infection control fundamentals

Gloves

- protect hands

An infection occurs as a result of a cyclical process. The six components of an infection are a. infectious agent, source of infection, portal of exit, mode of transmission, portal of entry, and susceptible host. b. infectious agent, reservoir, portal of exit, vehicle of movement, portal of entry, and susceptible host. c. infectious agent, reservoir, portal of exit, vehicle of transmission, portal of entry, and unsusceptible host. d. invading agent, reservoir, portal of exit, vehicle of transmission, portal of entry, and susceptible host.

A

The nurse is caring for a patient who has been diagnosed with methicillin-resistant Staphylococcus aureus located in her incision. What transmission-based precautions will the nurse implement for the patient? a. Private room b. Private, negative-airflow room c. Mask worn by the staff when entering the room d. Mask worn by the staff and the patient when leaving the patient's room

A

When caring for a patient with rubella, in addition to standard precautions, which precautions would be used? a. Droplet precautions b. Airborne precautions c. Contact precautions d. Universal precautions

A

what are the appropriate barriers for droplet precautions

A regular surgical mask worn within three feet of the patient. Standard precautions. N0 special airflow is required

The nurse is caring for a patient that has a diagnosis of methicillin-resistant Staphylococcus aureus (MRSA). Which of the following infection-control practices should the nurse implement? (Select all that apply.) a. Wear a protective gown when entering the patient's room. b. Don a particulate respirator mask when administering medication to the patient. c. Ensure that all staff serving the patient's meal trays don gloves prior to delivering of tray. d. Instruct all visitors to wear a surgical mask when entering the patient's room. e. Use sterile gloves when performing dressing changes. f. Use a face shield before irrigating the patient's wounds.

A, C, F

You are making a home visit to a family of 5 children. The youngest, aged 5, has a temperature of 101.1°F, is lethargic, and has a poor appetite. This assessment leads you to the diagnosis of influenza. Based on your knowledge that influenza is an airborne communicable disease, all of the following patient teachings regarding infection are appropriate for the mother and family except a. keep children home from day care and school while symptoms are present. b. remind family that they only need to wash their hands if they are visibly dirty. c. do not share tissues, dishes, or personal care items to reduce the risk of transmission. d. encourage the family to receive their annual influenza vaccine

B

types of diseases that require droplet precautions

Bacterial Meningitis Influenza Pertussis

Inflammation:

Body's cellular response to injury, disease, infection, or irritation; Protective vascular reaction that delivers fluid, blood products, and nutrients to injury

A new patient is admitted to a medical unit with Clostridium difficile. Which type of precautions or isolation does the nurse know is appropriate for this patient? a. Airborne precautions b. Droplet precautions c. Contact precautions d. Protective isolation

C

During normal patient care that does not soil hands, effective hand hygiene between patients requires a. at least a 20-second soap and water scrub. b. at least a 23-minute scrub with antimicrobial soap. c. use of an alcohol-based antiseptic handrub. d. a mask must be worn while scrubbing is occurring.

C

A nurse is caring for an overweight 60-year old woman with a reddened area over her coccyx. The priority nursing diagnosis for this patient is a. Imbalanced Nutrition: More Than Body Requirements related to immobility. b. Impaired Physical Mobility related to pain and discomfort. c. Chronic Pain related to overweight. d. Risk for Infection related to altered skin integrity.

D

Of the following patients, which patient is at a higher risk of infection? a. 27-year-old female who is an athlete b. 60-year-old male with arthritis c. 12-year-old female with a broken leg d. 36-year-old female with HIV

D

Susceptible host:

Decreased immune system

Normal Flora:

Found in skin, saliva, mouth, GI, GU tract

Sequence for Removing PPE

Gloves Face shield or goggles Gown Mask or respirator Wash hands!

Sequence* for Donning PPE

Gown first Mask or respirator Goggles or face shield Gloves

types of diseases that require contact precautions

MRSA (methicillin-resistant staph aureus) VRE (vancomycin-resistant enterococcus) Purulent wounds Infectious diarrhea

Portal of entry to host:

Often same as exit

Body System Defenses:

Organ's unique defenses against organisms ex. cilia in respiratory tract

Standard Precautions

Previously called Universal Precautions; Assumes blood and body fluid of ANY patient could be infectious; Recommends PPE and other infection control practices to prevent transmission in any healthcare setting; Decisions about PPE use determined by type of clinical interaction with patient

Contact-

Required when an organism can be transmitted to others by coming in contact with infectious secretions.

what are appropriate barriers for contact preacutions

Standard Precautions Gown and/or gloves Private room or cohort patients Dedicate patient care equipment to single patient when possible Decontaminate equipment after use

what are appropriate barriers for airborne precautions

Standard precautions Negative airflow room Special respirators - N95 (for TB) Patient wears surgical mask for transport

Asepsis

The state of being free of living pathogenic microorganisms. The process of removing pathogenic microorganisms or protecting against infection by such organisms.

what diseases require airborne precautions

Tuberculosis Measles Chicken Pox Appropriate

Mode of transmission:

Unwashed hands, sneeze

Airborne Precautions- barriers:

When a patient coughs, AIRBORNE ORGANISMS can potentially stay suspended in the air for hours without proper ventilation.

Of the following assessment findings, which signs indicate to a nurse that a patient has a surgical site infection? (Select all that apply.) a. Thick, white drainage in the Jackson-Pratt tubing b. Redness or warmth at the affected site c. Purulent drainage at the incision site d. Temperature 100.4 F (38 C) e. Tenderness and localized pain f. Wound with well-approximated edges g. Purulent drainage at the incision site

a, b, c, d, e, g

In which situations does the nurse wear clean gloves as part of standard precautions? (Select all that apply.) a. In the care of a patient diagnosed with an infectious process b. When the patient is diaphoretic c. During care of each individual under treatment in the facility d. In the presence of urine or stool e. When taking the patient's blood pressure

a, c, d

Of the following hospitalized patients, who is most at risk for acquiring a health-care-associated infection? a. 60-year-old who smokes two packs of cigarettes per day b. 40-year-old who has an indwelling urinary catheter in place c. 65-year-old who is a vegetarian and slightly underweight d. 60-year-old who has a white blood cell count of 6000

b

The nurse is caring for a patient who had abdominal surgery and has developed an infection in the wound while hospitalized. Which agent is most likely the cause of the infection? a. Virus b. Bacterium c. Fungus d. Spore

b

Pathogen:

bacteria, virus

A patient develops food poisoning from contaminated food. What is the means of transmission for the infectious organism? a. Direct contact b. Vector c. Vehicle d. Airborne

c

The nurse is providing patient education on infection prevention. Which definition of an infection does the nurse use as a teaching point? a. An illness resulting from living in an unclean environment b. A result of lack of knowledge about food preparation c. A disease resulting from pathogens in or on the body d. An acute or chronic illness resulting from traumatic injury

c

What is the proper order of removal of soiled personal protective equipment when the nurse leaves the patient's room? a. Gown, goggles, mask, gloves, and exit the room b. Gloves, wash hands, remove gown, mask, and wash hands c. Gloves, goggles, gown, mask, and wash hands d. Goggles, mask, gloves, gown, and wash hands

c

A nurse is preparing to change a sterile dressing and has donned two sterile gloves. To maintain surgical asepsis, what else must the nurse do? a. Keep the amount of splashes on the sterile field to a minimum. b. If a sneeze is imminent, cover the nose and mouth with a gloved hand. c. With a moist saline sponge, use the dominant hand to clean the wound and then apply a dry dressing. d. Regard the outer 1 inch of the sterile field as contaminated.

d

Infection

entry and multiplication of an organism in a host

Reservoir:

food, water, O2

Medical asepsis, or clean technique,

includes procedures used to reduce the number of organisms present and prevent the transfer of organisms; Hand washing, Clean gloves, gowning , Wearing facial masks when appropriate, Separating clean from contaminated

Pathogen

infectious agent

Colonization

occurs when a pathogen is present but does not cause an infection

Communicable Disease

occurs when the disease is transferred from one person to another

Goggles -

protect eyes

Face shields -

protect face, mouth, nose, and eyes

Masks and respirators-

protect mouth/nose; Respirators - protect respiratory tract from airborne infectious agents

Gowns/aprons -

protect skin and/or clothing

Portal of exit:

skin, resp., GI, GU, blood

Droplet -

when the patient coughs, large droplets containing infectious organisms that are aerosolized, land within three feet of the patient