Nursing: Unit 2 - Safety & Infection Control

Front 1

Communicable diseases

Back 1

Communicable diseases

- caused by pathogenic microorganisms & transmitted by direct contact, droplet spread, contaminated articles, or through carriers

Front 2

Nosocomial infections

Back 2

Nosocomial infections

- an infection in the hospital
- most often caused by Staphylococcus aureus

Front 3

Standard Precautions (barrier) - used with all patients/ clients

Back 3

Standard Precautions (barrier) - used with all patients/ clients

1. Primary strategy for nosocomial infection control
2. Most important way to reduce transmission of pathogens
c. Apply to blood, all body fluids, secretions, and excretions, except sweat and nonintact skin & mucous membranes

Front 4

Airborne Precautions

Back 4

Airborne Precautions

1. Used with pathogens that are transmitted by airborne route
2.Private room with monitored negative pressure with 6-12 air changes per hour
3. Keep door closed and patient in room
4. Can cohort or place patient with another patient with the same organism, but no other organism
5. place mask on patient if being transported

Front 5

Airborne Precautions - Examples of disease in category

Back 5

Airborne Precautions - Examples of disease in category

measles (rubeola)
M. tuberculosis (pulmonary or laryngeal)
varicella (chicken pox)
disseminated zoster (shingles)

Front 6

Droplet Precautions

Back 6

Droplet Precautions

1. Used with pathogens transmitted by infectious droplets
2. Involves contact of conjunctive or mucous membranes of nose or mouth; happens during coughing, sneezing, talking, or during procedures such as suctioning or bronchoscopy
3. Private room or with patient with same infection but no other infection
4. Maintain spatial separaion of three fee between infected patient and visitors or other patients
5. Door may remain open
6. Place mask on patient if being transported

Front 7

Droplet Precautions - Examples of disease in category

Back 7

Droplet Precautions - Examples of disease in category

- streptococcus pharyngitis
- pneumonia (mycoplasmal/meningococcal)
- pnuemonic plague
- scarlet fevers in infants & young children
- pertussis
- meningitis caused by H. inluenza type b
- mumps

Front 8

Contact Precautions

Back 8

Contact Precautions

1. Needed with patient care acitivities that require physical skin-to-skin (e.g. turn patients, bathe patients), or occurs between two patients (e.g. hand contact), or occurs by contact with contaminated inanimate objects in patient's environment
2. Private room with patient with same infection but no other infection
3. Clean, nonsterile gloves when entering room
4. Change gloves before leaving patient's environment & wash hands with antimicrobial agent
6. Wear gown when entering room if clothing will have contact with patient, environment surfaces, or if patient is incontinent, has diarrhea, and ileostomy, colostomy, or wound drainage
7. remove gown before leaving room
8. Use dedicated equipment or clean and disinfect between patients

Front 9

Contact Precautions - Examples of disease in category

Back 9

Contact Precautions - Examples of disease in category

- infection by multidrug-resistant organisms (e.g. MRSA)
- pediculosis
- scabies
- respiratory synctial virus
- shigella & other enteric pathogens
- major wound infections
- herpes simplex
- disseminated varicella zoster

Front 10

Tuberculosis - Assessment

Back 10

Tuberculosis - Assessment

1.Progressive fatigue, nausea, anorexia, weight loss
2. Irregular menses
3. Low-grade fever over a period of time
4. Night Sweats
5. Irritable
6. Cought with mucopurulent sputum, occasionally streaked with blood; chest tightness & a dull aching chest; dyspnea

Front 11

Tuberculosis - Diagnostic Procedures

Back 11

Tuberculosis - Diagnostic Procedures

1.skin testing
2.sputum smear for acid-fast bacilli; induuce by respiratory therapy in AM & PM
3.chest x-ray routinely performed on all persons with positive PPD to detect old & new lesions

Front 12

Tuberculosis - Risk Factors

Back 12

Tuberculosis - Risk Factors

a. close contact with someone who has active tb
b. immunocompromised
c. IV drug abuser
d. persons who live in institutions
e. lower socioeconomic group
f. immigrants from countries with a high prevalence of tb (Latin American, Southeast Asia, Africa)

Front 13

Tuberculosis Skin Testing

Back 13

Tuberculosis Skin Testing

1. Mantoux Test (PPD)
2. Multiple Punture Test (Tine)

Front 14

Mantoux Test (PPD) - TB Skin Testing

Nursing Considerations

Back 14

Mantoux Test (PPD) - Nursing Considerations

1. Given intradermally in the forearm
2. 10-mm induration (hard area under the skin) = significant (positive) reaction
3. Read in 48-72 hours (2-3 days)
4. Does not mean that active disease is present, but indicates exposure to TB or the presence of inavtice (dormant) disease
5. Greater than 5mm for clients with AIDS = positive reaction

Front 15

Multiple Punture Test (Tine) - TB Skin Testing

Nursing Considerations

Back 15

Multiple Punture Test (Tine) - Nursing Considerations

1. Read test in 48-72 hours
2. Vesicle formation = positive reaction
3. Screening test only
4. Questionable or positive reactions verified by Mantoux Test

Front 16

Tuberculosis - Teaching

Back 16

Tuberculosis - Teaching

a. Cover mouth & nose with tissue when coughing, sneezing, laughing; burn tissues
b. Avoid excessive exposure to dust and silicone
c. Handawashing
d. Must take full course of meds
e. Encourage to return to clinic for sputum smears
f. Good nutrition

Front 17

Tuberculosis - Precautions

Back 17

Tuberculosis - Precautions

Airborne

Front 18

Tuberculosis - Definition

Back 18

Tuberculosis - Definition

- lung infection caused by Mycobacterium tuberculosis
- any tissue can be infected, but tb is often found in the lung
- transmitted by aerosolization
- bacillus multiplies in bronchi or alveoli resulting to pneumonitis
- may lie dormant for many years and be reactivated in periods of stress

Front 19

Tuberculosis - Laboratory & diagnostic findings

Back 19

Tuberculosis - Laboratory & diagnostic findings

1. Positive tuberculin skin test (indicated exposure)
2. Appearance of characteristic Ghon tubercle on chest x-ray
3. Positive acid fast bacillus sputum culures (provides definitive diagnosis of infection)

Front 20

Tuberculosis - Medication Therapy

Back 20

Tuberculosis - Medication Therapy

a. Antibiotic prophylaxis - for individuals exposed to clients with active disease
b. Isoniazid (INH) - drug of choice for 6 months if no clinical evidence of disease
c. INH durg of choice for 12 months if abnormal chest x-ray or high risk population such as with human immunodeficiency virus (HIV) or drug induced immunosuppression

Front 21

Tuberculosis - 1st Line Medications

Back 21

Tuberculosis - 1st Line Medications

Isoniazid (INH)
(Laniazid, Nydrazid)
Rifampin (Rifadin)
Ethambutol (Myambutol)
Streptomycin
Pyrazinamide (Pyrazinamide)

Front 22

Tuberculosis - 2nd Line Medications

Back 22

Tuberculosis - 2nd Line Medications

Capreromycin (Capastat)
Ethionamide (Trecator - SC)
Aminosalicylate sodium (Tubasal)
Cycloserine (Seromycin)
Kanamycin (Kantrex)

Front 23

Rubeola (Measles)- Description

Back 23

Rubeola (Measles)- Description

1. Agent: Virus
2. Incubation Period: 13- 17 days
3. Communicable Period: From 4days before to 5 days after the rash appears; mainly during prodromal (catarrhal) stage
4. Source: Respiratory tract secretions, blood, or urine of infected person
5. Transmission: airborne or direct contact with infectious droplets

Front 24

Rubeola (Measles)- Assessment

Back 24

Rubeola (Measles) - Assessment

1. Fever
2. Malaise
3. Caryza and cough
4. Rash appears as red, discrete maculopapules that blanch easily with pressure & gradually turn a brownish color (lasts 6-7days); rash begins behind the ears and spreads downward to feet
5. Koplik spots: small, red spots with a bluish white center and a red base; located on the mucosa and last 3 days

Front 25

Rubeola (Measles)- Implementation

Back 25

Rubeola (Measles)- Implementation

1. Respiratory precautions if the child is hospitalized
2. Restrict to quie activities & bed rest
3. Use a cool mist vaporizer for cough & coryza
4. Dim lights if photophobia is present
5. Administer antipyretics for fever

Front 26

Chickenpox (Varicella) - Description

Back 26

Chickenpox (Varicella) - Description

1. Agent: Varicella zoster virus (VZV)
2. incubation Period: