Nursing 221 Exam #3
Background of Infection Control and Prevention: - correct answer oHigh risk for infection when entering any health care facility
o1:25 patients in any day will develop a health care associated infection
oTjc-patient safety issue and essential to provide for safe health care environment
oRisk factors for hcai-decreased resistance due to pre-existing conditions, medications or decreased immune response
oExposure to multiple drug resistant pathogens
OInvasive procedures
Risk for Healthcare Workers: - correct answer oHigh risk to the health care worker: exposure to blood, body fluids, airborne pathogens, equipment and surfaces
oProtection includes use of basic infection prevention and control procedures
oUse of ppe (personal protective equipment)
oHigh risk for mdro (multi-drug resistant organisms); tb; hiv; hep b & c
The Nature of Infection: - correct answer oInfection-invasion of a susceptible host such as a human by pathogens or microorganisms producing illness
oColonization-presence and growth of microorganisms within a host but without tissue invasion/damage
oInfectious disease-that which can be transmitted from one person to another
oCommunicable disease-that which is transmitted to others
oSymptomatic-displaying signs and symptoms of illness
oAsymptomatic-no signs or symptoms are present
The Chain of Infection: - correct answer oCycle of infection consists of:
oInfectious agent or pathogen
oReservoir or source for growth
oPortal of exit oMethod of transmission
oPort of entry to host
oSusceptible host
oChain must be intact for infection to spread
Infectious Agent: - correct answer -Bacteria, Viruses, Fungi, Protozoa
oNormal skin flora (resident pathogens)-do not cause illness
oVirulence-the ability of an organism to produce disease; ability to enter and survive in a host and the susceptibility of the host
oSkin flora can cause serious illness if allowed to enter the host through a break in skin or invasive procedure
oImmunocompromised-severely weakened immune system
oTransmission may occur from patient to hcw by touching dressings, skin or body fluids
oStress the importance of hand hygiene
Reservoir: - correct answer oA place where the microorganisms survive, multiply and transfer to host
oExamples include humans, animals, insects, food, water, and inanimate surfaces
oCommon hai reservoirs: hands, patients, equipment, environment
oHuman reservoirs can be symptomatic or asymptomatic
oOrganisms must have the right environment to survive-light, ph, food, oxygen, water, temperature
oFood-organic matter, undigested food, carbon dioxide
Oxygen:
•-aerobic-requiring oxygen for survival and replication
•-more apt to cause infections in humans (staph aureus)
•-anaerobic-little or no oxygen; cause infection in deep cavities, dark areas
oWater-moisture, spore which resists drying
oIdeal temp for pathogenic growth is 68-109 degrees f
oCold temperatures prevent growth and multiplication of bacteria (bacteriostasis
oBactericidal-agent or temperature which destroys bacteria Reservoir-portal of Exit: - correct answer oPh-acidity of environment; preferred is 5.0-7.0
oLight-dark is preferred
oPortal of exit-after growth must leave host and cause infection
oBlood, urine, respiratory secretions, etc are portals of exit
oSkin and mucous membranes-portal of exit as breaks cause exit of pathogens
oRespiratory tract-sneezing or coughing
oUrinary tract-normal urine is sterile
oGi tract-mouth, emesis, bowels, drainage tubes
oReproductive tract
oBlood-normally sterile; wounds, venipuncture, bloody stool
Modes of Transmission: - correct answer Airborne
Droplet
Contact Equipment
Portal of Entry: - correct answer oEntrance into susceptible patient via break in skin, etc
oImmune suppression is major factor
oSusceptibility-depends on the persons ability to fight infection-resistance
oNatural defenses may protect person
oPoor nutrition, chronic disease, trauma, smoking increase risk for infection
oIncreasing use of antibiotics
Process of Infection: - correct answer oLocalized-contained in one area such as a surgical wound
oLocal symptoms such as redness, warmth, swelling, pain at site
oSystemic-involves the entire body-may lead to death; sepsis
oNursing care is based on the type and course of infection
oTreatments may often have additional effects on the patient Defenses against Infection: - correct answer oNatural defenses including normal flora, inflammation
oFailure of these defenses leads to infection or sepsis
oNormal flora-microorganisms normally reside on the skin, in the mouth, gi and gu tracts
oTypically do not cause disease-may be important in disease prevention
oMaintain a balance that is protective oAnything which disrupts balance can lead to infection/disease
oUse of broad spectrum antibiotics wipe out the normal flora causing an overgrowth of bacteria which produces infection
Body Defenses: - correct answer oSkin-intact, multilayers; shedding of outer layers, sebum-antibacterial
oMouth-intact mucosa, saliva washes away bacteria and contains lysozyme, an antibacterial agent
oEye-tears, eyelashes
oRespiratory tract-cilia, macrophages
oUrinary tract-flushing of urine, intact epithelium
oGi tract-acid secretions, peristalsis
Systemic Defenses: - correct answer oInflammatory response-protective vascular reaction which delivers blood, fluids and nutrients to injured area
oPathogens are neutralized or eliminated
oNecrotic or dead tissue is destroyed
oS/s: redness (erythema), inflammation/edema, warmth, tenderness, pain
oIf systemic, patient may be febrile, nauseated, vomiting, diarrhea, lymphadenopathy
oPhysical agents-trauma, temperature, radiation
oChemical agents-poisons, chemotherapy
oInflammatory response includes formation of exudates or fluid/cells released from cells or blood vessels (pus, serum)
Vascular and Cellular Response: - correct answer oAcute inflammation is first response to injured cells
oVasodilation occurs which permits increased blood flow to the area
