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Questions and Answers
What are the three types of exudate mentioned in the text?
Serous, Sanguineous, Purulent
What type of precautions aim to protect against infections smaller than 5 mcg such as measles and varicella?
Clients with a protective environment requirement always need a private room.
False
___ precautions protect visitors and caregivers against direct client and environmental contact infections.
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What is the chain of infection?
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Inflammatory response involves phagocytic cells, complement system, and interferons.
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What is virulence?
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Pathogens are ______ that cause infections, and they can be bacteria, viruses, fungi, prions, and parasites.
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Match the mode of transmission with the corresponding example:
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Which of the following illustrate the rationale for reporting communicable and infectious diseases? (Select all that apply)
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A client who has had a cough for 3 weeks and is beginning to cough up blood may have manifestations of which of the following conditions?
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A client reporting a severe sore throat, pain when swallowing, and swollen lymph nodes is experiencing which stage of infection?
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Which of the following are manifestations of a systemic infection? (Select all that apply)
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Which interventions should a nurse include in the plan of care for a client with a suspected diagnosis of pertussis? (Select all that apply)
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What is the primary concern when managing infections in older adult clients?
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What is the primary goal of achieving at least six air exchanges per hour in a client's room?
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During which stage of infection do the findings specific to the infection become apparent?
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What is a potential complication of systemic infections in older adult clients?
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When providing care to a client with a suspected diagnosis of MRSA, what is the most important intervention to prevent transmission?
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What is a critical component of infection management in a healthcare setting?
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What is a characteristic of older adult clients that can impact their immune response to infections?
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What is a potential challenge when managing infections in older adult clients with chronic illnesses?
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What is a characteristic of a systemic infection?
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What is a potential consequence of decreased mobility in older adult clients with infections?
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What is a consequence of antimicrobial resistance?
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What is a key principle of infection control in a healthcare setting?
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What is the primary goal of using current evidence-based practice guidelines to prevent HAIs due to multidrug-resistant organisms?
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What is the primary mechanism by which good pulmonary hygiene decreases the growth of micro-organisms and the development of pneumonia?
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What is the primary type of infection that can result from a diagnostic or therapeutic procedure?
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What is the primary purpose of using aseptic technique and proper personal protective equipment in the provision of care?
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What is the primary stage of infection during which damaged tissue is replaced by scar tissue?
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What is the primary type of exudate that contains red blood cells?
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What is the primary purpose of ensuring immobile clients receive pulmonary hygiene every 2 hours or as prescribed?
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What is the primary type of infection that is not always preventable and not always iatrogenic?
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Study Notes
Infection Control
- Infection occurs when a pathogen leads to a chain of events, and all components of the chain must be present and intact for the infection to occur.
Types of Pathogens
- Bacteria: Staphylococcus aureus, Escherichia coli, Mycobacterium tuberculosis
- Viruses: HIV, Hepatitis, Herpes zoster, Herpes simplex virus (HSV)
- Fungi: Candida albicans, Aspergillus
- Prions: Protein particles (new variant Creutzfeldt-Jakob disease)
- Parasites: Protozoa (malaria, toxoplasmosis) and helminths (worms, flukes)
Infection Process
- Chain of Infection: Causative agent, reservoir, portal of exit, mode of transmission, portal of entry
- Mode of Transmission: Contact (direct and indirect), droplet, airborne, vector-borne, fecal-oral
Immune Defenses
- Nonspecific Innate Immunity: Native immunity restricts entry or immediately responds to a foreign organism through phagocytic cells, complement, and inflammation
- Specific Adaptive Immunity: Allows the body to make antibodies in response to a foreign organism (antigen)
Stages of an Infection
- Incubation: Interval between the pathogen entering the body and the presentation of the first finding
- Prodromal Stage: Interval from onset of general findings to more distinct findings
- Illness Stage: Interval when findings specific to the infection occur
- Convalescence: Interval when acute findings disappear, and total recovery takes days to months
Risk Factors
- Inadequate hand hygiene
- Compromised health or defenses
- Indwelling devices
- Break in the skin
- Poor oxygenation
- Impaired circulation
- Chronic or acute disease
- Poor personal hygiene or nutrition
- Smoking, excessive alcohol consumption, and stress
Health-Care Associated Infections (HAIs)
- Infections acquired while receiving care in a health care setting
- Can come from an exogenous source (outside the client) or an endogenous source (inside the client)
- Prevented through frequent and effective hand hygiene
Laboratory Tests
- Leukocytosis: WBCs greater than 10,000/µL
- Elevated Erythrocyte Sedimentation Rate (ESR): An increase indicates an active inflammatory process or infection
- Gallium Scan: Nuclear scan that uses a radioactive substance to identify hot spots of WBCs
Patient-Centered Care
- Use frequent and effective hand hygiene
- Educate clients about required and recommended immunizations
- Encourage good oral hygiene and adequate fluid intake
- Implement standard precautions for all clients### Infection Control Measures
- Masks, eye protection, and face shields are required when within 3 ft of the client and environmental contact infections are possible.
- Clean gloves are worn when touching anything that has the potential to contaminate the hands of the nurse.
- Contact precautions require a private room or a room with other clients who have the same infection.
- Hand hygiene is required after removal of the gown.
- Gloves and gowns are worn by caregivers and visitors.
Protective Environment
- A protective environment is an intervention to protect clients who are immunocompromised.
- A private room is not necessary unless the client is unable to maintain appropriate hygienic practices.
- Positive airflow of 12 or more air exchanges per hour is required.
- HEPA filtration for incoming air is used.
Transmission Precautions
- Airborne precautions protect against droplet infections smaller than 5 mcg.
- Airborne precautions require a private room, masks, and respiratory protection devices for caregivers and visitors.
- Negative pressure airflow exchange in the room of at least six to 12 exchanges per hour is required.
- If splashing or spraying is a possibility, wear full face protection.
Droplet Precautions
- Droplet precautions protect against droplets larger than 5 mcg and travel 3 to 6 ft from the client.
- Droplet precautions require a private room or a room with other clients who have the same infectious disease.
- Masks for providers and visitors are required.
- Clients who have a droplet infection should wear a mask while outside of the room/home.
Medications
- Antipyretics are used for fever and discomfort as prescribed.
- Antimicrobial therapy kills or inhibits the growth of microorganisms.
- Antimicrobial medications either kill pathogens or prevent their growth.
- Anthelmintics are used for worm infestations.
Nursing Actions
- Monitor fever to determine effectiveness of medication.
- Document the client's temperature fluctuations on the medical record for trending.
- Administer antimicrobial therapy as prescribed.
- Monitor for medication effectiveness.
- Maintain a medication schedule to ensure consistent therapeutic blood levels of the antibiotic.
Reporting Communicable Diseases
- More than 60 communicable diseases must be reported to the public health departments.
- Reporting allows for ensuring appropriate medical treatment of diseases, monitoring for common-source outbreaks, planning and evaluating control and prevention plans, and determining public health priorities.
Client Education
- Teach the client about infection control measures at home.
- Teach the client about self-administration of medication therapy.
- Teach the client about complications to report immediately.
Infection Control
- Iatrogenic infections are a type of Healthcare-Associated Infection (HAI) resulting from a diagnostic or therapeutic procedure.
- HAIs are not always preventable and are not always iatrogenic.
Stages of Infection
- Incubation: interval between the pathogen entering the body and the presentation of the first finding.
- Prodromal stage: interval from onset of general findings to more distinct findings, during which the pathogen multiplies.
- Illness stage: interval when findings specific to the infection appear.
Types of Exudate
- Serous (clear fluid, pulmonary excretions, stimulating ciliary movement and clearance).
- Sanguineous (contains red blood cells).
- Purulent (contains leukocytes and bacteria).
Infection Prevention
- Use current evidence-based practice guidelines to prevent HAIs due to multidrug-resistant organisms.
- Ensure good pulmonary hygiene, including turning, coughing, deep breathing, and incentive spirometry, to prevent stasis of secretions and development of pneumonia.
- Use aseptic technique and proper personal protective equipment (gloves, masks, gowns, and goggles) when providing care to all clients.
Older Adult Clients
- Slowed response to antibiotic therapy.
- Slowed immune response.
- Loss of subcutaneous tissue and thinning of the skin.
- Decreased vascularity and slowed wound healing.
- Decreased cough and gag reflexes.
- Chronic illnesses.
- Decreased gastric acid production.
- Decreased mobility, bowel and bladder incontinence, dementia, and greater incidence of invasive devices (urinary catheter or feeding tube).
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Description
Learn about the safety and infection control measures in healthcare, including the role of antibodies and immunity in response to antigens.
