Fundamentals Of Nursing, Chapter 15

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MICROOGRANISM

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ORGANISM ONLY VISIBLE WITH A MICROSCOPE, THAT THEN IT MULTIPLIES AND CAUSES TISSUE DAMAGE, AND MAY RESULT IN ILLNESS AND DISEASE

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INFECTION

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IS THE ENTRY INTO THE BODY BY AN INFECTIOUS AGENT

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AEROBIC

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NEEDING OXYGEN TO LIVE AND GROW

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ANAEROBIC

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NO OXYGEN IS NEEDED TO LIVE AND GROW

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COLONIZATION

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A DEVELOPMENT OF A BACTERIAL INFECTION, MICROORGANISMS TAKE UP RESIDENCE AND GROW

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CROSS-CONTAMINATION

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TRANSMISSION OF INFECTIOUS MICROORGANISMS FROM ONE PERSON OR OBJECT TO ANOTHER

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CULTURE

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PROPAGATION OF LIVING ORGANISMS OR TISSUE IN SPECIAL MEDIA CONDUCTIVE TO THEIR OWN GROWTH

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ENDOTOXIN

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A HEAT STABLE TOXIN ASSOCIATED WITH THE OUTER MEMBRANES OF CERTAIN GRAM-NEGATIVE BACTERIA THAT IS RELEASED WHEN THE CELLS ARE DISRUPTED

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GRAM-NEGATIVE

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BACTERIA THAT LOSE THE STAIN IN GRAM'S METHOD OF STAINING

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GRAM-POSITIVE

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BACTERIA THAT RETAIN THE STAIN IN GRAM'S METHOD OF STAINING

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HOST

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AN ANIMAL OR PLANT THAT HARBORS AND PROVIDES SUSTENANCE FOR ANOTHER ORGANISM (A PARASITE)

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INFECTION

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INVASION AND MULTIPLICATION OF MICROORGANISMS IN BODY TISSUES, WHICH SERVES TO CONTAIN THE INJURIOUS AGENT AND INJURED TISSUE

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INFLAMMATION

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LOCALIZED RESPONSE CAUSED BY INJURY OR DESTRUCTION OF TISSUES, WHICH SERVES TO CONTAIN THE INJURIOUS AGENT AND INJURED TISSUE

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LEUKOCYTOSIS

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INCREASE IN THE NUMBER OF LEUKOCYTES (WHITE BLOOD CELLS) IN THE BLOOD, DUE TO INFECTION OR OTHER CAUSES

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NOSOCOMIAL

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INFECTION ACQUIRED DURING HOSPITALIZATION OR OTHER HEALTH CARE FACILITY

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PHAGOCYTES

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CELLS CAPABLE OF INGESTING PARTICULATE MATTER, (MACROPHAGES)

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PHAGOCYTOSIS

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THE ENGULFING OF MICROORGANISMS AND FOREIGN PARTICLES BY PHAGOCYTES

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SPORES

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OVAL BODIES FORMED WITHING BACTERIA AS A RESTING STAGE DURING THE LIFE CYCLE OF THE CELL; CHARACTERIZED BY RESISTENCE TO ENVIRONMENTAL CHANGES (HEAT, HUMIDITY OR COLD)

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TOXIN

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A POISON; A POISONOUS PROTEIN PRODUCED BY CERTAIN BACTERIA

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VECTORS

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CARRIERS THAT TRANSPORT AN INFECTIVE AGENT FROM ONE HOST TO ANOTHER SUCH AS ANIMALS, INSECTS AND RODENTS

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VIRULENCE

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DEGREE TO WHICH A MICROOGANISM CAN CAUSE INFECTION IN THE HOST OR INVADE THE HOST

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PATHOGENS

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MICROORGANISMS THAT ARE CAPABLE OF CAUSING DISEASE

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BACTERIA

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ARE SINGLE-CELL MICROORGANISMS LACKING A NUCLEUS THAT REPRODUCE ABOUT EVERY 20 MINUTES

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NORMAL FLORA OF THE BODY

SITE: UPPER RESPIRATORY TRACT

NOSE, MOUTH, THROAT

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NORMAL FLORA

STAPLHYLOCOCCI
CORYNEBACTERIA
STREPTOCOCCUS PYOGENES (GROUP A)
NEISSERIA SPECIES
STREPTOCOCCI (VIRIDIANS GROUP)
ENTEROBACTER SPECIES
HAEMOPHILUS
KLEBSIELLA SPECIES
LACTOBACILLI
VARIOUS TYPES OF ANAEROBES

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NORMAL FLORA OF THE BODY


SITE: SKIN

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NORMAL FLORA

STAPHYLOCOCCUS AUREUS
STAPHYLOCOCCUS EPIDERMIDIS
CORYNEBACTERIA
YEASTS

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NORMAL FLORA OF THE BODY


SITE: SMALL BOWEL AND COLON

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NORMAL FLORA

ENTEROBACTER FAMILY (COLIFORMS)
BACTEROIDES SPECIES
STREPTOCOCCUS FAECALIS (ENTEROCOCCI OR GROUP D)
CLOSTRIDIUM PERFRINGENS
ANAEROBES

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NORMAL FLORA OF THE BODY


SITE: VAGINA

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NORMAL FLORA

LACTOBACILLUS SPECIES
STAPHYLOCOCCUS EPIDERMIDIS
ALPHA-HEMOLYTIC STREPTOCOCCI
ENTEROCOCCI
ENTEROBACTERIACEAE
MANY TYPES OF ANAEROBES

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FINAL IDENTIFICATION IS BY CHEMICAL TESTING OF THE BACTERIA GROWN BY

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CULTURE

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VIRUSES

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ARE EXTREMELY SMALL AND CAN BE SEEN ONLY WITH AN ELECTRON MIRCROSCOPE

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VIRUSES

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CAN GROW AND REPLICATE ONLY WITHIN A LIVING CELL

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PROCESS OF INFECTION

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LINK ONE - CAUSATIVE AGENG
LINK TWO - RESERVOIR
LINK THREE - PORTAL OF EXIT
LINK FOUR - MODE OF TRANSFER
LINK FIVE - PORTAL OF ENTRY
LINK SIX - SUSCEPTIBLE HOST

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THE MOST EFFECTIVE MEANS FOR DESTROYING VIRUSES AND ALL OTHER KINDS OF MICROORGANISMS IS TO EXPOSE THEM TO MOIST HEAD AT A TEMP OF 250 DEGREES F FOR 15-20 MIN, THIS IS ACCOMPLISHED BY USING AN AUTOCLAVE

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STERILIZATION

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THE CENTERS FOR DISEASE CONTROL PROVIDES A WEALTH OF INFORMATION ON ALL ASPECTS OF DISEASE AND ITS PREVENTION

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CDC

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THE CENTERS FOR DISEASE CONTROL PROVIDES A WEALTH OF INFORMATION ON ALL ASPECTS OF DISEASE AND ITS PREVENTION

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CDC

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ISOLATION TECHNIQUES AND BARRIER PRECAUTIONS THAT INCLUDE THE PROPER HANDLING AND DISPOSAL OF SECRETIONS, URINE AND FECES, AND EXUDATE CAN PREVENT TRANSFER OF PATHOGENS

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PREVENTION

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FACTORS THAT INCREASE SUSCEPTIBILITY TO INFECTION
1-AGE
2-MALNUTRITION
3-EXCESSIVE STRESS OR FATIGUE
4-LOW WBC COUNT
5-ALCOHOLISM
6-CHRONIC ILLNESS
7-INDWELLING TUBES OR EQUIPMENT
8-IMMUNOSUPPRESIVE TREATMENT

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FACTORS TO INCREASE INFECTION

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BREAKING THE CHAIN OF INFECTION
1. RESERVOIR-INFECTED PATIENT

PREVENT TRANSFER OF MIROCROORANGISMS

HANDWASHING, GLOVES, STANDARD PRECAUTIONS, ISOLATION TECHNIQUES

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WAYS TO BREAK CHAIN

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MICROORGANISMS

ARE ABUNDANT IN OUR ENVIRONMENT AND MANY CAN CAUSE INFECTION

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MICROORGANISMS

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PATHOGENS INCLUDE:

BACTERIA, VIRUSES, PROTAZOA, RICKETTSIAS, FUNGI, AND HELMINTHS

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PATHOGENS

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CLASSIFICATION OF BACTERIA
COCCI-ROUND
BACILLI-ROD SHAPED
SPIROCHETES-SPIRAL OR CORKSCREW
STREPTOCOCCI-CHAINS
DIPLOCOCCI-PAIRS
STAPHYLOCOCCI-CLUSTERS

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CLASSIFICATIONS OF BACTERIA / SHAPES TO IDENTIFY

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ANTIBIOTICS

CHEMICAL STUBSTANCES THAT CAN KILL OR ALTER THE GROWTH OF MICROORGANISMS-ARE MOST EFFECTIVE AGAINST THE BACTERIA

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ANTIBIOTICS

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VIRUSES

ARE EXTREMELY SMALL AND CAN BE SEEN ONLY WITH AN ELECTRON MICROSCOPE

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VIRUSES

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INFECTIOUS AGENTS

BACTERIA
VIRUSES
PROTOZOA
RICKETTSIAS
FUNGI
HELMINTHS

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TYPES OF INFECTION

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BREAKING THE CHAIN OF INFECTION

RESERVOIR-INFECTED PERSON
PREVENT TRANSFER OF MICROORGANISMS
HANDWASHING, GLOVES, STANDARD PRECAUTIONS, ISOLATION TECHNIQUES

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BREAKING THE CHAIN OF INFECTION-RESERVOIR

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BREAKING THE CHAIN OF INFECTION-PORTAL OF EXIT

SECRETIONS-FECES-BLOOD-URINE-SPUTUM
PREVENT CONTAMINATION
HANDWASHING, STANDARD PRECAUTIONS, NO RECAPPING NEEDLES, SHARPS, CONTAINING CONTAMINATION, DISINFECTION, MEDICAL ASEPTIC PRACTICE

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BREAKING THE CHAIN OF CONTAMINATION
PORTAL OF EXIT-SECRETIONS

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BREAKING THE CHAIN OF INFECTION
MODE OF TRANSFER
HANDS-CONTAMINATED FOOD-CONTAMINATED SUPPLIES AND OTHER OBJECTS
PREVENT CONTAINATION, ELIMATE VECTORS,
USE OF STANDARD PRECAUTIONS, HANDWASHING, STERILIZATION, CLEANING,

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BREAKING THE CHAIN-MODE OF TRANSFER

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BREAKING THE CHAIN OF INFECTION-
ENTRANCE
MOUTH, BREAK IN SKIN, MUCOUS MEMBRANES
-PUT ONLY CLEAN THINGS IN MOUTH, PROTECT SKIN, PROTECT MUCOUS MEMBRANES--INTERVENTIONS:: HYGIENE, OBJECTS OUT OF MOUTH, SKIN CARE

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;

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BREAKING THE CHAIN OF INFECTION

RESERVOIR-PATIENT
PORTAL OF EXIT-SECRETIONS
MODE OF TRANSFER-HANDS
ENTRANCE-MOUTH
HOST-SUSCEPTIBLE PERSON

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INTERVENTIONS
HANDWASHING
USE OF STANDARD PRECAUTIONS
NO RECAPPING NEEDLES
USE OF STANDARD PRECAUTIONS
COVER SKIN BREAKS

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HANDWASHING

1. BEGINNING OF SHIFT
2. BEFORE AND AFTER CARING FOR EACH PATIENT
3. BEFORE PERFORMING PROCEDURES
4. BEFORE ENTERING SPECIAL CARE AREAS
5. WHENEVER HANDS ARE CONTAMINATED
6. BEFORE BEGINNING SHIFT, HANDS FOR 30 SECONDS OR ACCORDING TO AGENCY POLICY
7. AFTER THAT, VIGOROUSLY FOR 10 SECONDS TO 4 MINUTES

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HANDWASHING

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STANDARD STEPS FOR NURSING PROCEDURES

AT THE BEGINNING OF THE PROCEDURE

A: CHECK THE ORDER IN THE CHART
WASH YOUR HANDS
B: CHECK PATIENTS ID
EXPLAIN THE PROCEDURE TO THE PATIENT
C: PROVIDE PRIVACY
RAISE BED TO WORKING HEIGHT
ARRANGE SUPPLIES AND EQUIPMENT
D:

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STANDARD STEPS OF NURSING PROCEDURES

A, B, C

AT THE BEGINNING OF THE PROCEDURE

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STANDARD STEPS FOR NURSING PROCEDURES

DURING THE PROCEDURE:

D: USE STANDARD PRECAUTIONS AND ASEPTIC TECHNIQUE, AS APPROPRIATE. DON GLOVES FOLLOWING STANDARD PRECAUTIONS
DON (PUT ON) EYEWARE, MASK, AND GOWN AS APPROPRIATE

E: PERFORM THE TASK ACCORDING TO PROTOCOL. MENTALLY REVIEW THE STEPS OF THE PROCEDURE BEFORE HAND.
DISCUSS THE PROCEDURE WITH YOUR INSTRUCTOR IF NEEDED; CONFIRM CORRECT PROTOCOLS

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STANDARD STEPS FOR NURSING PROCEDURES

STEPS D AND E

DURING THE PROCEDURE

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STANDARD STEPS FOR NURSING PROCEDURES

AT THE END OF THE PROCEDURE

X: DISPOSE OF SHARPS APPROPRIATELY
REMOVE GLOVES USING ASEPTIC TECHNIQUE, AND WASH YOUR HANDS

Y: MAKE THE PATIENT COMFORTABLE
RESTORE THE UNIT
WASH YOUR HANDS AGAIN

Z: RECORD AND DOCUMENT THE PROCEDURE
REPORT ABNORMALITIES AS NEEDED

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STANDARD STEPS FOR NURSING PROCEDURES

STEPS X, Y, Z

AT THE END OF THE PROCEDURE

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HANDWASHING SKILL
REVIEW AND CARRY OUT STEPS A,B,C,D

1.DETERMINE WASH TIME
2.CHECK TO SEE IF YOU HAVE SOAP/TOWELS
3.CRANK OUT TOWELS BEFORE BEGINNING
PUSH WRISTWATCH UP THE ARM
4.TURN ON WATER, ADJUST TEMP
KEEP BODY AWAY FROM SINK
5.WET HANDS, POINTING FINGERS TOWARDS SINK
6.APPLY 2-4ML SOAP
7.WASH HANDS (10 CIR. STROKES PALMS)
WASH BACK OF HAND 10 CIR MOTIONS)
FINGERS, NAILS
8.RINSE WRIST, HANDS, FINGERTIPS,
AVOID TOUCHING SINK
9.DRY HANDS AND WRISTS, BEGINNING AT FINGERTIPS AND UP THE HAND
DRY GENTLY, ONE TOWEL PER HAND

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HANDWASHING

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STANDARD PRECAUTIONS
DEVELOPED BY CDC
TO BREAK THE CHAIN OF INFECTION

THEY PROTECT BOTH THE NURSE, PATIENT, AND ARE TO BE USED FOR EVERY PATIENT CONTACT

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CDC REASONS

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REMOVING GLOVES

NONSTERILE GLOVES ARE USED FOR STANDARD PRECAUTIONS AND MOST ISOLATION PROCEDURES. AFTER USE THEY ARE REMOVED IN A MANNER TO PREVENT THE SPREAD OF MICROORGANISMS

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1. GRASP THE CUFF OFF THE GLOVE OF HONE AND HA

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CLEANING AND DISINFECTION

PATHOGENS CAN BE KILLED OR INACTIVATED BY DISINFECTION, BY STERILIZATION, OR BY THE USE OF ANTI-INFECTIVE DRUGS.

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ELIMINATING THE RESERVOIR IS A GOOD WAY TO BREAK TRANSMISSION

TO CLEAN OBJECTS

RINSE WITH COLD WATER
WASH THE ITEM IN HOT SOAPY WATER
USE A STIFF BRISTLED BRUSH
RINSE OBJECT HOT WATER
DRY OBJECT

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RECOMMENDED DISINFECTANT

1:10 RATIO

I PART CHLORINE BLEACH
10 PARTS WATER

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CHRLORINE RATIO

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STERILIZATION IS THE BEST METHOD OF ELIMINATING MICROORGANISMS FROM EQUIPMENT AND SUPPLIES

4 METHODS OF STERILIZATION
1.MOIST HEAT (STEAM UNDER PRESSURE)
2.ETHYLENE OXIDE GAS (MICROO & SPORES)
3.BOILING WATER
4.RADIATION-UV, IONIZING

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STERILIZATION