Chapter 26 - Asepsis

Describe medical asepsis

"Clean technique" Handwashing Wearing gloves Gowning Disinfecting

Describe surgical asepsis

"Sterile technique" Used to prevent the introduction of microorganisms from the environment to the patient Used for surgical procedures, invasive procedures, procedures that invade the bloodstream or break the skin: dressing changes & wound care

What are the three components of innate immunity?

1. Normal Flora 2. Barriers 3. Inflammation

What are the five cardinal symptoms of inflammation?

1. Redness 2. Swelling 3. Heat 4. Pain 5. Loss of function

What are antibodies?

Immunoglobulin molecules that recognize foreign invaders.

How does hand hygiene break the chain of infection?

Interrupts the mode of transmission

What are factors that contribute to microorganism resistance?

Overuse of antibiotics for nonbacterial infections Use of inappropriate antibiotic for the infecting microorganism Incomplete courses of antibiotics. Antibiotic use in animals

Which body system has proteins with antimicrobial properties and promotes phagocytosis? a. Respiratory system b. Gastrointestinal system c. Integumentary system d. Musculoskeletal system

a. Respiratory system

What is disinfection?

The removal of pathogenic microogranimsms Destroys everything except spores

Describe acute infections

Develop and run their course rapidly Ex: Coughs, colds, ear infections

What is another term for the source of an infection?

Reservoir or host Reservoirs can be inanimate objects such as surfaces, equipment, medication, air, food, and water on which microorganisms live Human sources of infection are health care personnel, family, friends, and patients. Animals such as insects, rats, birds, pigs, and cows spread disease Inanimate objects like soil, water, food, hospital equipment

When does airborne transmission occur?

When microorganisms are dispersed by air currents and inhaled or deposited o the skin of susceptible host Ex: TB, measles, chickenpox

What does the differential WBC help determine?

Whether the body is mounting a immune response to an infection. A shift to left indicates infection

What are HAI's

Health care-associated Infections

What are the blood-born pathogens of primary concern in healthcare?

Hepatitis B Hepatitis C HIV

Can viruses be killed with antibiotics?

No

What are parasites?

Organisms that live on or in other organisms. Typically transmitted through sexual contact, insects, and domestic animals. Ex: Malaria, intestinal worm infestations

What are signs of localized infections?

Redness Swelling Warmth Pain Tenderness Drainage Numbness Loss of function to the affected area Confusion

What is implemented to limit direct exposure to blood and bodily fluids?

Standard Precautions

What is the mode of transmission?

The form of transportation in which a microorganism travels from the source to a susceptible host. Modes of transmission include contact, airborne, vehicle (e.g., food, water, contaminated objects), droplet, and vector-borne (e.g., insects, animals).

What is innate immunity?

The innate (nonspecific) immune system provides immediate defense against foreign antigens. Skin, normal flora, inflammatory response, cough reflex, mucus, enzymes on the skin and in tears, and acid in the gastrointestinal tract prohibit harmful substances from entering the body. Innate immunity provides short-term and nonspecific defense against foreign antigens immediately or within hours of the antigen's presence in the body. Once the antigen has been destroyed and the reaction is over, there is no memory of the event for future immunity. The same antigen will cause the same reaction in the future.

Which term describes a microorganism that causes serious disease? a. Pathogen b. Antigen c. Virulent d. Invasive

a. Pathogen Pathogens are potentially dangerous microorganisms that can cause serious illness when they gain entry into the host.

What are the three mechanisms of inflammation?

1. Capillary Dilation: blood flow to the site of injury is increased, which causes the area to feel warm and appear reddened. 2. Increased Capillary Permeability: Chemical mediators allow fluid, cells, and protein to leak from surrounding blood vessels into the injured tissue, which results in swelling and pain. 3. Exudate Formation and Repair: leukocyte (white blood cells) migration to the injury site. Phagocytosis occurs to prevent pathogen multiplication.

What are the six main components in the chain of infection?

1. The infection agent 2. The source of infection 3. The portal of exit 4. The mode of transmission 5. The portal of entry 6. The susceptible host

What is humoral immunity?

A defense system that involves white blood cells (WBCs; B lymphocytes) that produce antibodies in response to antigens or pathogens circulating in the lymph and blood. Humoral immunity enables production of inflammatory molecules such as interferon and interleukin-1, which cause fever. If a pathogen gets past the innate response, it is attacked by the adaptive immune system, which generates antigen-specific antibodies and lymphocytes

What is the immune response?

Activated by inflammation The body's attempt to protect itself from foreign and harmful substances. Initiated by the recognition of antigens.

What is adaptive immunity?

Adaptive immunity provides active, long-term defense against a foreign antigen. Adaptive immunity is acquired by exposure to specific antigens. If a pathogen gets past the innate response, adaptive immunity is activated, eliminating the pathogen and providing memory of the event for future immunity from the same specific antigen. Adaptive immunity responses include the generation of: Antigen-specific antibodies Lymphocytes Subsequent exposure to the antigen produces a stronger and faster immune response by these memory cells Long-term active immunity can be artificially acquired by immunization with vaccines.

What are vectors?

Carry the pathogens from one host to another. Ex: Ticks, raccoons Ex: Lyme disease, rabies, west nile

_____________________ is a late sign of infection, indicating septicemia and shock.

Decreased blood pressure

What are signs of systemic infections?

Fever Increased HR Increased R Lethargy Anorexia Tenderness or enlargement of lymph nodes Confusion

What are the two types of adaptive immunity?

Humoral (antibody-mediated) Cellular (cell-mediated) immunity

What does Erythrocyte Sedimentation Rate (ESR) assess?

Measure the degree of inflammation in the body - the result can be an indicator of infection. Times how fast red blood cells settle to the bottom of a tube of whole blood; they settle faster when inflammation is present.

What is normal flora?

Non-disease-causing microorganisms (e.g., bacteria, fungi, protozoa) that live in or on the body. These benign microorganisms are found in and on the skin, eyes, nose, mouth, upper throat, lower urethra, small intestine, and large intestine. The normal flora constitutes the body's first line of defense against infection because it inhibits pathogenic microorganisms from colonizing healthy individuals

What nutrients must be replaced to ensure adequate functioning of the body's defense mechanism during infections?

Proteins Vitamins Minerals Water

What is the definition of asepsis?

Refers to freedom from and prevention of disease-causing contamination.

What are bacteria?

Single-cell organisms. Bacteria live as normal flora on and in the skin, eyes, nose, mouth, upper throat, lower urethra, lower intestine, and large intestine. They are capable of causing disease in the human population when they overgrow as a result of immune system compromise or when they enter different areas of the body. Bacteria are identified when a sample taken from the body is cultured, and exact antibiotic sensitivity is tested so that appropriate antibiotics are prescribed.

What is susceptible host?

Someone exposed to an infectious disease who is likely to contract the disease. Increase susceptibility: Age Malnutrition Immunocompromised Trauma/Surgery

What is portal of entry?

The means by which the microorganism enters the susceptible host.

What is portal of exit?

The means by which the pathogen escapes from the reservoir of infection. Microorganisms escape through emesis, sputum, urine, stool, blood, genital secretions, and wound drainage.

What is the inflammatory response?

The second line of defense A local response to cellular injury or infection that includes capillary dilation and leukocyte infiltration. Produces heat, redness, pain, and swelling.

What are HAI's associated with?

Use of medical devices: Catheters Ventilators Complications after surgical procedure Contagious transmission between patients and health care workers Overuse of antibiotics

What are the smallest microorganisms?

Viruses

Altered ___________________ signs can indicate infection.

Vital Ex: Increase in temperature, BP, Pulse, Respirations

What is passive immunity?

When a person receives an antibody produced in another body. Passive immunization provides immediate but short-term protection against antigens. Infants acquire passive immunity naturally in utero or through breast milk, and these antibodies disappear between the ages of 6 and 12 months. Passive immunity can be acquired artificially when antibodies are transferred from one person to another by injection of an antibody-rich serum (e.g., immune globulin).

When does contact transmission occur?

When body surfaces touch surfaces of other bodies. Direct contact involves a physical transfer of the microorganism. Indirect transfer occurs when the microorganism is transferred by way of a contaminated object: dressing, needle, surgical instrument

When does droplet transmission occur?

When the mucous membranes of the respiratory tracts are exposed to the secretions of an infected invidual. Droplets cannot remain suspended in the air for long. Ex: Flu

What does a sensitivity test help determine?

Which antibiotics, if any, can be used to treat the infection

The nurse works in a hospital and understands that health care-associated infections (HAI) are difficult to treat. Which patients are at increased risk of developing HAI? Select all that apply. a. A patient who underwent bronchoscopy b. A patient who receives broad-spectrum antibiotics c. A patient who has an indwelling urinary catheter d. A patient suffering from diabetes mellitus e. A patient who has a fever

a. A patient who underwent bronchoscopy b. A patient who receives broad-spectrum antibiotics c. A patient who has an indwelling urinary catheter d. A patient suffering from diabetes mellitus Rationale: Bronchoscopy bypasses the natural defenses of the body and predisposes to HAIs. Broad-spectrum antibiotics suppress the normal flora and promote growth of resistant strains of microorganisms. An indwelling urinary catheter surpasses the natural defenses and also serves as a port of entry for microorganisms. Diabetes mellitus suppresses the body's immunity and increases the risk of HAIs. Fever does not affect the natural defense mechanism, and therefore does not increase the risk of HAIs.

The nurse is attending to a patient who has a pressure ulcer that needs a dressing change. Which actions would the nurse perform to ensure preparation of a sterile field? Select all that apply. a. Choose a clean, dry work surface above waist level. b. Remove bracelets, rings, and watches. c. Perform hand hygiene before handling equipment. d. Hold inner edge of flap when opening the dressing kit. e. Check labels and condition of supply packaging and equipment.

a. Choose a clean, dry work surface above waist level. b. Remove bracelets, rings, and watches. c. Perform hand hygiene before handling equipment. e. Check labels and condition of supply packaging and equipment. Rationale: A clean, dry work surface above waist level should be used, since a sterile object that is held below the waist is considered contaminated. Bracelets, rings, and watches can harbor microorganisms and hence need to be removed. Hand hygiene before handling equipment helps reduce spread of microorganisms. Checking labels and the condition of supply packaging and equipment gives an idea of any previous opening that may cause soiling or contamination; also labels provide information about the date of packaging and other important information about sterility of the product. The outer edge of the outermost flap should be held when opening the commercial kit, as the outer surface is considered unsterile and helps keep the inner kit sterile.

A head nurse is teaching cough etiquette to staff members at the hospital. Which instructions would the nurse include in the teaching? Select all that apply. a. Cover the nose and mouth with a tissue when coughing. b. Dispose of any contaminated tissue promptly. c. Maintain a distance of at least 2 feet from persons with respiratory infections. d. Maintain a distance of greater than 3 feet from persons with respiratory infections. e. Place a surgical mask on a patient if it does not compromise respiratory function.

a. Cover the nose and mouth with a tissue when coughing. b. Dispose of any contaminated tissue promptly. d. Maintain a distance of greater than 3 feet from persons with respiratory infections. e. Place a surgical mask on a patient if it does not compromise respiratory function. Rationale: Cough etiquette involves covering the nose and mouth with a tissue when coughing. It helps prevent the spread of infections. Disposing of contaminated tissue promptly helps contain the microbes. Spatial separation of greater than 3 feet from persons with respiratory infections helps avoid contracting infection through droplets. Placing a surgical mask on a patient if it does not compromise respiratory function helps prevent infection in the patient. A distance of 2 feet is too close and promotes spread of infection through droplets.

During which encounters is a patient at risk for acquiring health care-associated infections (HAIs)? Select all that apply a. Dialysis treatment b. Outpatient surgery c. Provider office visit d. Rehabilitation session e. Neighborhood pharmacy

a. Dialysis treatment b. Outpatient surgery c. Provider office visit d. Rehabilitation session

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 perineal 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. In the care of a patient diagnosed with an infectious process c. During perineal care of each individual under treatment in the facility d. In the presence of urine or stool Rationale: The nurse uses standard precautions for situations in which an infectious disease is known or when there is a possibility of contact with blood or body fluids (except perspiration). Gloves are not necessary when taking the blood pressure of a patient who is not in isolation and who does not have any other risk factors.c.

Nurses understand that normal flora protect against infection by which mechanism? a. Inhibiting microorganisms from colonizing b. Preventing pathogens from entering circulation c. Destroying infectious agents on body surfaces d. Neutralizing and eliminating foreign antigens

a. Inhibiting microorganisms from colonizing Normal flora is the body's first line of defense because it inhibits pathogenic microorganisms from colonizing in healthy individuals.

A patient who underwent a hysterectomy 10 days ago comes for a follow-up visit. The patient notices purulent drainage at the incision site. The nurse suspects wound infection and performs assessment for confirmation. Which clinical findings would the nurse evaluate? Select all that apply. a. Pain b. Redness c. Paleness d. Tenderness e. Cold sensation

a. Pain b. Redness d. Tenderness Rationale: Pain is an important finding in wound infection due to inflammation. Redness is commonly seen in wounds that are infected. Tenderness is observed in a wound infection due to localized swelling and inflammation. The infected wound appears red; it does not appear pale. The skin around the infected wound is warm to the touch.

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. Private room Rationale: A private room decreases the chance of another patient contracting the infection. The other precautions (i.e., private room with negative airflow, mask worn by staff when entering the room, and mask worn by staff and patient when leaving the patient's room) are airborne precautions, which are not necessary in managing this patient.

Which areas of the human body would the nurse understand to have normal flora on their surface as part of the body's defenses against infection? Select all that apply. a. Skin b. Lower throat c. Upper urethra d. Large intestine e. Lower intestine

a. Skin d. Large intestine e. Lower intestine Rationale: Normal flora is a group of non-disease-causing microorganisms such as bacteria, fungi, and protozoa. These microorganisms live within or on the body and act as the first line of defense against infections. They are usually found in or on the skin, eyes, nose, mouth, large intestine, and lower intestine. Normal flora is not evident in the lower throat but is observed in the upper throat. Normal flora is not observed in the upper part of the urethra but is observed in the lower urethra.

The nurse is caring for a patient after cardiac surgery. Which interventions would reduce the risk of an infectious illness? Select all that apply. a. Wash hands before and after giving care. b. Monitor the patient's temperature every 4 hours. c. Evaluate the patient's white blood count as ordered. d. Follow strict aseptic techniques while suctioning the patient. e. Encourage the patient to perform deep breathing and coughing exercises.

a. Wash hands before and after giving care d. Follow strict aseptic techniques while suctioning the patient e. Encourage the patient to perform deep breathing and coughing exercises Rationale: Handwashing interrupts the infection cycle and helps avoid the spread of infection. Following strict aseptic techniques helps avoid the spread of disease-causing microorganisms. The nurse encourages the patient to perform deep breathing and coughing exercises, which helps remove secretions and prevent respiratory complications. The nurse should monitor the patient's temperature to identify the start of an infection, but it will not help prevent an infectious illness. The nurse should evaluate the patient's white blood count as an elevated total white blood count usually indicates an infection, but this will not help reduce the risk of an infectious illness.

Your ungloved hands come in contact with drainage from your patient's wound. Which method to clean your hands is correct? a. Wash them with soap and water. b. Use an alcohol-based hand cleaner. c. Rinse them and use the alcohol-based hand cleaner. d. Wipe them with a paper towel.

a. Wash them with soap and water Rationale: Physically removing wound drainage is most effectively accomplished by washing with soap and water. Soap and water must be used to thoroughly clean hands if there is any visible soiling or dirt and with certain infections such as Clostridium difficile and vancomycin-resistant enterococci when preparing for a sterile or surgical procedure, before and after eating, and after using the restroom. In all other situations, a hand sanitizer is as effective as soap and water. Rinsing alone is not a method of hand hygiene nor is simply wiping your hands on a paper towel.

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

b. A 40-year-old who has an indwelling urinary catheter in place Rationale: Hospital-acquired infections are associated with indwelling urinary catheters. A normal white blood cell count, smoking cigarettes, or being a vegetarian has not been associated with hospital-acquired infections.

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. Bacterium Rationale: The cause of an infection in the surgical wound in a hospitalized patient who has had abdominal surgery is most likely bacteria because it is present on the skin as normal flora. Fungi and spores are the focus of removal during the surgical preparation. Viruses are target specific and do not usually live on the skin.

Which precaution/isolation does the nurse follow while providing care to a patient with Clostridium difficile infection? a. Droplet precaution b. Contact precaution c. Airborne precaution d. Protective isolation

b. Contact precaution Rationale: Transmission-based precautions include contact, droplet, airborne, and protective isolation. The mode of transmission for Clostridium difficile, a highly contagious, gram positive bacterium, infection is through contact. In addition to standard precautions, the nurse should use contact precautions while providing care for patients with Clostridium difficile infection. The nurse should use droplet precautions while providing care for a patient with known or suspected contagious diseases that can be transmitted through large droplets in the air, like pertussis. The nurse should use airborne precautions while providing care for a patient with known or suspected contagious diseases that can be transmitted through small droplets in the air, like tuberculosis. The nurse should follow protective isolation precautions while caring for an immunocompromised patient, like one with leukemia. STUDY TIP: Think Clostridium = Contact precautions.

Which method of sterilizing a straight urinary catheter and suction tube in the home setting is appropriate? a. Use an autoclave. b. Use boiling water. c. Use ethylene oxide gas. d. Use chemicals for disinfection.

b. Use boiling water Rationale: The best sterilizer in a home setting is boiling water. An autoclave, ethylene oxide gas, and disinfection chemicals are not available in nor appropriate for the home care setting. Test-Taking Tip: When the question asks about a particular setting, consider what is likely to be available in that setting. Autoclaves and ethylene oxide gas are not likely to be present in the home setting, so you can eliminate those choices. Even specific chemicals for disinfection may not be available. The availability of boiling water makes it the clear choice.

The nurse has been splashed in the face with body fluids. In what order will the nurse respond? List in Order a. Flush splashed areas to the nose and mouth with water b. Wash exposed skin, cuts, and needle stick injuries c. Irrigate eyes with clean water or saline if available d. Report exposure to immediate supervisor

b. Wash exposed skin, cuts, and needle stick injuries a. Flush splashed areas to the nose and mouth with water c. Irrigate eyes with clean water or saline if available d. Report exposure to immediate supervisor

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. A disease resulting from pathogens in or on the body Rationale: A disease resulting from pathogens in or on the body is the definition of an infection. An illness resulting from living in an unclean environment, from lack of knowledge about food preparation, or from trauma can lead to an infection but does not define an infection.

A nurse is assessing a group of patients in a health screening program. Which technique would the nurse use to determine the risk of infections in these patients? Select all that apply. a. Inquire about appetite. b. Compare monthly earnings. c. Assess immunization details. d. Inquire about travel history. e. Inquire about medication history.

c. Assess immunization details. d. Inquire about travel history. e. Inquire about medication history. Rationale: Assessing immunization details is important to understand about the vaccines taken as preventive measures. Travel history can reveal important information regarding the risk of exposure to communicable diseases. Medication history will help identify any medications that can increase the susceptibility of infections. Information about appetite is not relevant in assessment of risk of infection. Comparing monthly earnings is unrelated to assessment of risk of infection.

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. Contact precautions Rationale: Contact precautions are used with C. difficile because transmission of a contagious disease is possible through contact with the patient or with the equipment or items in the patient's room. Airborne precautions are used when a contagious disease is spread by small droplets that remain suspended in the air for a long period. Droplet precautions are used when a disease is spread by large droplets in the air. Protective isolation is used for patients who are immunosuppressed.

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. Gloves, goggles, gown, mask and wash hands Rationale: Gloves are removed before the rest of personal protective equipment because they usually are the most contaminated. Protective eyewear or goggles are removed next by grasping them by the earpieces. Gowns are removed by untying the waist and then the neck and grasping inside the neck. The mask is removed last because it prevents the spread of respiratory microorganisms. Hands should be washed thoroughly after the equipment has been removed and before leaving the room.

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. Vehicle Rationale: Contaminated food is a vehicle for transmitting an infection. Direct contact requires close proximity between the susceptible host and an infected person. A vector is a nonhuman carrier. In airborne transmission, the organism is carried through the air on a small droplet or dust particles.

A nurse works in a medical-surgical unit. Which patient would the nurse evaluate as the highest risk for health care-associated infections (HAIs)? a. 20-year-old patient admitted with gastroenteritis b. 24-year-old patient admitted with a fracture of the leg c. 34-year-old patient admitted for appendectomy d. 53-year-old diabetic patient admitted for herniorrhaphy

d. 53-year-old diabetic patient admitted for herniorrhaphy Rationale: HAIs are those which are acquired by patients in the hospital during their stay. People whose immunity is compromised are at risk of these infections. Those who are at greater risk include the elderly, the malnourished, or those who have some underlying conditions that compromise their immunity, such as diabetes or malignancies. Therefore the 53-year-old diabetic patient is at increased risk of HAI. Gastroenteritis, fracture, and appendectomy do not increase the risk of HAIs.

Which type of immunity serves as the body's first line of defense by providing immediate protection against foreign antigens? a. Active immunity b. Passive immunity c. Adaptive immunity d. Innate immunity

d. Innate immunity

A family member is providing care to a loved one who has an infected wound. Which action would you instruct the family member to perform after providing care and handling contaminated equipment or organic material? a. Wear gloves before eating or handling food. b. Place any soiled materials into a bag and double-bag it. c. Have the family member check with the doctor about need for immunization. d. Perform hand hygiene after care and/or handling contaminated equipment or material.

d. Perform hand hygiene after care and/or handling contaminated equipment or material. Rationale: Clean hands interrupt the transmission of microorganisms from family members. Soap and water must be used to thoroughly clean hands if there is any visible soiling or dirt and with certain infections such as Clostridium difficile and vancomycin-resistant enterococci when preparing for a sterile or surgical procedure, before and after eating, and after using the restroom. In all other situations, a hand sanitizer is as effective as soap and water. The family member does not need to wear gloves before eating or handling food. There is no need to double-bag soiled materials. The family member does not need to consult the doctor regarding immunizations.

A nurse is preparing to change a sterile dressing and has donned a pair of 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. Regard the other 1 inch of the sterile field as contaminated Rationale: Considering the outer 1 inch of the sterile field as contaminated is a principle of sterile technique. Moisture contaminates the sterile field. Sneezing or coughing would contaminate the sterile glove and necessitate replacing the contaminated glove with a new sterile one. The hand used to clean the wound would not be used to apply a dry dressing. The hand would have to be regloved.

Which precautions will be implemented for a patient admitted for suspected West Nile virus? a. Contact b. Droplet c. Airborne d. Standard

d. Standard precautions will be implemented for this patient because West Nile virus is transmitted by a vector, specifically mosquitos. There are no other precautions required for vector transmitted pathogens.

What is sterilization?

A process used to destroy all microorganisms, including spores. (Note: If expiration date on package is expired, equipment is no longer considered sterile)

What are factors that can cause an individual to be more susceptible to infections?

Age Gender Culture, Ethnicity, Religion Disability Morphology

What is the normal adult total white blood cell count?

Between 4,500 and 10,500 cells/mm3.

What is cellular immunity?

Involves defense by WBCs against any microorganisms that the body does not recognize as its own. Led by T-Cells T lymphocytes, such as cytotoxic T cells, directly attack cells displaying nonself antigens (e.g., infected cells). Helper T cells release interleukins and other substances that stimulate antibody production by B cells and antigen destruction by other cells (e.g., macrophages).

Describe chronic infections

May persist for months or years Ex: Wounds, bone infections, hepatitis, AIDS

What are some examples of fungi?

Molds & yeasts Present in the air, soil, and water Responsible for symptoms such as athlete foot, ringworm, and yeast infections. Treated with anti fungal medications

What is the definition of infection?

The establishment of a pathogen in a susceptible host; a disease state is caused by the infectious agent.

What does a culture of a specimen help determine?

Which microorganism is causing an infection

The nurse is teaching a group of new parents about immunizations for children. Which type of immunity is the nurse promoting? a. Active b. Innate c. Nonspecific d. Inflammatory

a. Active Rationale: ong-term active immunity can be artificially acquired by immunization with vaccines. Innate or nonspecific immunity present in most people protects the body against foreign antigens. The skin, cough reflex, and acid production in the gastrointestinal tract are parts of the body's innate immunity. Inflammation is a local response that helps the body mount its third defense, which is the immune response. There is no such immunity called inflammatory.

Of the following assessment findings, which signs indicate to a nurse that a patient has a surgical site infection? (Select all that apply.) a. Redness or warmth at the affected site b. Purulent drainage at the incision site c. Tenderness and localized pain d. Wound with well-approximated edges e. White blood cell count 6500 cells/mm3

a. Redness or warmth at the affected site b. Purulent drainage at the incision site c. Tenderness and localized pain Rationale: Purulent drainage, tenderness, localized pain, and redness or warmth are results of the inflammatory response to an infection. Well-approximated edges are a desired outcome of wound healing. The normal white blood count for adults is 4500 to 10,500 cells/mm3.

What is an antigen?

Any substance that provokes an adaptive immune response. Protein molecules on the surface of pathogens and nonliving substances such as toxins, chemicals, drugs, or particles.