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58 Cards in this Set

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an infection acquired in a health care setting in a previously uninfected patient
healthcare-associated infection (HAI)
infections acquired unrealted to healthcare treatment
community acquired
proliferation of microorganisms on or within body sites without detectable host/immune response, cellular damage, or producation of a clinical infection
colonization
the absence of disease-causeing organisms
asepsis
in general refers to the removal of all foreign material from an object, usually done with water and mechanical scrubbing, possibly detergent
cleaning
washing with chemicals known to kill pathogens, such as iodine-based compounds, isoprophyl alcohol, or glutaraldehyde
disinfection
not sharing certain items between patients
segregation
locating patients with similar diagnoses on the same hospital unit to prevent spread of their infections to those not infected
cohorting
What are the 2 tiers of infection precasutions
tier 1 standard precations tier 2 transmission precation
do NOT use alcohol based waterless cleansers with patients who are on contact precautions for _________
C-diff (clostridium difficile)
what are the 4 types of tier 2 isolation precations
contact,droplet, airborne, reverse (protective)
N95 respirator (HEPA filter )should be worn for what type of tier 2 precaution
airborne
private rooms with negative pressure air flow are used in what type of tier 2 isolation?
airborne
patients with compromised immune systems should be in what tier 2 isolaition
reverse (protective)
A sterile object remains sterile only when it is touched by__________
another sterile object
a sterile object is considered contaminated when___
out of range of vision or below waist line
the two types of wounds
those with loss of tissue and those without
acute wounds without tissue loss, and are easily pulled close together iwth sutures, clips, or steri-strips healing quickly usually within 14 days and scaring is minimal and risk of infection low
Primary Intention Healing
Tissue is lost, cavity left so the wound has to be left open and heal from the bottom up with granulation tissue
secondary intention healing
a wound in which the edges could be pulled together and closed with sutures or staples, but is purposely left open for 3-5 days due to excessive drainage, hemorrhage, or infection in the wound before it is closed
tertiary intention healing (delayed primary closure)
four types of wound drainage
serous, serosanginous, sanguinous, purulent
clear and watery drainage
serous
a pale red and watery type of drainage (has some red blood cells in it)
serosanginous
frank blood a thick type of drainage
sanguinous
liquified necrotic tissue, pus
purulent
4 types of wound complications
dehiscence, evisceration, fistula, enterocutaneous fistula
partial seperation of wound layers at the surface of the wound, most occur with abdominal wounds (after abdominal surgery it typically occurs around the 7th postoperative day if its going to) obese patients are especially risk because of the constant strain on the owund, plus fatty tissue heals poorley
dehiscence
_______drainage occurring more than 48 hours after a wound is closed may be a sign of impending dehiscence, if it occurs place the patient in LOW fowlers with knees bent to decrease the tension
serosanguinous
total separation of all layers of a wound with protrusion of abdominal organs a MEDICAL EMERGENCY
evisceration
an abnormal passageway connecting one epithelial surface with another
fistula
an abnormal passageway connection an epithelial surface with an organ once they form a stoma ("mouth" at surface of ski) they can only be healed by surgically removeing
enterocutaneous fistula
3 types of drains
penrose, jackson-pratt (JP), hemovac
for cleaning clean, non infected wounds use ____all of which deliver a force of __________
bulb syringe, piston syringe with no needle, or a gravity drip through IV tubing; a force of 2-4 pounds psi
for infected wounds a _____cc syringe with a ____guage needle works well and delivers about ____psi
35cc, 19 gauge needle, 8 lb psi
flow pressure should be between ___-___ fro non infected wounds
4-15 psi
force pressure of ___ for infected wounds
30 psi
___ solutions are used with low pressure cleaning of wounds
sterile
normal saline is used except when dressing or ointments incorporate_____
silver
irrigate from ____ to____
least to most contaminated (the wound is considered less contaminated then the surrounding skin)
two types of necrotic tissue that may appear in wounds
slough, eschar
loose, stringy, hydrated tissue that is usually yellow
slough
dehydrated, think, leathery tissue that is usually black
eschar
types of debridement
mechanical, autolytic, enzymatic, biological, surgical (sharp)
romoval of dead tissue by direct pressure or force, (wet-dry, pulsed low pressure irrigation, whirlpool)
mechanical debridement
covering the wound with a transparent occlusive synthetic dressing such as a transparent (tegaderm). It seals the wound, akeeps it moist and allows dead tissue to be "self-diegested" by the body
autolytic debridement
application of a topical enzyme ointment that breaks down dead tissue
enzymatic debridement
using sterile maggots
biological debridement
using a scalpel or scissors or sharp instrument to cut away dead tissure
surgical ( sharp) debridement
transpearent film is good on what kind of wounds
superficial wounds with little draingage
on an infected wound use what kind of dressing
dry gauze with topical antibiotics packed light but full
wet-to-dry dressings should never be used on what kind of wound
clean granulating wounds that contain no dead tissue
how often should a wet-to-dry or wet to moist dressingbe changed
twice daily
an occlusive type dressing impermeable to water, water vapor, and oxygen, good for partial and full thickness wounds with minimum to moderate drainage (not very obsorbant and shouldnt' be applied to infected owunds)
hydrocolloid (duo-derm)
available as sheets, impregnated gauze or gels. they keep dry wounds moist and sooth and cool the wound (often used for thermal burns and painful sounds) needs to be changed daily
hydrogels
made of highly absorbant material manufactured from seaweed-can absorb up to 40 times their own weight in fluid (good for wounds which drain copiously change every 1/2 -3 ddays DONT use on dry wounds)
alginate
which dressing would be best for full-thickness wounds with minimum to moderate drainage
hydrocolloid (duo-derm
Dont use alginate dressings on what kind of wound
dry
often used for thermal burns and painful wounds
hydrogels