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28 Cards in this Set
- Front
- Back
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___ infections result from hospital or hospital-like settings after 48 hours of admission or within 30 days after discharge |
Nosocomial |
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The most common nosocomial infections are of what type? |
Urinary tract infections Some studies say pneumonia |
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What is the single most important measure in controlling nosocomial infections? |
Hand washing |
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Immunosuppressants, steroids, antineoplastics and antacids all leave patients more susceptible to what? |
Nosocomial infections |
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What are some common causes of altered mental status? |
Alcohol, endocrine, insulin (hypoglycemia), oxygen, overdose, uremia (AEIOU) Trauma, temperature, infection, psychiatric, stroke, shock, space occupying lesion (TIPS) |
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Most nosocomial UTIs are associated with what? |
Catheters |
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What is the most common causative organism in nosocomial UTIs? |
E. Coli |
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What is the treatment method for nosocomial UTIs if febrile and bacteremic? |
IV broad spectrum abx: cipro, levofloxacin, 3rd generation cephalosporings, piperacillin-tazobactam (zosyn) |
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What is the treatment method for nosocomial UTIs without bacteremia? |
Nitrofurantoins, TMP--SMX |
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What are some preventative measures that can be taken to prevent nosocomial UTIs? |
Avoid catheter use or limit duration < 5 days. Proper insertion technique, drainage tube below the bladder. |
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What are the indications for a foley catheter? |
Urinary retention, stage 4 decubitis ulcer on the buttocks |
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What is the leading cause of death from nosocomial infections? |
Hospital acquired pneumonia |
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Hospital acquired pneumonia is usually due to pathogens entering the body in what way? |
Microaspiration of oropharyngeal secretions |
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What organism involved in hospital acquired pneumonia produces the highest mortality rate? |
Pseudomonas aeriginosa |
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What are some of the common microbes involved in nosocomial pneumonia (4)? |
Pseudomonas aeruginosa, klebsiella, e. coli, acinetobacter |
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Why is ventilator associated pneumonia (VAP) increased with ET intubation? |
Impaired cough reflex, no clearance of secretions, accumulation of bacteria above the inflated tube |
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Worsening or new pulmonary infiltrate PLUS either bacteremia or pleural fluid culture OR two of the following: Fever Leukocytosis Purulent tracheobronchial secretions Hypoxemia + Blood culture These are the clinical criteria for diagnosing what kind of pneumonia? |
Ventilator Associated Pneumonia (VAP) |
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Number one causative organism in VAP? |
P. Aeruginosa followed by staph aureus |
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What are some preventative measures that can be taken to reduce the incidence of VAP? |
HOB > 30 degrees, frequent oral care, frequent extubation evaluation, chlorohexadine rinse q6h while intubated.mupirocin BID x6 doses for MRSA eradication, carafate while intubated, NPO during intubation |
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Nosocomial pneumonia treatment for non-icu patients |
2/3 generations cephalosporin with zithromax, moxiflaxacin IV then PO with clinical improvement |
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Nosocomial pneumonia treatment for ICU patients |
ABX with pseudomonas coverage: 3rd or 4th generation cephalosporins, carbapenems, fluoroquinolones, aminoglycoside, aztreonam |
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Treatment for nosocomial pneumonia in pts with increased risk of staph aureus |
Vancomycin |
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Nosocomial pneumonia treatment in HIV pts |
Bactrim (pentamidine if sulfa allergic) |
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Pre-operative hair removal (increases/decreases) surgical site infections |
INCREASES |
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To prevent surgical site infections, antimicrobial prophylaxis should be given when? |
Within 1 hour of skin incisions |
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Antibiotics before surgical colon procedures should include coverage for what organisms? |
E. coli, bacteroides fragilis |
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Most common cause of IV catheter associated infections? |
Staph epidermidis (coagulase negative staphylococci) |
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Where is the preferred IV site to prevent IVCA infections? What site should be avoided? |
Preferred: Subclavian Avoided: Femoral (increased risk in adults) |
