Infection Fundamentals Final Review

Questions and Answers

What are the types of pathogens that can cause infection?

Bacteria

Viruses

Fungi

All of the above (correct)

Common cold viruses respond to antibiotics.

False

What is the first line of defense against infection?

Skin and mucous membranes

The _ ______ from a reservoir refers to how an organism escapes it.

portal of exit Signup and view all the answers

Match the following stages of infection with their descriptions:

Incubation period = Organisms growing and multiplying Prodromal stage = Most contagious with few symptoms Full stage of illness = Harsh symptoms at peak Convalescence period = Recovery stage Signup and view all the answers

Which type of immunity is acquired through breastfeeding?

Passive Immunity Signup and view all the answers

Surgical asepsis involves a clean technique with low numbers of pathogens.

False Signup and view all the answers

What does RACE stand for in case of a fire?

Rescue, Alarm, Contain, Evacuate Signup and view all the answers

How often should oral care be done for intubated patients?

Every 4 hours Signup and view all the answers

What is the highest Braden Scale score indicating?

Low risk for injury Signup and view all the answers

Chemical restraints include sedative medications.

True Signup and view all the answers

How often should an incentive spirometer be used?

5-10 times an hour every 1-2 hours Signup and view all the answers

The _ Phase of wound healing involves the body generating new tissue.

Proliferative Signup and view all the answers

Coughing can help clear secretions even if it is a non-productive cough.

True Signup and view all the answers

What type of injury does shear refer to?

One layer of tissue sliding over another Signup and view all the answers

What is the oxygen concentration of room air?

21% Signup and view all the answers

Match the types of wounds with their descriptions:

Intentional = Planned like surgery Unintentional = Accidentally created Open Wound = Skin is broken Closed Wound = Skin is not broken Signup and view all the answers

Which mask provides the highest concentration of oxygen?

Non-rebreather mask Signup and view all the answers

What is the purpose of a tracheostomy?

To provide long-term airflow in patients who cannot breathe spontaneously Signup and view all the answers

Pulse oximetry measures oxygen saturation in the bloodstream.

True Signup and view all the answers

What is the primary trigger for the respiratory center?

High carbon dioxide levels Signup and view all the answers

Match the following types of anesthesia with their definitions:

General Anesthesia = Loss of consciousness and reflexes, requires intubation Moderate Sedation = Patient maintains their airway and is conscious Local Anesthesia = Used on mucous membranes and skin Regional Anesthesia = Injected near a nerve to inhibit sensation Signup and view all the answers

What should be checked before administering oxygen?

Smoking habits, electrical equipment, distilled water for humidifier, full oxygen tank Signup and view all the answers

What are the two stages of sleep?

NREM and REM Signup and view all the answers

What can occur due to lack of sleep?

Obesity Signup and view all the answers

What are the six main types of nutrients?

Carbohydrates, proteins, fats, vitamins, minerals, and water Signup and view all the answers

What is the BMI formula?

kg/m^2 or lbs/inches^2 x 703 Signup and view all the answers

What is considered a normal BMI range?

18 to 24.5 Signup and view all the answers

Which of the following are types of carbohydrates?

Complex carbs Signup and view all the answers

What is the energy provided by one gram of protein?

4 kcal Signup and view all the answers

Match the following vitamins with their functions:

Vitamin A = Helps with vision Vitamin B = Helps with cell maintenance and energy Vitamin C = Absorption of calcium Vitamin E = Acts as an antioxidant Vitamin K = Helps with clotting Signup and view all the answers

Anorexia nervosa is characterized by an overwhelming fear of gaining weight.

True Signup and view all the answers

What is considered high risk waist circumference for cardiovascular problems in males?

Above 40 inches Signup and view all the answers

Albumin is a good indicator for ______.

malnutrition Signup and view all the answers

What does NPO stand for in medical terms?

Nothing by Mouth Signup and view all the answers

What is the normal pH level of urine?

5-6 Signup and view all the answers

What is anuria?

Less than 50 mls of urine in 24 hours or no urine output. Signup and view all the answers

Men are at a higher risk for UTIs than women.

False Signup and view all the answers

Which of the following is a sign of acute kidney injury?

Oliguria Signup and view all the answers

TPN stands for ______.

Total Parenteral Nutrition Signup and view all the answers

Which dietary restriction is part of a cardiac diet?

Low sodium Signup and view all the answers

What is a common cause of decreased sense of touch?

Diabetes Signup and view all the answers

Sensory deprivation can lead to confusion and anxiety.

True Signup and view all the answers

What should you do when speaking to an unconscious patient?

Speak to the patient in a normal voice and use a sense of touch often. Signup and view all the answers

Which of the following is true about chyme?

It is partially digested food. Signup and view all the answers

Match the digestive system organs with their functions:

Small intestine = Digestion of food and absorption of nutrients Large intestine = Absorption of water and formation of feces Rectum = Expulsion of feces Stomach = Digestion of food with acids and enzymes Signup and view all the answers

The sympathetic nervous system stimulates movement in the digestive system.

False Signup and view all the answers

What can indicate cystic fibrosis during a stool examination?

Steatorrhea Signup and view all the answers

Breastfed infants typically have 1-10 stools a day that are yellow and liquid.

True Signup and view all the answers

People with _______ can suffer from chronic constipation due to laxative use.

weak intestines Signup and view all the answers

What color are stools associated with upper gastrointestinal bleeding?

Black Signup and view all the answers

What is used to assess perianal area and changes in bowel patterns?

COCA assessment. Signup and view all the answers

A patient in a state of hypovolemia has increased lab values.

True Signup and view all the answers

What is a common manifestation of hypernatremia?

Thirst Signup and view all the answers

What is the medical criteria for determining death?

No activity in ECG, no reflexes, no breathing, and no response to pain stimuli. Signup and view all the answers

What is the primary focus of palliative care?

Providing comfort and emotional support Signup and view all the answers

The _______ model of grief includes stages such as denial and acceptance.

Kubler-Ross Signup and view all the answers

What should be provided for a patient with hypokalemia?

Foods high in potassium. Signup and view all the answers

Study Notes

Infection Overview

Pathogens include bacteria (gram-positive/negative), viruses, and fungi.
Common viruses: Common Cold, Hepatitis (A, B, C), HIV; do not respond to antibiotics.
Fungi present in air, soil, water (e.g., mold, yeast).

Infection Cycle

Stages:
- Infectious agent: Bacteria, virus, fungi.
- Reservoir: Organism's habitation.
- Portal of exit: Pathway out of the reservoir.
- Means of transmission: How the organism travels (e.g., surfaces).
- Portal of entry: How the organism enters a new host.
- Susceptible host: Individuals prone to infection.

Stages of Infection

Incubation: Pathogens multiply.
Prodromal: Highly contagious, few vague symptoms.
Full stage of illness: Pronounced, specific symptoms.
Convalescence: Recovery phase.

First Line of Defense

Skin, mucous membranes, and normal flora serve as initial protective barriers.

Inflammatory Response

Vascular phase: Initial vasoconstriction followed by vasodilation causing redness, heat, and increased WBC permeability.
Cellular phase: WBC migration to inflammation site; exudate varies in type (serous, sanguineous, purulent).

Immunity Types

Active immunity: Developed through immunizations.
Natural immunity: Inherent defenses (skin, WBC, flora).
Passive immunity: Acquired from another source (e.g., breastfeeding).

Asepsis Types

Medical asepsis: Clean technique minimizes pathogens.
Surgical asepsis: 100% sterile, free of microorganisms.

Sterile Field Guidelines

Sterile solutions valid for 24 hours post-opening.
Maintain a 1-inch border around sterile areas.
Contamination protocols include not reaching over or turning back to sterile fields.

Donning and Doffing PPE

Do (putting on): Gown, Mask, Face shield, Gloves.
Doff (removing): Gloves, Face shield, Gown, Mask.

Precautions

Standard precautions: Applied to all patients; involves hand hygiene and protective gear.
Airborne: Requires negative pressure rooms, N95 masks, and isolation for diseases (e.g., TB).
Droplet: Maintain distance; surgical masks for patients moving.
Contact: For MRSA, VRE; requires gloves, gowns, private rooms.
Reverse isolation: Protects immunocompromised patients from infections.

Safety Considerations

High risk of suffocation for infants; assess all patient safety practices.
Risks associated with impaired sensory perception (e.g., hearing, sight).
Falls are leading cause of fatalities in the elderly; use Morse fall scale for risk assessment.
Emergency guidelines: RACE (Rescue, Alarm, Contain, Evacuate) and PASS (fire extinguisher use).

Use of Restraints

Chemical restraints: Meds to sedate.
Document necessity; used only for patient safety.
Maximum restraint duration: 4 hours for adults, 2 for children, and 1 for under 9 years.

Incident Reporting

Report incidents immediately with factual recounts, excluding in patient chart.

Terrorism Types

Bioterrorism: Intentional infection spread.
Chemical terrorism: Harm through chemical release; requires decontamination.
Nuclear terrorism: Use of radioactive materials.
Triage Classes:
- Class 1: Life-threatening, high survival chance.
- Class 2: Requires immediate care.
- Class 3: Minor injuries, can wait.

Medication Administration

Absorption rates vary with route: oral (slow), IM (faster), IV (fastest).
Adverse reactions are unpredictable and potentially life-threatening.
Trough levels indicate elimination efficiency; peak levels indicate effectiveness time.
Special instructions for enteral routes and tube feedings for accurate medication administration.

Hygiene Factors

Skin integrity as first defense against infection.
Developmental level impacts hygiene needs.
Perform oral care for comatose patients; recognize glossitis in vitamin deficiencies.

Skin Integrity and Wounds

Types of wounds: intentional (surgical) vs. unintentional (trauma).
Understand healing phases: hemostasis, inflammatory, proliferative, maturation.
Pressure ulcers classified by stages (1-4) based on tissue damage.

Wound Care

RYB classification assists in treatment (Red: protect, Yellow: cleanse, Black: debride).
Braden Scale assesses pressure ulcer risk; lower scores indicate higher risk.

Heat and Cold Therapy

Heat increases blood flow; caution with application duration.
Cold reduces inflammation, contraindicated for open wounds and impaired circulation.

Oxygenation Overview

Respiratory center in medulla responds to high CO2; gas exchange in alveoli.
Monitoring oxygen saturation via pulse oximetry is crucial.
Varying delivery methods for oxygen (nasal cannula, masks) exist, each providing different concentration levels.

Perioperative Care

Surgical processes divided into preoperative, intraoperative, and postoperative phases.
Types of surgery classified by urgency and purpose (diagnostic, ablative, palliative, etc.).
General anesthesia requires intubation and loss of consciousness.### Anesthesia Types and Consent
CNS depression leads to analgesia, where the brain does not respond to pain stimuli.
Moderate sedation allows conscious awareness during short procedures without intubation.
Regional anesthesia involves injections near a nerve to block sensory input to the CNS.
Topical or local anesthesia, like lidocaine, is applied directly to skin or mucous membranes.
Informed consent is required for any invasive procedure and must involve discussion of risks, alternatives, and the option to refuse.
The healthcare provider must ensure the patient fully understands consent, while the nurse acts as an advocate and witness.
Minors may not sign consent unless emancipated; they need to provide legal documentation.
Advance directives specify end-of-life wishes, including intubation preferences.

Post-Surgery Guidelines

Preoperative assessments include medical history, allergies, medications, and vital diagnostic tests.
Patients should be educated on surgery duration, aftercare equipment, and pain management before discharge.
Postoperative care requires monitoring vital signs and hydration, assessing pain, and inspecting the surgical site for complications.
Warning signs include dyspnea, bleeding, changes in mental status, and signs of infection.

Mobility and Exercise

Abduction: moving away from the body; adduction: moving towards the body.
Types of exercise: isotonic (everyday activities), isometric (muscle contraction without movement), isokinetic (resistance training).
Immobility can cause pneumonia, DVT, skin breakdown, and orthostatic hypotension; reposition every 2 hours.
Assessing signs of immobility includes monitoring for pressure ulcers and hydration status.

Pain Management Concepts

Transduction converts painful stimuli to electrical impulses; transmission carries them to the brain.
Pain can be classified as acute (short-term), chronic (lasts over six months), neuropathic, or psychogenic.
Factors affecting pain include emotional state, cultural background, and previous experiences.
Pain assessment includes location, quality, severity (1-10 scale), and timing; use appropriate scales based on patient age and communication ability.
Non-pharmacological pain relief strategies include relaxation techniques, distraction, and music therapy.

Nutrition Essentials

Nutrients are categorized into macronutrients (carbs, proteins, fats) and micronutrients (vitamins, minerals).
Body Mass Index (BMI) evaluates weight in relation to height, with normal range 18-24.9.
Carbohydrates provide 4 kcal/g; should make up 45-65% of the diet; complex carbs are preferred over simple sugars.
Key vitamins:
- Vitamin A for vision
- Vitamin C for calcium absorption
- Vitamin K for clotting
Assess for signs of malnutrition, including skin health and hair condition.

Dietary Considerations

Various diets include:
- Cardiac: low salt
- Diabetic: 1800 calories with low carbs
- Low residue: low fiber
- Enteral nutrition is administered through feeding tubes if oral intake isn't possible.
Proper patient positioning is crucial during enteral feeding to prevent aspiration.
Parenteral nutrition is used when the GI system fails; TPN is delivered via central lines, while PPN can be administered peripherally for short durations.

Sleep and Rest

Sleep consists of NREM (75% of sleep) and REM stages (25%).
Deep sleep during REM is crucial for cognitive function and emotional stability.
Circadian rhythms dictate sleep patterns, affected by age, diet, and activity level.
Insomnia and hypersomnia disrupt normal sleep patterns, impacting overall health.
Nursing interventions promote restful environments and healthy sleep habits.

Other Key Medical Information

Hypokalemia indicates alkalosis; hyperkalemia indicates acidosis.
IV tubing should be changed every 72-96 hours; body compensates for metabolic acidosis by increasing ventilation.
Stomas should appear shiny and moist; normal gastric residual volume is 200-250 mL.
Conditions such as renal stasis can lead to complications like UTIs; assess bowel and wound health diligently.### TPN and Parenteral Nutrition
Monitor glucose every 6 hours to prevent hyperglycemia from TPN. Hypoglycemia is possible if TPN is not available.
Change TPN and PPN solutions and tubing every 24 hours to maintain sterility.
Risk of pneumothorax exists with central lines due to close proximity to the lungs.
Medications should not be given with TPN, except for pre-combined insulin or heparin.

Kidney Function and Urination

Nephrons filter kidney contents; normal urine output is 1-2L daily.
The adult bladder typically holds 200-250 mL; signals to urinate begin around 150 mL.
Anuria: less than 50 mL in 24 hours. Oliguria: less than 400 mL.
Dysuria: painful urination, whereas nocturia refers to frequent night urination.
Assess for hematuria (blood in urine), proteinuria (protein in urine), and polyuria (excessive urination).

Urinary Disorders and Symptoms

Urgency describes the strong feeling to urinate, while frequency refers to how often urination occurs.
Retention indicates inability to urinate, and incontinence means inability to hold urine.
Enuresis is involuntary bedwetting typically controlled by age 3-5 years.
Dehydration leads to concentrated urine; fluid overload results in increased urine output.

Urinary Diversion and Specimen Collection

Understand care for urinary diversions; ostomy specimens require sterile technique.
A 24-hour urine collection should begin after the first void and requires preservation on ice.
Diagnostic tests such as cystoscopy and intravenous pyelograms require informed consent and potential allergy assessments.

Urinary Tract Infections (UTIs)

Women, especially postmenopausal, and elderly are at higher risk for UTIs. Clients with diabetes are also susceptible due to higher sugar concentrations.
Prevention strategies include proper hygiene, increased fluid intake, and wearing breathable clothing.
Cystitis is bladder inflammation; untreated UTIs can lead to kidney involvement, indicated by flank pain.

Catheter Types and Care

Condom catheters provide non-invasive drainage; indwelling catheters are for long-term use but increase CAUTI risk.
Suprapubic catheters are for patients who can’t urinate through the urethra.
Foley catheter care requires maintaining strict indications for use and ensuring the drainage system is secure to avoid infections.

Dialysis and Renal Failure

Hemodialysis and peritoneal dialysis are treatments for renal failure; patients typically face fluid restrictions.
In patients with fistulas from dialysis, do not take blood pressure on the affected arm.

Sensory Function Assessment

Regular assessments of vision and hearing are critical. Common issues include glaucoma, cataracts, and hearing loss due to ototoxic medications.
For patients with decreased tactile sensation, assess for wounds and educate on skin care.

Gastrointestinal Function and Bowel Elimination

The small intestine absorbs nutrients; the large intestine absorbs water and forms feces.
Typical infant stool frequency varies based on diet; adults should aim for adequate fiber and hydration.
Conditions like IBS or diverticulitis can alter bowel habits; watch for signs of GI bleeding.

Stool Collection and Testing

Stool collection requires avoiding contamination; the guaiac test detects occult blood.
Various endoscopic procedures assess bowel health; dietary restrictions apply before tests.

Fluid and Electrolyte Balance

Distinguish between intracellular (ICF) and extracellular fluid (ECF) distribution in the body.
Dehydration leads to increased laboratory markers, while overhydration can cause complications like heart failure.
Monitor vital signs, output, and weight to assess fluid status and respond appropriately to abnormalities.

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Prepare for your finals with our comprehensive quiz on infection fundamentals. Review key concepts related to pathogens, the infection cycle, and differences between bacteria, viruses, and fungi. This quiz will help solidify your understanding and readiness for exam questions.