Chapter 23. Promoting Asepsis & Preventing Infection

Chapter 23. Promoting Asepsis & Preventing InfectionMULTIPLE CHOICE 1. Which of the following behaviors indicates the highest potential for spreading infections among clients? The nurse: a. Disinfects dirty hands with antibacterial soap b. Allows alcohol-based rub to dry for 10 seconds c. Washes hands primarily after leaving each room d. Uses cold water for medical asepsis ANS: C Patients acquire infection by contact with other patients, family members, and healthcare equipment. But most infection among patients is spread through the hands of healthcare workers. Handwashing interrupts the transmission and should be done before and after all contact with patients, regardless of the diagnosis. When the hands are soiled, healthcare staff should use antibacterial soap with warm water to remove dirt and debris from the skin surface. When no visible dirt is present, an alcohol-based rub should be applied and allowed to dry for 10 to 15 seconds. Difficulty: Easy Client Need: SECE Cognitive Level: Comprehension PTS: 1 2. What is the most frequent cause of the spread of infection among institutionalized patients? a. Airborne microbes from other patients b. Contact with contaminated equipment c. Hands of healthcare workers d. Exposure from family members ANS: C Patients are exposed to microbes by contact (direct contact, airborne, or otherwise) with other patients, family members, and contaminated healthcare equipment. Some of these are pathogenic (cause illness) and some are nonpathogenic (do not cause illness). But most microbes causing infection among patients are spread by direct contact on the hands of healthcare workers. Difficulty: Easy Client Need: SECE Cognitive Level: Recall Page 523 PTS: 1 3. A patient infected with a virus but who does not have any outward sign of the disease is considered a: a. Pathogen b. Fomite c. Vector d. Carrier ANS: D Some people might harbor a pathogenic organism, such as HIV, within their body and yet do not acquire the disease/infection. These individuals, called carriers, have no outward sign of active disease, yet they can pass the infection to others. A pathogen is an organism capable of causing disease. A fomite is a contaminated object that transfers a pathogen, such as pens, stethoscopes, and contaminated needles. A vector is an organism that carries a pathogen to a susceptible host through a portal for entry into the body. An example of a vector is a mosquito or tick that bites or stings. Difficulty: Moderate Client Need: SECE Cognitive Level: Comprehension Page 519 PTS: 1 4. A patient is admitted to the hospital with tuberculosis. Which precautions must the nurse institute when caring for this patient? a. Droplet transmission b. Airborne transmission c. Direct contact d. Indirect contact ANS: B The organisms responsible for measles and tuberculosis, as well as many fungal infections, are spread through airborne transmission. Neisseria meningitidis, the organism that causes meningitis, is spread through droplet transmission. Pathogens that cause diarrhea, such as Clostridium difficile, are spread by direct contact. The common cold can be spread by indirect contact or droplet transmission. Difficulty: Moderate Nursing Process: Interventions Client Need: SECE Cognitive Level: Comprehension Page 521 PTS: 1 5. A patient becomes infected with oral candidiasis (thrush) while receiving intravenous antibiotics to treat a systemic infection. Which type of infection has the patient developed? a. Endogenous nosocomial b. Exogenous nosocomial c. Latent d. Primary ANS: A Thrush in this patient is an example of an endogenous nosocomial infection. This type of infection arises from suppression of the patient’s normal flora as a result of some form of treatment, such as antibiotics. Normal flora usually keep yeast from growing in the mouth. In exogenous nosocomial infection, the pathogen arises from the healthcare environment. A latent infection causes no symptoms for long periods. An example of a latent infection is HIV infection. A primary infection is the first infection that occurs in a patient. Difficulty: Difficult Nursing Process: Assessment Client Need: PHSI Cognitive Level: Application Page 522 PTS: 1 6. A patient admitted to the hospital with pneumonia has been receiving antibiotics for 2 days. His condition has stabilized, and his temperature has returned to normal. Which stage of infection is the patient most likely experiencing? a. Incubation b. Prodromal c. Decline d. Convalescence ANS: C The stage of decline occurs when the patient’s immune defenses, along with any medical therapies (in this case antibiotics), are successfully reducing the number of pathogenic microbes. As a result, the signs and symptoms of infection begin to fade. Incubation is the stage between the invasion by the organism and the onset of symptoms. During the incubation stage, the patient does not know he is infected and is capable of infecting others. The prodromal stage is characterized by the first appearance of vague symptoms. Convalescence is characterized by tissue repair and a return to heal as the organisms disappear. Difficulty: Moderate Nursing Process: Diagnosis Client Need: PHSI Cognitive Level: Analysis Page 522