Infection Control and Isolation Procedures
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Questions and Answers

Which condition is associated with respiratory complications?

  • Increased urination
  • Loss of appetite
  • High blood pressure
  • Decreased air exchange (correct)
  • What is a common intervention for managing constipation?

  • Increasing physical activity (correct)
  • Encouraging smoking habits
  • Taking sedatives
  • Reducing fiber intake
  • Which psychosocial complication may arise from loss of mobility?

  • Enhanced self-esteem
  • Increased socialization
  • Increased independence
  • Isolation (correct)
  • What is the recommended intervention to help prevent urinary retention?

    <p>Encouraging fluid intake (D)</p> Signup and view all the answers

    Which intervention is specific for managing atelectasis?

    <p>Using an incentive spirometer (B)</p> Signup and view all the answers

    What describes the motion of pronation?

    <p>Turning to face backwards (D)</p> Signup and view all the answers

    Which condition is characterized by loss of lean muscle mass?

    <p>Sarcopenia (B)</p> Signup and view all the answers

    What intervention should be taken to monitor emotional status?

    <p>Encouraging expression of feelings (A)</p> Signup and view all the answers

    What type of isolation requires a private room with a negative pressure system?

    <p>Airborne isolation (D)</p> Signup and view all the answers

    Which type of PPE is recommended for caregivers treating a patient with a Herpes Simplex infection?

    <p>Gown and gloves (A)</p> Signup and view all the answers

    When should hand hygiene be performed?

    <p>Before and after client interaction (A)</p> Signup and view all the answers

    Which PPE is necessary for a provider exposed to potential splash contamination?

    <p>Face shield (D)</p> Signup and view all the answers

    What is the primary reason for using soap and water for hand hygiene in cases of clostridium difficile?

    <p>To effectively remove spores (D)</p> Signup and view all the answers

    Which type of infection is associated with ventilator use?

    <p>Ventilator associated pneumonia (A)</p> Signup and view all the answers

    What is a critical consideration for protective isolation?

    <p>No plants in the room (D)</p> Signup and view all the answers

    Which of the following is NOT a type of healthcare-associated infection?

    <p>Bladder infection (B)</p> Signup and view all the answers

    What is apnea characterized by?

    <p>Cessation of breathing (D)</p> Signup and view all the answers

    Which condition is associated with Cheyne-Stokes breathing?

    <p>Stroke (C)</p> Signup and view all the answers

    How would you document a pulse that is weak or diminished?

    <p>+1 (B)</p> Signup and view all the answers

    What is the normal range for oxygen saturation?

    <p>95-100 (C)</p> Signup and view all the answers

    Which temperature measurement site is considered the most accurate?

    <p>Rectal (D)</p> Signup and view all the answers

    What distinguishes active range of motion (ROM) from passive ROM?

    <p>Performed by the client themselves (B)</p> Signup and view all the answers

    What is the primary benefit of the prone position?

    <p>Facilitates postural drainage (D)</p> Signup and view all the answers

    How should crutches be properly fitted according to the guidelines?

    <p>2 inches below the axilla (C)</p> Signup and view all the answers

    What is a recommended intervention for low oxygen saturation?

    <p>Auscultate lungs (A)</p> Signup and view all the answers

    Which site for temperature measurement is considered non-intrusive?

    <p>Temporal (B)</p> Signup and view all the answers

    What is the first step when applying antiembolism stockings?

    <p>Use on dry, clean legs (C)</p> Signup and view all the answers

    In case a client can bear no weight, what assistive device is recommended?

    <p>Lift (B)</p> Signup and view all the answers

    What complication can arise from immobility in the cardiovascular system?

    <p>Cardiac deconditioning (D)</p> Signup and view all the answers

    What should be done to help prevent pressure injuries in immobile patients?

    <p>Reposition every two hours (B)</p> Signup and view all the answers

    What is a common sign of systemic infection?

    <p>Enlarged lymph nodes (C)</p> Signup and view all the answers

    Which exudate type indicates a purulent infection?

    <p>Contains leukocytes and bacteria (B)</p> Signup and view all the answers

    What is an effective action to break the chain of infection?

    <p>Using personal protective equipment (D)</p> Signup and view all the answers

    Which intervention is a part of falls risk assessment?

    <p>Developing fall prevention policies (D)</p> Signup and view all the answers

    Why are restraints used in healthcare settings?

    <p>To prevent patient injury (A)</p> Signup and view all the answers

    What is the purpose of ISBARR in client communication?

    <p>To provide concise handoff of information (A)</p> Signup and view all the answers

    Which is a key nursing intervention during a seizure?

    <p>Calling for Rapid Response Team (D)</p> Signup and view all the answers

    What is the normal range for blood pressure?

    <p>120/80 (B)</p> Signup and view all the answers

    What defines Stage 1 hypertension?

    <p>130-139 mmHg systolic or 80-89 mmHg diastolic (C)</p> Signup and view all the answers

    What is a nursing intervention for hypotension?

    <p>Increasing fluid intake (C)</p> Signup and view all the answers

    Where is the apical pulse taken?

    <p>At the fifth intercostal space at left mid-clavicular line (A)</p> Signup and view all the answers

    What should be noted when measuring blood pressure?

    <p>The first and fifth Korotkoff sounds should be documented (A)</p> Signup and view all the answers

    Which method is effective for counting respirations?

    <p>Inhale and exhale equals one breath (A)</p> Signup and view all the answers

    Which of the following is a cause of eupnea?

    <p>Relaxation and no danger (B)</p> Signup and view all the answers

    Flashcards

    Isolation Precautions

    Guidelines to prevent disease transmission for patients with infections.

    Contact Isolation

    Used for infections like RSV and Scabies requiring gowns and gloves.

    Droplet Isolation

    For diseases like Strep Throat; involves wearing a surgical mask.

    Airborne Isolation

    For highly contagious diseases requiring an N95 mask and negative pressure rooms.

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    Protective Isolation

    Used for immunocompromised clients; involves positive airflow and no plants.

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    When to Wear Gloves

    Wear gloves when contacting blood, bodily fluids, or non-intact skin.

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    Hand Hygiene Importance

    Critical to perform hand hygiene before and after client interaction to reduce germs.

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    Health Care Associated Infections

    Infections from medical care like CAUTI and SSI; costly with serious implications.

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    Respiratory Complications

    Issues like decreased air exchange, pneumonia risk, atelectasis, and thicker sputum.

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    Gastrointestinal Complications

    Conditions such as malnutrition, constipation, GERD, and impaction.

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    Genitourinary Complications

    Problems including urinary retention and renal calculi.

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    Psychosocial Complications

    Issues like loss of mobility affecting self-esteem, roles, and isolation.

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    Musculoskeletal Complications

    Conditions like osteoporosis, muscle atrophy, and joint contractures.

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    Flexion

    Bending a joint, reducing the angle between bones.

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    Extension

    Straightening a joint to increase the angle between bones.

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    Abduction and Adduction

    Abduction is moving away from the body; adduction is moving towards the body.

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    Signs of Infection

    Fever, chills, increased pulse, malaise, fatigue, anorexia, nausea, vomiting, cramping, diarrhea, enlarged lymph nodes.

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    Local Inflammation Signs

    Includes redness, warmth, edema, pain, loss of use of the affected area.

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    Exudate Stages

    First stage: Serous (clear). Second stage: Sanguineous (RBC). Third stage: Purulent (leukocytes and bacteria).

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    Chain of Infection Break

    Actions include proper handwashing, sterilization, and isolating infected patients.

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    Falls Risk Interventions

    Include multidisciplinary assessment, non-skid footwear, adequate lighting, and fall education.

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    Use of Restraints

    Applied to prevent harm; must be snug but not too tight. Requires monitoring.

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    Nursing Actions in Fires

    Remove persons in danger, activate alarms, and close doors/windows.

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    Client Identification

    Two identifiers are required to confirm patient identity.

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    Seizure Precautions

    Call for help, protect the head, clear dangerous objects, monitor airway and vitals.

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    Home Oxygen Safety

    No smoking, keep flames away, and turn off O2 in fires.

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    Proper Body Mechanics

    Stand close to the object, keep abdominal muscles contracted, and avoid twisting.

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    Blood Pressure Normal Range

    Normal BP is 120/80 mm Hg.

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    Hypertension Stages

    Stage 1: 130-139/80-89 mm Hg; Stage 2: >140/>90 mm Hg; Crisis: >180/>120 mm Hg.

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    Orthostatic Hypotension Diagnosis

    Diagnosed by a significant BP drop upon changing positions.

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    Apnea

    Cessation of breathing often due to opioid overdose or heart failure.

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    Cheyne-Stokes

    Cyclical breathing pattern ranging from shallow to deep with pauses.

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    Kussmaul’s breathing

    Deep, rapid, and regular breathing often seen in diabetic ketoacidosis.

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    Peripheral pulses locations

    The common sites to check pulse: Temporal, Carotid, Brachial, Femoral, Popliteal, Dorsalis Pedis, Posterior Tibial.

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    Pulse quality scale

    Documentation scale: 0 = Absent, +1 = Weak, +2 = Normal, +3 = Strong, +4 = Bounding.

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    Normal oxygen saturation

    Normal levels of oxygen in blood range from 95% to 100%.

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    Low oxygen interventions

    Actions include auscultating lungs, providing higher flow oxygen, monitoring for respiratory arrest, and possible intubation.

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    Temperature measurement sites

    Common sites include Temporal, Axillary, Rectal, Tympanic, and Oral.

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    Active vs Passive ROM

    Active ROM involves client movement; Passive ROM is without client's help.

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    Supine position

    Patient lies flat on their back, face up.

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    Proper crutch fit

    Crutches should be 1-2 inches below axilla with a 15-30 degree elbow angle.

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    Ambulation assistance

    Ensure equipment is locked; support under arms or use a gait belt.

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    Effects of immobility

    Complications include DVT, pressure injuries, and cardiac issues due to decreased movement.

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    Interventions for immobility

    Reposition every 2 hours, use cushions, monitor symptoms, assist with movement.

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    Temperature site accuracy

    Rectal is the most accurate; Temporal is easy but less precise.

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    Study Notes

    Infection Control and Isolation

    • Room Assignments: Clients with infections require specific rooms, based on the type of infection.

    • Isolation Precautions (Types): Different types of isolation are used to prevent the transmission of infections.

      • Contact Precautions: Used for infections spread by direct contact (e.g., wound infections, RSV, scabies). Caregivers and visitors wear gowns and gloves. Patients are placed in private rooms or cohorted with others with the same infection, maintaining 3 feet between clients. PPE must be removed before leaving the room.

      • Droplet Precautions: Used for infections spread through large droplets produced by coughing or sneezing (e.g., rubella, pertussis, mumps). Providers and visitors wear surgical masks. Private rooms or cohorting are used, with at least 3 feet between clients. Clients wear masks when moving outside their rooms. Cough etiquette and hand hygiene are crucial. Use individual equipment whenever possible.

      • Airborne Precautions: Used for infections spread by small airborne particles (e.g., measles, varicella, tuberculosis, COVID-19). Patients need private rooms with negative pressure and closed doors. Providers and visitors wear N95 or higher masks (fit testing is required). Wear full PPE if splashing is expected.

      • Protective Isolation: Used for immunocompromised clients, especially during the first 100 days after hematopoietic stem cell transplant or as needed. No plants; this is maintained using positive airflow, and masks should be worn if they move outside the room.

    Personal Protective Equipment (PPE)

    • Gloves: Worn when contact with blood, bodily fluids, secretions, excretions, non-intact skin, mucous membranes, or contaminated items is anticipated.

    • Eye Protection: Protective eyewear should be worn if there's a risk of splash contamination when dealing with body fluids or during wound irrigation.

    Hand Hygiene

    • Frequency: Hand hygiene is performed before and after client interaction.

    • Importance: Essential to prevent the spread of germs.

    • Specific Situations: Different techniques may be necessary for different pathogens. For Clostridium difficile, soap and water are essential to eliminate spores.

    Healthcare-Associated Infections (HAIs)

    • Types: Include catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAPs), and central line-associated bloodstream infections (CLABSIs).

    • Concerns: HAIs are costly. They pose serious risk of morbidity and mortality, and generate a negative perception of the healthcare system.

    Signs of Infection and Inflammation

    • Generalized Infection Signs: Fever, chills, increased pulse and respiratory rate, malaise, fatigue, anorexia, nausea/vomiting, abdominal cramping/diarrhea, and enlarged lymph nodes.

    • Inflammation Signs (Local): Redness, warmth, edema, pain/tenderness, and loss of function in the affected area.

    • Inflammation Signs (Exudate): Clear (serous), bloody (sanguineous), or pus-filled (purulent) discharge.

    • Inflammation Signs (Late Stages): Tissue repair with formation of scar tissue.

    Breaking the Chain of Infection

    • Methods: Proper handwashing, disinfection/sterilization, and isolation of infected patients are vital.

    Safety

    Fall Risk Assessment and Interventions

    • Assessment: Multidisciplinary approach with strong administrative support to review past falls, investigate causes, and develop policies.

    • Interventions: Non-skid footwear, low bed positions, locked bed wheels/wheelchair brakes, adequate lighting, call lights within reach, client education, signage.

    Restraints

    • Rationale: Restraints are used with extreme caution and when necessary to minimize risk of injury.

    • Application: Applied correctly, with minimal tightness to prevent circulation problems.

    • Nursing Care: Regular assessment, repositioning, care to prevent skin breakdown, frequent monitoring of vital signs.

    • Complications: Potential for complications including pressure injuries, circulation impairments and emotional distress.

    Fire Safety

    • Actions: Remove persons from danger, activate alarm, close doors/windows, address small fires.

    Client Safety Goals

    • Identification: Use of two client identifiers.

    • Communication: Clear communication; use ISBARR method and communicate critical results.

    • Medication Safety: Label medications correctly; be aware of high-alert medications like anticoagulants; perform medication reconciliation.

    Seizure Precautions

    • Interventions: Call rapid response team (RRT), place in side-lying position (avoid aspiration), protect head, remove harmful objects, loosen tight clothing around the neck, continuous monitoring, document seizure characteristics, and monitor ABCs (airway, breathing, circulation).

    Home Oxygen Use Education

    • Precautions: No smoking around oxygen; keep open flames and electrical appliances away; never use while cooking; turn off if a fire; install/test smoke detectors.

    Body Mechanics

    • Positioning: Stay close to the object; contract abdominal/back muscles, keep head/shoulders aligned, slightly bend your knees, and pivot/step instead of twisting.

    Vital Signs

    Blood Pressure

    • Technique: Use a cuff appropriate size to client arm; place cuff 1 inch above elbow crease, with arrow aligned with brachial artery; client can be seated or lying, arm supported at heart level, palm up, or thigh if needed; inflate 30 mmHg above expected systolic, release slowly 2 mmHg /sec; record first and fifth Korotkoff sounds. Use a two-step process when possible.

    • Normal Range: 120/80 mmHg

    • Hypertension Stages: Stage 1 (130-139/80-89), Stage 2 (>140/>90), Crisis (>180/>120).

    • Risk Factors: Excessive sodium, obesity, alcohol consumption, stress, family history.

    • Interventions: Exercise, stress reduction, low-sodium diet, and weight loss (if needed).

    • Hypotension Intervention: Change positions slowly, increase fluids, avoid temperature extremes, elevation (unless contraindicated).

    • Orthostatic Hypotension: Measure blood pressure changing position (lying to sitting, sitting to standing). Diagnosed by drop of at least 20 mmHg systolic, or 10 mmHg diastolic.

    Apical Pulse

    • When Taken: When illness, weakness or rapid radial pulse are suspected.

    • Duration: 1 minute

    • Where: At apex of the heart (5th intercostal space, left mid-clavicular line).

    Respirations

    • Counting: One breath in and one breath out equals one respiration count.

    • Patterns: Eupnea (normal), apnea (cessation), Cheyne-Stokes (cyclical shallow/deep with apnea), Kussmaul (deep, rapid, regular).

    • Causes of Patterns: Eupnea occurs when relaxed; Apnea in opioid overdose & heart failure; Cheyne-Stokes in stroke, brain tumor, and heart failure; Kussmaul in DKA and renal disease.

    Peripheral Pulses

    • Locations: Temporal, carotid, brachial, femoral, popliteal, dorsalis pedis, posterior tibial.

    • Documentation: 0 absent, +1 weak, +2 normal, +3 strong, +4 bounding.

    Oxygen Saturation

    • Obtaining: Place sensor on intact digit, earlobe, or bridge of nose; document stable readings.

    • Normal: 95-100%.

    • Low Interventions: Auscultate lungs, increase oxygen flow, monitor for respiratory arrest, possible intubation.

    Temperature

    • Sites: Oral, temporal, rectal, axillary, tympanic.

    • Benefits/Limitations: Assess benefits and drawbacks of temperature from chosen sites.

    Mobility

    Range of Motion (ROM)

    • Active vs. Passive: Active ROM performed by the client; Passive ROM supported by staff

    Bed Positions

    • Positions Used For: Supine, prone, semi-Fowler's, Fowler's, Trendelenburg, semi-prone positions with their intended use.

    Mobility Aids

    • Crutches Fit: Crutches should be placed 1-2 inches below the axilla, at a 15-30 degree angle, with body weight supported by hands, not axilla.

    • Stockings (Anti-embolism): Applied in the morning before leg distention, or 15-30 minutes after elevation.

    • Ambulation Assistance: Support the back and hold the gait belt.

    • Moving Clients in Bed: Place sling from shoulders to mid-thigh, raise the side rail, move to the other side of the bed, then lower the side rail and roll the client.

    • Transferring: Methods based on patient's weight bearing: lift, sit-to-stand, gait belt/ambulation, or no assistance.

    • Immobility Complications: A summary of complications by system, categorized by complication with interventions.

    Movement Pairs

    • Types: Flexion/extension, abduction/adduction, pronation/supination, circumduction, rotation, inversion/eversion, dorsiflexion/plantar flexion.

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    Description

    This quiz explores the critical aspects of infection control and isolation practices in healthcare settings. It covers the specific types of isolation precautions, including contact and droplet precautions, and the necessary procedures for room assignments and protective equipment. Perfect for healthcare professionals and students in infection prevention.

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