Nursing Management of the Adult with Inflammation and Infection
Infection
- Infection is a process that occurs in response to tissue injury and to the invasion of organisms.
- usually accompanied by inflammation. However, inflammation can occur without infection.
- Inflammation does not always mean that an infection is present.
Chain of Infection
- If no break in chain then they are susceptible
-
High Risk Individuals
- Elderly
- Infants
- Diabetics
- Patients receiving steroids
o Raise blood sugar
- Patients receiving chemotherapy/radiation therapy
- Immuno-suppressed
- Malnourished
- Stress
What are some ways we can break the chain of infection?
- Hand hygiene
- Cleaning (infection control)
o Disinfectants
o Antiseptics - bactericidal, bacteriostatic
- Use Standard & Transmission Based Precautions
- PPE
- Sterile Technique
- Adequate staffing
- Patient placement:
o Cohorting
- Patient transportation
Terms Related to Infection
- Local versus systemic
o Term for systemic is bacteremia
- Healthcare associated infection (HAI)
- Sepsis
o life-threatening organ dysfunction due to a dysregulated host response to infection
- Early presenting symptoms are called systemic inflammatory response syndrome (SIRS)
o Now conflicting evidence as to if SIRS criteria are most best predictor of sepsis
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, Nursing Management of the Adult with Inflammation and Infection
Healthcare Associated Infections (HAI)
Main Types
CAUTI – catheter associated urinary tract infection
CLABSLI – central line associated bloodstream infection
SSI – surgical site infection
VAP – ventilator associated pneumonia
Multiple agencies have guidelines often called “bundles”
- Evidence basesed guidelines
- Remove cath
- Wash in wash out
Improvements have been made in most areas except SSIs
- Most common HAI
Systemic Inflammatory Response Syndrome (SIRS)
Temperature > 38C or < 36 C
HR > 90 bpm
RR > 20 /minute or PaCo2 > 32mm/Hg
WBCs > 12,000, < 4000 or > 10% immature WBCs
- Now, immature granulocytes are closely looked at (IG)
Progression of Infection
Incubation period
- time between pathogen’s entrance and appearance of symptoms
- no symptoms
- still infectious
Prodromal period
- nonspecific symptoms occur (nausea, fever, general weakness, aches)
Acute phase
- specific symptoms of illness occur
Convalescent period
- body systems return to normal; antibodies appear in blood.
Clinical Manifestations of Infection vary according to type and severity of infection
The Febrile Response
Body temperature elevates in response to exposure to pyrogens.
Pyrogens which cause chemical reactions stimulating the hypothalamus to increase body
temperature.
Cytokines also stimulate the hypothalamus
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