy 5. The use of corticosteroids 6. Radiation therapy 7. Urinary catheterization 8. Respiratory care procedures such as ventilators 9. Surgical procedures are closely linked to HAIs

culture and sensitivity

A culture is a test to find germs (such as bacteria or a fungus) that can cause an infection --identifying the pathogen A sensitivity test checks to see what kind of medicine, such as an antibiotic, will work best to treat the illness or infection --drawn prior to antibiotic administration

diagnostics

CBC WBC >11.0mm3 (11 years and more adults) elevated B and T lymphocyte, neutrophil and monocyte indicative of bacterial or viral infection significant elevation of neutrophils - BACTERIAL infection elevation of neutrophil and basophil - PARASITIC infection Bands - immature neutrophils, greater than 6% of total neutrophils, indicate acute bacterial infection

compromised host - chronic disease and associated treatments

DM, cancer, hepatic disorders increase vulnerability to infecton medical therapy - antineoplastic, corticosteroids, antibiotics, presence of invasive devices (IV siste, catheter insertion, intubation)

Asymptomatic

No clinical evidence of disease, even with an invasion by microorganisms.

disease-specific isolation precautions (specific)

Provide precautions to protect against a specific disease. These precautions call for use of private rooms with special ventilation, sharing of rooms only with other clients infected with the same organism, and gowning to prevent gross soilage of clothes for specific infectious diseases

Category-specific Isolation Precautions: (Non-specific)

Strict isolation, Contact isolation, Respiratory isolation, Tuberculosis isolation, Enteric precautions, Drainage/Secretions precautions, and Blood/Body Fluid precautions

Describe the role of the nurse in obtaining or having specimens obtained prior to becoming antimicrobial treatment

The nurse is able to obtain the sample without an order. If they have a suspicion that the specimen will be ordered

disposal of soiled equipment and supplies

bagging linens lab specimens dishes blood pressure equipment disposable needles, syringes, and sharps disposable equipment and supplies nondisposable equipment and supplies

nutrition

a balanced diet enhances the health of all body tissues, helps keep the skin intact, and promotes the skin's ability to repel microorgs. adequate nutrition enables tissues to maintain and rebuild themselves and helps keep the immune system functioning well. in addition, because antibodies are proteins, inadequate nutrition can impair the body's ability to synthesize them, especially when protein reserves are depleted.

asepsis

absence of disease-causing microorganisms

Risk factors

age - infant immune system is immature elderly - changes take place in skin, respiratory tract, GI system, kidneys, and immune system that may predispose

bactericidal

an agent that destroys bacteria

susceptible host

an individual at increased risk for one or more reasons is more likely than others to acquire an infection

nonspecific defenses

anatomical and physiological barriers and the inflammatory response

broad spectrum antibiotics

antibiotic that acts against a wide range of disease-causing bacteria. A broad-spectrum antibiotic acts against both Gram-positive and Gram-negative bacteria,

portal of exit

break by hand hygiene, waste disposal, control of body fluids, PPE

antibiotics

broad spectrum peak and trough level monitor wbc monitor site of infection

C. diff vs MRSA

c. diff -Healthcare workers should follow isolation guidelines, which include the use of gloves and gowns when taking care of patients with C-diff. Keep in mind, hand sanitizers do not kill the C-diff bacteria. Always wash your hands with soap and water after patient care. MRSA - using standard precautions, such as gloves and gowns, when treating patients with MRSA. As always, hand washing is one of the best ways to prevent the spread of infections like MRSA.

reservoirs

can break by immunization, staff health, hygiene, environmental cleaning, food safety, disinfection sterilization

microorganism

can break first chain by identification and appropriate antibiotics

portal of entry

catheter care, hygiene, wound care, skin preparation, aseptic procedure, PPE

geographical location

cholera

narrow spectrum antibiotics

effective against specific families of bacteria

purulent

containing, consisting of pus

radiological examination

do not lead to confirmation of infection help visualize possibility of infection and/or its extend of infection

sleep

essential to maintaining health and renewing energy

Chain of infection

etiologic agent - microorganism - bacteria, fungi, protozoa, viruses, prions reservoir - source (where they thrive) - people, food, equipment, water (characteristic of/dependent on nutrients, O2, moist/dry, pH, temp.) EX: mouth, intestines, nose and skin in people portal of exit from reservoir (body fluids, skin, droplets) method of transmission - direct contact, ingestion, airborne, fomites portal of entry to the susceptible host - broken skin, GI tract, mucous membrane, respiratory tract susceptible host - immunosuppression, diabetes, immobility, age, surgery, cancer, normal flora suppression

stress

excessive stress predisposes people to infections. nature, number, and duration of stressors can influence susceptibility to infection. stressors elevate blood cortisone, and the prolonged elevation of blood cortisone decreases anti-inflammatory responses, depletes energy stores, leads to a state of exhaustion, and decreases resistance to infection.

fluid

fluid intake permits fluid output, which flushes out the bladder and urethra, removing microorgs that could cause infection

urine analysis

frequent urination pain or burning during urination cloudy, bloody, or foul-smelling urine

personal protective equipment

gloves gowns face masks eye wear

transmission route

hand hygiene, disinfection and sterilization, airflow control, food handling, PPE, isolation

specific defenses

immune system's process that begins when the body becomes sensitive to an antigen, and continues when antibodies are formed to contain or destroy the antigen

compromised host

immunodeficiency malnutrition - may cause increased metabolic rate, check albumin level and hemoglobin medication for the prevention of rejection of transplanted organs

infection process

incubation prodromal period acute phase or illness phase covalescence

CAUTI bundle

indwelling urinary catheters should be used in accordance with established evidence-based guidelines that address limiting their use and duration to those that are necessary for patient care aseptic technique securing the catheter to allow for unobstructed urine flow and drainage maintaining the urine collection system's sterility and replacing it when needed collecting urine samples selecting measures and monitoring compliance using evidence-based guidelines or best practices evaluating the effectiveness of infection prevention efforts.

nosocomial infections

infections that have been caught in a hospital and are potentially caused by organisms that are resistant to antibiotics. not present or incubating prior to the patient's being admitted to the hospital, but occurring within 72 hours after admittance to the hospital.

iatrogenic infections

infections transmitted during medical treatment and care --medication or physician

bacteriostatic

inhibiting growth or multiplication of bacteria

hygiene

intact skin and mucous membranes are one barrier against microorgs. entering the body. in addition, good oral care reduces likelihood of oral infection. regular bathing and shampooing removes microorgs. and dirt that can result in an infection

infection v2

invasion of body tissue by microorganisms with the potential to cause illness or disease moisture, warmth, nutrients, pH (stomach = 2), source of o2 (anaerobic or aerobic)

socioeconomic status

lack of preventive care or access to immunization

sanguinous exudate

large amount of RBCs that form a bright or dark red indicating new or old damage to capillaries

Illness stage

maximal impact of the infectious process occurs as pathogen proliferates and disseminates rapidly Toxic byproducts of microbial metabolism, cell lysis, immune response -- produce tissue damage and inflammation manifestations are more pronounced and specific to the infecting organism fever and chills may be significant alcoholic clients and older adults may respond to severe infection by becoming hypothermic PT often tachycardic and tachypneic because of increased metabolic demands local manifestations: redness, heat, swelling, pain, and impaired function ***Rapid multiplication, inflammatory and immune responses triggered, manifestation of the disease (local vs systemic)

pathogen

microorganism causing disease in healthy individuals

antifungal

monitor site of infection

indirect method of transmission

no human-to-human contact poor hand hygiene Vehicle: water, food, blood, plasma, fomites: glucose machine, surgical instruments, or dressing, clothing, bedding, sink Vector: mosquitoes, flies, mites, fleas, ticks, rodents, or dogs ingestion: fecal-oral transmission (through water and food, cholera, hep.A) inhalation (airborne transmission) - droplet (TB) or dust

antiviral

no treatment for viral infection

systemic manifestations of infection

nonspecific symptoms shared by other diseases if febrile - temp. > 100.4 F or 38 C Tachypnea: Resp >20 Tachycardia HR > 100bpm alcoholic and elderly may not develop temp. --hypothermic chills fever and shivering may be absent in eldery -- instead: altered mental status, disorientation, tachypnea chills, malaise, loss of energy, headache, loss of appetite, aching

covalescent stage

occurs when the infection is contained and the pathogen is eliminated affected tissues are repaired and manifestations resolve resolution of infection -- total elimination of pathogen from body without residual manifestations chronic disease, latency or carrier state may develop (host defenses eliminate infectious disease, but the organism continues to multiply on mucosal sites)

Who should get vaccinated for influenza

people who are at high risk of developing serious complications like pneumonia if they get sick with the flu. Includes: people who have certain medical conditions, including asthma, diabetes, and chronic lung disease. Pregnant women. People 65 years and older.

incubation period

period from exposure to first symptoms when the pathogens begins active replication but does not yet cause symptoms insufficient number to create disease -- NO recognizable symptoms Asymptomatic

immunization

pneumococcal is recommended for older adults who were last vaccinated more than 5 years previously and for individuals who are immunocompromised, or have risk factors such as chronic pulmonary, liver, or cardiac disease.

medical asepsis

procedures used to reduce number of microorganisms and prevent their spread hand washing and "no touch" dressing technique

colonization

process by which strains of microogranisms become resident flora, but do not cause disease

serous

producing or containing serum

environmental condition

sanitation condition crowded living conditions

isolation precaution = implementation of standard precaution

standard precautions - used in the care of all hospitalized individuals regardless of their diagnosis or possible infection status transmission-based precautions - used in addition to standard precautions for clients with known or suspected infections that are spread by contact or by airborne or droplet transmission

surgical asepsis

sterile technique procedure used to eliminate any microorganisms sterilization of surgical instruments

local manifestation of infection

swelling - edema pain erythema - redness warmth impaired function drainage: purulent - bacterial infection clear - viral infection, allergies

Prodromal period

symptoms begin to appear -- nonspecific/vague and include: general malaise, fever, myalgias (undetermined body ache), headache, and fatigue, low grade temp.

universal precautions

techniques to be used with all clients to decrease the risk of transmitting unidentified pathogens obstruct spread of bloodborne pathogens, microorganisms carried in blood and body fluids that are capable of infecting other individuals with serious and difficult to treat viral infections, EX: Hep. B, Hep. C and HIV

infection

the invasion of body tissue by microorganisms with the potential to cause illness or disease

virulence

the severity of the disease and how infectious they are organism must have disease-causing potential to cause an infection

antibiotic peak and trough level

to make sure the amount of medication in the patient's blood stream is still high enough to be therapeutic vancomycin and gentamycin

direct method of transmission

touching, biting, kissing, sexual intercourse (sneezing, coughing, sneezing, spitting, or talking can project droplets in the conjunctiva and mucous membranes of eyes, nose, and mouth if people are within 3 feet of each other human-to-human contact

isolation practices

use strict aseptic technique when performing any invasive procedure (inserting needle or catheter) and when changing surgical dressings

airborne precaution

used for clients who are known to have or suspected of having serious illnesses transmitted by airborne droplet nuclei smaller than 5 microns EX: measles, varicella, TB