Chapter 11: Infection Control and Immunity
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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?

  • Airborne precautions (correct)
  • Contact precautions
  • Protective environment
  • Standard precautions

    • Clients with a protective environment requirement always need a private room.

    False

    ___ precautions protect visitors and caregivers against direct client and environmental contact infections.

    <p>Contact</p> Signup and view all the answers

    What is the chain of infection?

    <p>The sequence of events required for an infection to occur</p> Signup and view all the answers

    Inflammatory response involves phagocytic cells, complement system, and interferons.

    <p>True</p> Signup and view all the answers

    What is virulence?

    <p>Virulence is the ability of a pathogen to invade and injure a host.</p> Signup and view all the answers

    Pathogens are ______ that cause infections, and they can be bacteria, viruses, fungi, prions, and parasites.

    <p>micro-organisms</p> Signup and view all the answers

    Match the mode of transmission with the corresponding example:

    <p>Direct physical contact = Person to person Fecal-oral transmission = Handling food after using a restroom and failing to wash hands Droplet = Sneezing, coughing, and talking Vector borne = Animals or insects as intermediaries (ticks and malaria)</p> Signup and view all the answers

    Which of the following illustrate the rationale for reporting communicable and infectious diseases? (Select all that apply)

    <p>Planning and evaluating control and prevention strategies</p> Signup and view all the answers

    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?

    <p>Tuberculosis</p> Signup and view all the answers

    A client reporting a severe sore throat, pain when swallowing, and swollen lymph nodes is experiencing which stage of infection?

    <p>Prodromal</p> Signup and view all the answers

    Which of the following are manifestations of a systemic infection? (Select all that apply)

    <p>Fever</p> Signup and view all the answers

    Which interventions should a nurse include in the plan of care for a client with a suspected diagnosis of pertussis? (Select all that apply)

    <p>Wear a mask when providing care within 3 ft of the client</p> Signup and view all the answers

    What is the primary concern when managing infections in older adult clients?

    <p>Slowed response to antibiotic therapy</p> Signup and view all the answers

    What is the primary goal of achieving at least six air exchanges per hour in a client's room?

    <p>To reduce the risk of multidrug-resistant infections</p> Signup and view all the answers

    During which stage of infection do the findings specific to the infection become apparent?

    <p>Illness stage</p> Signup and view all the answers

    What is a potential complication of systemic infections in older adult clients?

    <p>Decreased cough and gag reflexes</p> Signup and view all the answers

    When providing care to a client with a suspected diagnosis of MRSA, what is the most important intervention to prevent transmission?

    <p>Wearing a mask and gown when entering the client's room</p> Signup and view all the answers

    What is a critical component of infection management in a healthcare setting?

    <p>Implementing proper hand hygiene practices</p> Signup and view all the answers

    What is a characteristic of older adult clients that can impact their immune response to infections?

    <p>Loss of subcutaneous tissue and thinning of the skin</p> Signup and view all the answers

    What is a potential challenge when managing infections in older adult clients with chronic illnesses?

    <p>Slowed immune response and decreased vascularity</p> Signup and view all the answers

    What is a characteristic of a systemic infection?

    <p>Fever and chills</p> Signup and view all the answers

    What is a potential consequence of decreased mobility in older adult clients with infections?

    <p>Increased risk of bowel and bladder incontinence</p> Signup and view all the answers

    What is a consequence of antimicrobial resistance?

    <p>Increased risk of multidrug-resistant infections</p> Signup and view all the answers

    What is a key principle of infection control in a healthcare setting?

    <p>Breaking the chain of infection</p> Signup and view all the answers

    What is the primary goal of using current evidence-based practice guidelines to prevent HAIs due to multidrug-resistant organisms?

    <p>To reduce the risk of antibiotic resistance</p> Signup and view all the answers

    What is the primary mechanism by which good pulmonary hygiene decreases the growth of micro-organisms and the development of pneumonia?

    <p>By preventing stasis of pulmonary excretions and stimulating ciliary movement and clearance</p> Signup and view all the answers

    What is the primary type of infection that can result from a diagnostic or therapeutic procedure?

    <p>Iatrogenic infection</p> Signup and view all the answers

    What is the primary purpose of using aseptic technique and proper personal protective equipment in the provision of care?

    <p>To prevent unnecessary exposure to micro-organisms</p> Signup and view all the answers

    What is the primary stage of infection during which damaged tissue is replaced by scar tissue?

    <p>Third stage</p> Signup and view all the answers

    What is the primary type of exudate that contains red blood cells?

    <p>Sanguineous</p> Signup and view all the answers

    What is the primary purpose of ensuring immobile clients receive pulmonary hygiene every 2 hours or as prescribed?

    <p>To prevent stasis of pulmonary excretions and stimulate ciliary movement and clearance</p> Signup and view all the answers

    What is the primary type of infection that is not always preventable and not always iatrogenic?

    <p>Hospital-Acquired Infection (HAI)</p> Signup and view all the answers

    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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