Prevention Of Infection (Basics In Nursing)

Front 1

(def)

a resistance of the body to infection in which the host receives natural or artificial antibodies produced by another source

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Acquired (passive) immunity

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(def)

a resistance of the body to infection in which the host produces its own antibodies in response to natural or artificial antigens

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Active immunity

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(def)

immunoglobulins, part of the body's plasma proteins, defend primarily against the extracellular phases of bacterial and viral infections

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antibodies

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(def)

immunity involving B lymphocytes

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Antibody-mediated immunity (also call humoral, circulating, and acquired immunities)

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(def)

a substance capable of inducing the formation of antibodies

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antigen

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(def)

agents that inhibit the growth of some microorganisms

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antiseptics

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(def)

those microorganisms carried in blood and body fluids that are capable of infecting other persons with serious and difficult to treat viral infections, mainly hep. B, hep. C, and HIV

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Blood-borne pathogens

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(def)

a risk to human health or the environment arising from biological work, esp. with microorganisms.

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biohazard

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(def)

a type of lymphocyte that originates in bone marrow and produces antibodies

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B lymphocyte (aka B cell)

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(def)

immunity that occurs through the T cell system

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Cell-mediated immunity

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(def)

period of recuperation and recovery from an illness

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convalescent period

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(def)

laboratory cultivations of microorganisms in a special growth medium

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culture

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(def)

agents than destroy pathogens other than spores

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disinfectants

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(def)

the rate at which red blood cells settle out in a tube of unclotted blood, expressed in millimeters per hour

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Erythrocyte sedimentation rate (ESR)

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(def)

inflammation of the liver

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hepatitis

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(def)

a retrovirus that causes AIDS

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HIV (Human Immunodeficiency Virus)

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(def)

caused by treatment or diagnostic procedures

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iatrogenic

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(def)

period of time during which symptoms and signs of disease occur

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illness

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(def)

interval between entrance of a pathogen into a susceptible host and the onset of illness caused by the pathogen

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incubation period

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(def)

a disease process caused by microorganisms

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infection

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(def)

waste material that contains disease producing microorganisms

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infective waste

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(def)

guidelines in place, which apply to all clients and patients in a health care setting, that are designed to prevent the spread of infection

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standard precautions

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(def)

infections associated with the delivery of health care services in a health care facility

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nosocomial infections

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(def)

the period between exposure to an illness and the onset of symptoms

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prodromal periods

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(def)

a container designed to safely dispose of needles, scalpels, or other articles that could cause woulds or punctures to personnel handling them

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sharps container

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(def)

a process that destroys all microorganisms, including spores and viruses

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sterilization

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(def)

Lymphocytes that mature in the thymus; responsible for cell-mediated immunity

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T-lymphocyte cell

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(def)

ability to cause disease

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virulence

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(def)

body cells that are part of the body's defense against infection and disease

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WBC (White blood cell)

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Infection is an invasion of body tissue by disease producing microorganisms. What is another term for disease producing?

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pathogenic

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To be able to cause disease, pathogenic microorganisms must be able to do what?

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proliferate (grow and multiply)

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(def)

the process by which strains of microorganisms may grow and multiply, but do not cause disease

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colonization

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The body is inhabited by many microorganisms that do not harm us. What are these called?

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Resident flora or Normal microbiota

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What are 4 categories of pathogenic organisms?

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- bacteria
- virus
- fungi
- parasites

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An infection that can be acquired in the community is said to be what?

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communicable

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An infection acquired during the delivery of health care is said to be what?

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nosocomial or HAI

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What is the most common site of HAIs?

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the urinary tract

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What are the 3 most common organisms involved in HAIs?

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E. Coli, S. aureus, and enterococci

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In addition to being damaging to the client, why are HAIs of so much concern to nurses?

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they are costly; medicaid and insurance will not pay

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What is the major cause of HAIs?

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insufficient handwashing

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(def)

developing from within

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endogenous

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(def)

developing from outside sources

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exogenous

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(def)

an infection limited to the specific part of the body where the microorganisms remain

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local infection

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(def)

an infection that spreads and damages different parts of the body

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systemic infection

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If a person's blood reveals microorganisms, this condition is called ___________. However if this condition results in a systemic infection, it is referred to as _________.

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bacteremia

septicemia

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What is the difference between acute and chronic conditions?

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acute = appear suddenly; last a short time

chronic = occur more slowly; may last months or years

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What are 5 examples of resistant microbes?

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- MRSA (CAMRSA)
- VRSA
- VRE
- PRSP
- MDRTB

Front 48

What age groups are most at risk for infections?

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newborns and the elderly

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Does heredity influence the risk for infection?

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yes, certain genetic conditions may impair the individuals response to infection

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How does stress relate to a person's risk for infection?

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high levels of stress can decrease a persons resistance to infection

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How does nutrition and the risk for infection relate?

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antibodies are proteins; a diet lacking proteins decreases defense against infection and impairs wound healing

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How long does a newborn have passive immunity from it's mother?

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3 months (longer if breastfeeding)

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How does smoking increase the risk for infection?

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inhibits ciliary action; depletes vitamin C

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How does alcohol ingestion increase the risk for infection?

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decreases the effectiveness of antibiotics and may result in poor nutritional choices

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Why does risky sexual behavior increase the risk of infection?

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exposure to HIV, Hep. B, etc. is increased

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What types of medications and treatments may reduce a person's resistance to infection?

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antineoplastic medications, anti-inflammatory medications, radiation, and invasive procedures

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Would a pre-existing disease, such as cancer or diabetes, increase a client's risk for infection?

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yes

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What is the body's first (and most important) line of defense?

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"intact" skin and mucous membranes

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Why is the misuse of antibiotics such a problem?

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because it alters the normal flora, which decreases normal body defenses

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What type of non-specific host defenses are found in the oral cavity? What about the vagina?

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Oral Cavity - shedding of mucosal epithelium, flow of saliva, microbial inhibitors

Vagina- low pH

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Would phagocytosis be a specific or non-specific defense?

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non-specific

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What is the inflammatory response?

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the adaptive response to neutralize pathogens and repair body cells

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What does the suffix "itis" mean?

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inflammation

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What are the characteristics of the inflammatory response?

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- pain
- swelling
- redness
- heat
- impaired function

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True/False:

The inflammatory response presents the same in all patients.

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False - the inflammatory response may be delayed in the elderly. Often it may present as fatigue, confusion, disorientation, agitation, incontinence, and lethargy

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True/False:

All fevers should be treated.

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False - fever can be beneficial in some cases. It stimulated the production of antibodies and T cells.

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__________ is a complex biochemical response that resists infection.

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Immunity

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What is recognized as foreign in the immune response?

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the invading antigen ( bacteria, fungi, etc.)

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What is produced by the body to destroy invading pathogens?

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antibodies

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In addition to destroying invading pathogens, what are 2 additional key functions of the immune system?

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- remove old/aging cells
- remove any mutated cells

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What are the two types of immunity?

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antibody mediated
cell-mediated

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What are the two types of antibody mediate immunity? Describe each.

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Active - host produces own antibodies
Passive - host receives the antibodies

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What are 2 ways of achieving active immunity?

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- natural exposure to antigens (ex. infection)
- artificial given via vaccines

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What are 2 ways to receive passive immunity?

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- from a nursing mother
- artificial source (injection_

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Cell Mediated immunity involves what type of cells.

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T cell lymphocytes

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True/False:

A person cannot receive T cells from a secondary source.

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True

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What are 2 causes of a decrease in Cell-mediated immunity?

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immunocompromise (HIV, AIDS) and malnutrition

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What are the 5 cardinal signs of a localized response to infection?

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- hyperemia (erythema) aka redness
- edema (swelling)
- heat
- pain
- impaired or loss of function

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What may you see in an infected open wound in addition to the 5 cardinal signs of a localized response to infection?

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exudate (drainage)

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What are the 5 cardinal signs of a systemic response to infection?

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- fever
- increased pulse and respiratory rate if fever is high
- malaise
- anorexia, nausea, vomiting
- lymphadenopathy (enlarged, tender lymph nodes)

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What is the normal range for WBC? What may an elevated leukocyte count indicate?

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Normal range is 4500-11000 per mL, elevated indicates infection

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ESR, or Erythrocyte Sedimentation Rate, is a test to measure settlement of RBCs. A rapid settlement indicates what?

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the presence of the inflammatory process

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What are the 4 stages of the infections process?

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1. Incubation Period
2. Prodromal Period
3. Illness Period
4. Convalescent Period

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Which stage of the infectious process is the acute phase?

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illness period

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Which stage of the infectious process?

period between invasion of the microorganism and before the first visible sign of disease

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incubation period

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Which stage of the infectious process?

characterized by nonspecific feelings of discomfort, feelings that illness is about to occur (malaise), low grade fever, fatigue

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prodromal period

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During which phase of the infectious process is the client most capable of spreading the disease to others?

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prodromal period

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Which is the shortest phase of the infectious process?

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prodromal period

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Which stage of the infectious process?

marked by signs and symptoms that are specific to the type of infection

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illness period

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Which stage of the infectious process?

fever is often present

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illness period

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Which stage of the infectious process?

acute symptoms of infection disappear

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convalescent period

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Which stage of the infectious process?

recovery occurs

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convalescent period

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What are the 6 links of the chain of infection?

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- etiologic agent
- reservoir
- portal of exit
- method of transmission
- portal of entry
- susceptible host

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What are the 3 methods of transmission of microorganisms?

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- direct
- indirect
- airborne

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Direct, Indirect, or Airborne?

Kissing

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direct

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Direct, Indirect, or Airborne?

droplet transmission within a 3 ft range

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direct

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Direct, Indirect, or Airborne?

handshake

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direct

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Direct, Indirect, or Airborne?

droplets further than 3 feet

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airborne

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Direct, Indirect, or Airborne?

tick

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indirect

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Direct, Indirect, or Airborne?

contaminated food

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indirect

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(def)

any substance that serves as an intermediate means to transport or introduce an infectious agent

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vehicle

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(def)

animal or insect that transports infectious agents

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vector

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True/False:

To clean washable items, you should first rinse with hot water.

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False - you should rinse with cold water; hot water coagulates proteins, encouraging adherence to surfaces

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What method of cleaning kills spores?

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sterilization

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How long should you boil an item to sterilize it?

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15 minutes

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What should you do whenever there is a possibility of coming into contact with blood or fluid?

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wear gloves

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Who established "standard precautions"?

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The CDC

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True/False:

You should always cover your mouth and nose with your hand when coughing or sneezing

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false- cover with your arm

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What HAI is often seen in ventilator patients? Why?

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VAP (Ventilator associated pneumonia) due to poor oral care.

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What is the proper order of application of Personal Protective Equipment?

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- Gown
- Mask
- Eyewear
- Gloves

(Removal is reversed)

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What type of precautions are followed in addition to standard precautions if there is a known pathogen?

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Transmission-based precautions

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TB, rubeola, varicella, and SARS are all have what in common?

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They are airborne pathogens

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Pertussis, mumps, rubella, meningitis, and scarlet fever all have what in common?

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They are all transmitted via droplet transmission

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Herpes, impetigo, lice, RSV, MRSA, VRSA, VRE, and Hep. A all have what in common?

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They are transmitted via direct contact

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What type of mask is used by HCP and visitors for airborne droplet transmission less than 5 microns?

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N-95

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What type of mask is worn by a client outside of his room with an airborne pathogen less than 5 microns?

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surgical mask

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True/False:

N95 masks should be thrown away after each use.

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False- N95 can be worn more than once; throw away at the end of your shift

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What type of masks should be worn to prevent droplet transmission?

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surgical masks

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True/False:

A surgical mask can be worn more than one time.

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False - surgical masks should be disposed of after use.

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What should be worn to avoid contact transmission?

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gloves, gown

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What is the purpose of reverse isolation? What needs to be worn when entering a client's room who is under reverse isolation?

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- protects a vulnerable client with a weakened immune system from environmental sources of infection. All persons must don sterile gown, sterile gloves, masks and shoe covers

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What are some of the psychological effects of isolation?

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- self-esteem disturbances
- sensory deprivation
-boredom, inactivity, slowness of thought, daydreaming, increased sleeping, panic, anxiety, hallucination, depression, hostility, thought disorganization

Front 123

What are some areas of teaching infection control in the community?

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- assess risk factors
- handwashing
- personal hygiene, proper nutrition, rest, activity
- food safety
- cleaning equipment, supplies
- signs/symptoms of disease
- proper immunization

Front 124

Who establishes the guidelines that protect the nurse from infection?

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CDC

Front 125

What are measures that insure skin integrity of the hands.

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decrease latex allergy, thorough rinsing and drying, non oil-based hand moisturizer

Front 126

What should you do if you are exposed to a skin puncture?

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- encourage bleeding on the way to the sink
- wash area immediately with soap and water
- report to instructor/supervisor
- complete injury report and follow agency policy

Front 127

What should you do for mucous membrane exposure?

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flush with saline/water for 5-10 minutes

Front 128

What is the difference between medical asepsis and surgical asepsis?

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- medical is clean with no pathogens involving the GI and vaginal tract
- surgical is sterile with no microorganisms and includes sterile body cavities such as the lungs, bladder, chest cavity, abdominal cavity and any IV access

Front 129

How long should you wash your hands?

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10-15 seconds