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