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133 Cards in this Set

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An infectious agent
pathogen
This refers to when a pathogen invades a host, and multiplies without causing infection
colonization
An _______ is infectious or communicable. It may pose a risk to the patient, but not to others.
infectious disease
Example: pneumonia, viral meningitis
If the infectious disease can be transmitted directly from one person to another, it is termed a _______.
communicable disease
If the pathogens multiply and cause clinical signs and symptoms, the infection is _____.
symptomatic
If the pathogens do not cause physical signs and symptom, this is referred to as _______.
asymptomatic
Ex. Hepatitis C is a communicable disease that can be asymptomatic
These steps are the _______. 1. Infectious agent 2. Reservoir 3. Portal of exit 4. Mode of transmission 5. Portal of entry 6. Host
chain of infection
The presence of a pathogen does not mean an infection will occur. It requires a presence of all of the following elements.
The ability for a microorganism to survive in the host or outside the body is called ___.
virulence
Resident skin microorganisms are not virulent, but can cause serious infection when surgery allows them to enter deep tissues or when a patient is immunocompromised.
Bacteria that requires oxygen for survival and for multiplication sufficient to cause disease is called _____.
aerobic bacteria
______ thrive where little or no free oxygen is available.
Anaerobic bacteria
_______ is the term used to describe a cold environment that prevents the growth and reproduction of bacteria.
Bacteriostasis
This destroys bacteria
bactericidal
Most organisms prefer an environment with a PH range of ____.
PH range of 5-7
Acid-reducing medications may cause an overgrowth of gastrointestinal organisms such as health care-associated pneumonia.
______ depends on the individual degree of resistance to a pathogen.
susceptibility
The severity of the clients illness depends on the extend of the infection, the ______ of the microorganisms.
pathogenicity
Pain and tenderness in a wound site, redness, heat, or loss of function of the body part affected would be considered a ____ infection.
localized
A ____ is a mode of transmission that requires an external mechanical transfer.
vector
A situation where you have personal contact with infected inanimate objects is an ____ mode of transmission.
indirect
Touching client feces is an example of a _____ mode of transmission.
direct
The _______ refers to the interval between entrance of pathogen into body and appearance of first symptoms.
incubation period
The ______ refers to the interval from onset of specific signs and symptoms to more specific symptoms.
prodromal stage
Ex. an onset of symptoms such as fever or malaise
The _____ refers to the interval when a client manifests signs and symptoms specific to type of infection.
illness stage
Ex. strep throat is manifested by sore throat pain
_____ do not usually cause disease when residing in their usual area of the body but instead participate in maintaining health.
Normal flora
Ex. Normal flora maintains a balance with other microorganisms to prevent infection. The skins normal flora exerts a bactericidal action.
The use of ______ can disrupt the normal flora of the body, and lead to a suprainfection.
broad-spectrum antibiotics
Why? It kills microbes that aid in defense against those that grow at will.
_____ is a protective vascular reaction that delivers fluid, blood products and nutrients to an area of injury.
inflammation
Serum proteins such as kinins, vasoactive amines, and prostaglandins serve to increase vasodilation. They play a key role in the inflammatory response.
Fluid and cells that are discharged from cells or blood vessels are called _____.
exudates
Ex. pus or serum
The accumulation of fluid appears as localized swelling referred to as ____.
edema
Injury causes tissue damage, and as a result the body releases chemical mediators that increases the permeability of small blood vessels. As a result, fluid, protein, and cells enter interstitial spaces causing fluid buildup.
The cellular response of inflammation involves _____, which describes the destruction and absorption of bacteria
phagocytosis
Fever is caused by phagocytic release of pyrogens from bacterial cells that cause a rise in the hypothalmic set point.
An increase in the number of circulating WBC's, is referred to as ____.
leukocytosis
Normal Serum WBC count:
5,000 to 10,000/mm3
Exudate may be ____ in color, or clear.
serous
Exudate may be ______, in that the color is red from containing RBC's.
sanguineous
Exudate may be ____, or white in color in that it contains pus, WBC's or bacteria.
purulent
When it comes to tissue repair, tissue defects may fill with _____.
granulation tissue
GT is not as strong as collagen and assumes the form of scar tissue.
An infection that results from being in a health care facility.
hospital-acquired infection (nosocomial)
_____ is a type of HAI from a diagnostic or therapeutic procedure.
Iatrogenic infection
Ex. Following a gastrointestinal endoscopy the client developed a P. aeruginosa infection.
A HAI that is present outside the client.
exogenous infection
Ex. A postoperative infection
An _____ can occur when part of the client's flora becomes altered and an overgrowth results.
endogenous infection
Assessment for infection prevention and control should include:
1. Immunizations/ vaccinations 2. Susceptibility 3. Client knowledge of how disease is transmitted 4. Review past diseases 5. Travel history 6. Status of defense mechanisms 7. Clinical appearance 8. Lab results
A _____ causes more generalized symptoms that a local infection. They usually result in fever, fatigue, nausea, vomiting and malaise.
systemic infections
True/False It is not uncommon to find that an older adult has an advanced infection before it is identified.
TRUE
Why? This is because older adults may have a reduced inflammatory and immune response. Older adults have increased fatigue and diminished pain sensitivity
True/False A reduced or absent fever response can occur from chronic use of aspirin or non-steroidal anti-inflammatory drugs.
TRUE
True/False Checking a client for breakage in skin would be an example of the status of defense mechanisms.
TRUE
Normal Value for Erythrocyte Sedimentation Rate (ESR):
up to 15mm/hr for men up to 20mm/hr for women
Normal Value for Iron:
60-90g/100ml
Normal culture for urine and blood:
normally sterile without microorganism growth
Normal cultures and gram stain of wound, sputum, and throat:
No WBC's on Gram stain, possible normal flora
An example for a nursing diagnosis related to infection prevention and control would be...
-risk for infection -imbalanced nutrition:less than body requirements -impaired oral mucous membrane -risk for impaired skin integrity -social isolation -impaired tissue integrity
Common goals of care applicable to clients with infection often includes:
-preventing exposure to infectious organisms -controlling or reducing the extent of infection -maintaining resistance to infection -verbalizing understanding of infection prevention and control techniques
Some implementation methods for infection and prevention control include:
-flu vaccine -hand hygiene -proper nutrition -rest
True/False A short term plan is written with a goal. And a long term plan is written with an outcome.
TRUE
____, or clean technique, includes procedures used to reduce the number of organisms present and prevent transfer of organisms.
Medical asepsis
The absence of pathogenic microorganisms is called ___.
asepsis
Procedures used to reduce the number of organisms present and prevent the transfer of organisms is called ____.
medical asepsis
The nurse follows ____ which are principles and procedures to prevent and control infection.
standard procedures
True/False Personal protective equipment does not need to be changed after contact with each client and between procedures.
FALSE
This transmission based precaution requires a private room, mask for caregiver and visitor, negative pressure airflow exchange in the room of at least 6-12 exchanges/hr.
airborne precaution
This transmission-based precaution requires a private room or room with others with the same infection, and a mask for caregivers and visitors
droplet precaution
This transmission based precaution requires private room or room with others of same infection. Gloves and gown for both the caregiver and visitors, dispose of materials in a single nonporous bag without touching the outside of the bag.
contact precaution
This transmission based precaution requires a private room, positive-pressure room with 12 or more air exchanges/hr, and a HEPA filtration for incoming air. It also requires the caregiver and visitors to wear respirator mask, gloves, and gown.
protective environment precaution
This type of precaution protects the patient from us and outside visitors
In ______ infection prevention and control, you would measure the success of the techniques, compare the client's response with expected outcomes, and if goals are not achieved, determine what steps must be taken.
evaluation of
The chain of infection begins with a _________
pathogen - a microorganism capable of causing disease. Could be bacteria, fungus, protozoa, or virus
E. coli
bacteria present in the colon, may cause gastroenteritis or UTI
Staphylococcus aureus
bacteria found on skin, hair, anterior nares, mouth. May cause wound infection, pneumonia, food poisoning
Streptococcus (beta hemolytic group A)
bacteria that may be found in the oropharynx, skin, and perianal area. Can cause strep throat, rheumatic fever, scarlet fever, or wound infections
Streptococcus (beta hemolytic group B)
bacteria that may be found on adult genitalia. May cause UTI, wound infection postpartum or neonatal sepsis
Staphylococcus epidermis
bacteria found on skin, may cause wound infection
Hepatitis A
virus found in feces, causes Hep A
Hepatitis B
virus found in blood and certain body fluids, sexual contact with infected person causes Hep B
Herpes simplex virus (type 1)
virus found in lesions of the mouth or skin, saliva, or genitalia. Can cause cold sores, aseptic meningitis and STDs
HIV
Human Immunodeficiency Virus: found in blood, semen, vaginal secretions, breast milk
Candidia Albicans
Fungus present on skin, mouth, colon, genital tract. Can cause cadnidas (yeast infection) pneumonia and sepsis
Plasmodium falciparum
Blood-borne protozoa causes malaria
Ideal conditions for microbes
warm, dark, moist, ideal PH, aerobic or anaerobic conditions depending on microbe, adequate food source
Microbes are present
just about everywhere - in air, on: food, plants, animals, soil, every surface you touch, in and on the body
A disease caused by a microorganism that is potentially transferrable but may or may not be easy to catch - is not generally a great threat to others (viral menengitis, pneumonia)
Infectious disease
An infectious disease that readily spreads from person to person and is easily caught from an infected person (common cold, flu, chicken pox)
communicable disease
Disease-causing microorganisms must be present in sufficient numbers - this refers to the infectious ______.
dose
the ability of any agent of infection to produce disease. Equal to the severity of the disease it is capable of causing
Virulence
The degree to which the patient is prone to a disease
susceptibility
In all people, susceptability is influenced by these 4 factors -
normal flora, body system defenses, the inflammatory response, the immune response.
Microorganisms that exist as a part of normal body function. Found on the surface and in deep layers of skin, saliva, oral mucosa, genitourinary, gastrointestinal tract. Exist in a sensitive balance with other microorganisms to prevent infection.
Normal flora
Name 10 body system defenses
Skin, mucus membranes, saliva, tears, blinking, pH levels, cilia, cough reflex, stomach acidity, gastric acidity, normal flora
The body's cellular response to injury, infection, or irritation. A protective vascular reaction that delivers fluid, blood products, and nutrients to an area of injury.
Inflammatory response
Name the 3 stages of the inflammatory response.
Vascular and cellular
Formation of inflammatory exudates
Tissue repair
Increased blood flow to the site of injury
Serum proteins (complement, kinins, prostaglandins, and vasoactive amines) cause increased vasodilation
Cell-mediated (WBC) immune response
Vascular and cellular inflammatory response
a foreign molecule that, when introduced into the body, triggers the production of an antibody by the immune system.
antigen
also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen.
Antibody
Immunity gained through exposure to a pathogen or vaccine
Active immunity
Immunity gained across the placenta prenatally, via antibodies in breast milk that enter the baby's blood stream, or via injection of antibodies from a human or animal.
Passive immunity
The suceptability of a particular person is affected by
Age, nutritional status, chronic disease, trauma, smoking, medical therapy
Describe the chain of infection (6 parts)
presence of infectious agent
reservoir
portal of exit from reservoir
mode of transmission to host
portal of entry
susceptible host
HAI
Healthcare associated infection - new term for nosocomial infection
Infection that resulted from a medical procedure
Iatrogenic infection
Infection that did not originate from flora in or on the body
exogenous infection
Infection that was the result of normal flora becoming pathogenic either through transportation to a different part of the body or some shift in balance that allowed it to thrive in an area where it is typically controlled.
endogenous infection
Number of deaths per year due to HAIs
99,000
Top 4 types of HAI in order starting with most frequently occuring
Urinary tract infections (32%)
Surgical site infection (22%)
Pneumonia (15%)
Blood stream infections (14%)
An attempt to eliminate 100% of microoganisms and spores through sterilization of all equipment and use of sterile technique.
surgical asepsis
With nuclei smaller than 5mcg, measles, chickenpox, pulmonary and larangeal TB require this type of precautions
airborne precaution - private room, negative pressure airflow of at least 6-12 air exchanges per hour. Mask or respiratory device for guest and caregivers.
Typically greater than 5 mcg, flu, Diptheria, rubella, streptococcal pharyngitis, pneumonia, scarlet fever, pertusis, mumps, mycoplasmal pneumonia require this type of precautions -
droplet precaution - private room or cohort clients. Mask or respiratory device required.
Colonization or infection with multidrug-resistant organism such as VRE and MRSA, Clostridium difficile, or respiratory syncytial virus (RSV); draining wounds where secretions are not contained and scabies require what type of precautions
Contact precaution - Private room or ccohort clients, gloves, gowns.
Patients receiving allogenic hematopoietic stem cell transplants must have what type of precautions -
protective environment precaution - private room, positive pressure room with 12 or more exchanges per hour, HEPA filtration for incoming air, respirator mask, gloves and gowns.
CDC standard precautions
Assume that every person is potentially infected
Hand hygiene
Personal protective equipment
Gowns
Mouth, nose, eye protection
Cough etiquette
Patient placement
Care of environment and equipment
Safe injection practices
Time of exposure to time of first symptom
incubation period
Time from first symptom to conditions typical of illness
prodromal stage
Timeframe that patient experiences symptoms specific to a particular illness
illness stage
Recovery phase of an illness
Convalescence stage
Normal (adult) WBC count is
5000 to 10,000 /mm3
Abnormal WBC counts can indicate
They will be higher in acute infection, decreased in certain viral or overwhelming infections
Normal (adult) Erythrocyte sedimentation rate
Up to 15 mm/hr for men
Up to 20 mm/hr for women
Abnormal Erythrocyte sedimentation rates indicate
Rates are elevated in presence of inflammatory process
Normal (adult) iron levels
60-90 g/100 mL
Abnormal iron levels may indicate
Lower in chronic infection
Cultures of urine and blood are usually -
Sterile without microorganism growth
Cultures and Gram stain of wound, sputum, and throat
No WBC's on Gram stain, possible normal flora
Differential Count indicates
The percentage of each type of WBC
% neutrophils in a normal differential WBC count
55 % - 70 %
A high % of neutrophils in differential WBC count may indicate
Acute suppurative (pus-forming) infection
A low % of neutrophils in differential WBC count may indicate
Overwhelming bacterial infection (esp. in older adult)
% Lymphocytes in a normal (adult) differential WBC count
20%-40%
A higher % of lymphocytes may indicate
Chronic bacterial or viral infection
A lower % of lymphocytes may indicate
Sepsis
Typical % of monocytes in WBC count
5%-10%
Increased % of monocytes in WBC count may indicate
protozoan, rickettsial, TB infections
Typical % of Eosinophils in WBC
1%-4%
Higher % of eosinophils in WBC count may indicate
parasitic infection
Typical % of Basophils in differential WBC count
0.5% - 1.5%
How does % of Basophils change with infection
The percentage remains the same
Typical nursing diagnoses associated with risk for infection -
Risk for infection
Imbalanced Nutrition: less than body requirements
Risk for impaired skin integrity
impaired oral or mucous membranes
impaired tissue integrity
social isolation
Nursing planning related to risk for infection
Client will remain free from infection
Client will describe risks for infection before discharge
Client will practice proper hand hygiene
Client will demonstrate significant protein intake with every meal
Client will verbalize correct use of antibiotics
Nursing process implementation related to risk for infection -
Observe for signs and symptoms of infection
Provide supportive therapy
Identify interventions to reduce risk
Patient teaching
Evaluating outcomes related to risk for infection -
Temperature remains within normal range
WBC remains within normal limits
Cultures do not exhibit pathogenic growth
Patient demonstrates appropriate hygiene
Respiratory secretions remain clear
Urine remains clear
Incision or wound remains clear