Chp 24 Asepsis

Lab data indicating infection are?

-Elevated WBC count: normal is 5000 to 10,000/mm3 -Increase in specific types of WBC -Elevated erythrocyte sedimentation rate (RBCs settle more rapidly to the bottom of a tube of whole blood when an inflammation is present) -Presence of pathogen in urine, blood, sputum, or draining cultures

A pediatric client's caregiver states, "I will never give my child vaccinations." What is the priority nursing response?

"Help me understand your thoughts about vaccinations."

HAND HYGIENE: USING AN ALCOHOL-BASED HANDRUB

Apply product to the palm of one hand, using the amount of product recommended on the package (it will vary according to the manufacturer but usually is 1 to 3 mL). Rub hands together, making sure to cover all surfaces of the hands, fingers, and in between the fingers. Also, clean the fingertips and the area beneath the fingernails. Continue rubbing until the hands are dry (at least 15 seconds).

Examples of medical asepsis(clean technique)?

Hand hygiene using clean gloves cleaning the environment routinely

The nurse working with the hospital's infection control team is attempting to decrease the transmission of healthcare-associated pathogens. Which intervention will be most effective?

Incentivizing health care workers to utilize hand hygiene

The nurse notices a student preparing to enter the room of a client with pulmonary tuberculosis with only gloves on. What is the appropriate nursing intervention?

remind the student that a fitted N95 respirator is required

The nurse is preparing to don a gown to care for a client requiring contact precautions. When should the nurse don the gown?

Before entering the client's room

When do we perform Hand hygiene?

Moment 1 - Before touching a patient Moment 2 - Before a clean or aseptic procedure Moment 3 - After a body fluid exposure risk Moment 4 - After touching a patient Moment 5 - After touching patient surroundings

Cardinal signs of infection are?

Redness Heat Swelling Spike in fever Pain loss of function

What is an accurate guideline for the use of PPE?

Replace gloves if they are visibly soiled.

The nurse is teaching a new nurse about preparing a sterile field. Which action made by the new nurse would indicate further teaching is required?

The new nurse touches 1.5 in. (4 cm) from the outer edges.

The nurses on a busy surgical ward use hand hygiene when caring for postsurgical patients. Which action represents an appropriate use of hand hygiene?

The nurse keeps fingernails less than 1/4 in (0.63 cm) long.

Surgical asepsis is defined as:

absence of all microorganisms.

The nurse is caring for a client who became very ill after ingesting seafood. How will the nurse document this condition?

noncommunicable disease

A nurse is taking care of a client with tuberculosis who has developed resistance to the ordered antibiotic. Which type of client is most likely at increased risk for infection?

older adult

A nurse is caring for a 55-year-old postoperative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first?

urinary catheter

Which is not appropriate regarding the use of gowns as PPE?

use of one gown per person per shift

when an alcohol-based handrub can be used to decontaminate hands (IHI, 2018):

Before direct contact with patients After direct contact with patient's skin After contact with body fluids, mucous membranes, nonintact skin, and wound dressings, if hands are not visibly soiled After removing gloves Before inserting urinary catheters, peripheral vascular catheters, or invasive devices that do not require surgical placement Before donning sterile gloves prior to an invasive procedure (e.g., inserting a central intravascular catheter) If moving from a contaminated body site to a clean body site during patient care After contact with objects (including equipment) located in the patient's environment

four categories that are responsible for a majority of HAIs in the acute care hospital setting

Catheter-associated urinary tract infection (CAUTI) Surgical site infection (SSI) Central line-associated bloodstream infection (CLABSI) Ventilator-associated pneumonia (VAP)

The nurse is removing soiled gloves after assisting with a sterile procedure. Which actions follow recommended guidelines for this procedure? Select all that apply.

Discard the gloves in appropriate container, removing additional PPE, if used, and performing hand hygiene. Use the dominant hand to grasp the opposite glove near cuff end on the outside exposed area. Remove the glove by pulling it off, inverting it as it is pulled, and keeping the contaminated area on the inside.

What is the most effective way to prevent the spread of infectious disease?

Hand hygiene

An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student?

Hand hygiene is needed after contact with objects near the client.

An operating room nurse is caring for a client who will soon undergo an appendectomy. Which handwashing technique is most appropriate for the nurse to use when caring for this client?

Perform surgical hand scrub using detergent.

The nurse is caring for a client who has active tuberculosis and is under airborne precautions. The health care provider prescribes a computed tomography (CT) examination of the chest. Which action by the nurse is appropriate?

Place a surgical mask on the client and transport to the CT department at the specified time.

The nurse uses a small amount of sterile solution from a large, multiuse bottle to moisten gauze in a sterile field. What technique does the nurse use?

Pour the liquid into a sterile container within the sterile field.

The nurse is preparing a sterile field for a dressing change. How would the nurse add paper-wrapped sterile items to the sterile field?

Separate the sealed flaps and drop contents onto field.

The nurse planning to insert an indwelling urinary catheter into a client should utilize which technique?

Surgical asepsis

A client has tested positive for methicillin-resistant Staphylococcus aureus after being swabbed on admission to the hospital. Bacterial resistance to antibiotics is an example of:

Survival adaptation

When a nurse picks up a client's contaminated tissue without gloves and fails to wash the hands sufficiently, the nurse provides for the client's organisms to be spread by which type of transmission?

contact

To eliminate needlesticks as potential hazards to nurses, the nurse should:

immediately deposit uncapped needles into a puncture-proof plastic container.

Examples of Surgical Asepsis (sterile technique)

inserting an undwelling urinary cath inserting an IV cath

Medical asepsis (clean technique)

involves procedures used to reduce and prevent the spread of microorganisms.

Surgical technique (sterile technique)

practices used to render and keep objects and areas free of microorganisms

The nurse observes an unlicensed assistive personnel (UAP) collecting a urine specimen from a client with Staphylococcus aureus infection. Which action by the UAP would require the nurse to intervene?

removes gloves and walks out of the room