Podcast
Questions and Answers
Which of the following best describes the role of normal flora in the human body?
Which of the following best describes the role of normal flora in the human body?
- Always pathogenic and requires immediate antibiotic treatment.
- Only present in immunocompromised individuals causing opportunistic infections.
- Harmless unless displaced; assists with vitamin K production. (correct)
- Actively attacks the body's own cells leading to autoimmune disorders.
During which step of the infection process is hand hygiene most effective?
During which step of the infection process is hand hygiene most effective?
- Portal of entry
- Susceptible Host
- Mode of Transmission (correct)
- Infectious agent.
A client with active tuberculosis is admitted to the hospital. What infection control measures are most appropriate?
A client with active tuberculosis is admitted to the hospital. What infection control measures are most appropriate?
- Standard Precautions
- Contact Precautions
- Droplet Precautions
- Airborne Precautions (correct)
A nurse is preparing to administer vancomycin to a client. Which laboratory value should the nurse review prior to administration?
A nurse is preparing to administer vancomycin to a client. Which laboratory value should the nurse review prior to administration?
Which of the following signs and symptoms in an older adult client could indicate the presence of an infection?
Which of the following signs and symptoms in an older adult client could indicate the presence of an infection?
What is the priority nursing intervention when caring for a client diagnosed with Clostridium difficile (C. diff)?
What is the priority nursing intervention when caring for a client diagnosed with Clostridium difficile (C. diff)?
Which statement made by a client indicates a need for further teaching regarding antibiotic use?
Which statement made by a client indicates a need for further teaching regarding antibiotic use?
A nurse is caring for a client with a surgical wound infection. Which laboratory result is most indicative of an infection?
A nurse is caring for a client with a surgical wound infection. Which laboratory result is most indicative of an infection?
Which intervention is most important for preventing healthcare-associated infections (HAIs)?
Which intervention is most important for preventing healthcare-associated infections (HAIs)?
A nurse is reviewing the medication list for a client who has been prescribed tetracycline. Which substance should the nurse instruct the client to avoid consuming simultaneously?
A nurse is reviewing the medication list for a client who has been prescribed tetracycline. Which substance should the nurse instruct the client to avoid consuming simultaneously?
What is the primary difference between medical and surgical asepsis?
What is the primary difference between medical and surgical asepsis?
Which of the following is considered a vehicle-borne mode of transmission?
Which of the following is considered a vehicle-borne mode of transmission?
A nurse is caring for a client with Vancomycin-resistant Enterococci (VRE). Which precaution is most important?
A nurse is caring for a client with Vancomycin-resistant Enterococci (VRE). Which precaution is most important?
Which of the following is a potential portal of entry for pathogens?
Which of the following is a potential portal of entry for pathogens?
What is the rationale for obtaining a culture and sensitivity test before initiating antibiotic therapy?
What is the rationale for obtaining a culture and sensitivity test before initiating antibiotic therapy?
A client is diagnosed with infectious mononucleosis. What is the most important instruction regarding transmission prevention?
A client is diagnosed with infectious mononucleosis. What is the most important instruction regarding transmission prevention?
Which of the following is a key difference between an epidemic and a pandemic?
Which of the following is a key difference between an epidemic and a pandemic?
The nurse is caring for a client receiving Amphotericin B. What electrolyte imbalance should the nurse monitor for?
The nurse is caring for a client receiving Amphotericin B. What electrolyte imbalance should the nurse monitor for?
A nurse is teaching a client about Zika virus prevention. Which statement indicates effective teaching?
A nurse is teaching a client about Zika virus prevention. Which statement indicates effective teaching?
A client with severe sepsis has a blood pressure of 70/40 mmHg and a heart rate of 120 bpm. Which intervention should the nurse implement first?
A client with severe sepsis has a blood pressure of 70/40 mmHg and a heart rate of 120 bpm. Which intervention should the nurse implement first?
In which scenario would the use of an alcohol-based hand rub be inappropriate?
In which scenario would the use of an alcohol-based hand rub be inappropriate?
The nurse is caring for a client receiving linezolid. Which food should the nurse instruct the client to avoid?
The nurse is caring for a client receiving linezolid. Which food should the nurse instruct the client to avoid?
Which of the following signs would indicate the presence of a localized infection?
Which of the following signs would indicate the presence of a localized infection?
A client is diagnosed with a helminth infection. What should the nurse include in the patient teaching?
A client is diagnosed with a helminth infection. What should the nurse include in the patient teaching?
A client has been prescribed Ciprofloxacin. Which instruction should the nurse give?
A client has been prescribed Ciprofloxacin. Which instruction should the nurse give?
Which is least likely to increase a client's risk of infection?
Which is least likely to increase a client's risk of infection?
A client is diagnosed with COVID-19. What type of transmission-based precautions will be implemented?
A client is diagnosed with COVID-19. What type of transmission-based precautions will be implemented?
Which assessment finding would least likely be associated with a respiratory infection?
Which assessment finding would least likely be associated with a respiratory infection?
A client with a central venous catheter (CVC) develops a bloodstream infection. Which intervention is most important for the nurse to implement?
A client with a central venous catheter (CVC) develops a bloodstream infection. Which intervention is most important for the nurse to implement?
A nurse is caring for a client with neutropenia. Which action should be taken?
A nurse is caring for a client with neutropenia. Which action should be taken?
Which of the following clients is at highest risk for developing a healthcare-associated infection (HAI)?
Which of the following clients is at highest risk for developing a healthcare-associated infection (HAI)?
A nurse is developing a community outreach program on preventing the spread of infectious diseases. What should be included in the program?
A nurse is developing a community outreach program on preventing the spread of infectious diseases. What should be included in the program?
Which of the following is NOT a sign or symptom of sepsis?
Which of the following is NOT a sign or symptom of sepsis?
Following the administration of Penicillin, your patient reports shortness of breath, anxiety and an audible wheeze immediately following administration. What intervention is priority?
Following the administration of Penicillin, your patient reports shortness of breath, anxiety and an audible wheeze immediately following administration. What intervention is priority?
Which of these statements regarding antibiotic use and resistance is correct?
Which of these statements regarding antibiotic use and resistance is correct?
A researcher discovers a novel mechanism by which Staphylococcus aureus evades detection by the host immune system, leading to persistent infections. This mechanism involves the bacteria's ability to:
A researcher discovers a novel mechanism by which Staphylococcus aureus evades detection by the host immune system, leading to persistent infections. This mechanism involves the bacteria's ability to:
What rare, but potentially fatal, complication is associated with the use of clindamycin?
What rare, but potentially fatal, complication is associated with the use of clindamycin?
A previously healthy 25-year old male is diagnosed with infectious mononucleosis (IM). Besides rest, what other direction should the healthcare provider give to the patient?
A previously healthy 25-year old male is diagnosed with infectious mononucleosis (IM). Besides rest, what other direction should the healthcare provider give to the patient?
A client is diagnosed with a viral infection. Which intervention is most appropriate for the nurse to implement?
A client is diagnosed with a viral infection. Which intervention is most appropriate for the nurse to implement?
In which of the following scenarios is it most appropriate to use soap and water, rather than an alcohol-based hand sanitizer, for hand hygiene?
In which of the following scenarios is it most appropriate to use soap and water, rather than an alcohol-based hand sanitizer, for hand hygiene?
A client is prescribed azithromycin for a respiratory infection. Which instruction regarding the administration of this medication is most important for the nurse to provide?
A client is prescribed azithromycin for a respiratory infection. Which instruction regarding the administration of this medication is most important for the nurse to provide?
Which approach represents the most nuanced and least intrusive method for identifying the causative agent in a suspected bloodstream infection in a client with an indwelling central venous catheter?
Which approach represents the most nuanced and least intrusive method for identifying the causative agent in a suspected bloodstream infection in a client with an indwelling central venous catheter?
Following a needlestick injury from a client with confirmed Hepatitis B, what action provides the most comprehensive and immediate protection for a healthcare worker who has not been previously vaccinated or has an unknown vaccination status?
Following a needlestick injury from a client with confirmed Hepatitis B, what action provides the most comprehensive and immediate protection for a healthcare worker who has not been previously vaccinated or has an unknown vaccination status?
Which of the following interventions is most effective at breaking the chain of infection?
Which of the following interventions is most effective at breaking the chain of infection?
A client is diagnosed with a fungal infection. Which medication is most appropriate?
A client is diagnosed with a fungal infection. Which medication is most appropriate?
What is the primary goal of standard precautions in healthcare settings?
What is the primary goal of standard precautions in healthcare settings?
Which of the following diseases requires airborne precautions?
Which of the following diseases requires airborne precautions?
A client is prescribed tetracycline. The nurse should provide which instruction to the client?
A client is prescribed tetracycline. The nurse should provide which instruction to the client?
Which of the following clients is at the highest risk of developing an infection?
Which of the following clients is at the highest risk of developing an infection?
Which laboratory finding is most indicative of a helminth infection?
Which laboratory finding is most indicative of a helminth infection?
Which of the following interventions is most appropriate for a client diagnosed with influenza?
Which of the following interventions is most appropriate for a client diagnosed with influenza?
A client is taking linezolid. Which of the following should the client avoid?
A client is taking linezolid. Which of the following should the client avoid?
A client is prescribed azithromycin for a respiratory infection. Which is most important when teaching the client?
A client is prescribed azithromycin for a respiratory infection. Which is most important when teaching the client?
After starting antibiotic therapy, a client develops watery stool, fever, and abdominal pain with 20 plus stools per day. What infection is the most likely cause?
After starting antibiotic therapy, a client develops watery stool, fever, and abdominal pain with 20 plus stools per day. What infection is the most likely cause?
The nurse is caring for a client with a localized infection on their lower leg. Which of the following findings would be expected?
The nurse is caring for a client with a localized infection on their lower leg. Which of the following findings would be expected?
Which of the following actions is of least importance when providing nursing care to a client being treated for an active infection?
Which of the following actions is of least importance when providing nursing care to a client being treated for an active infection?
A nurse is caring for a client with an infection who has a history of end-stage renal disease. Which assessment is most critical for the nurse to monitor?
A nurse is caring for a client with an infection who has a history of end-stage renal disease. Which assessment is most critical for the nurse to monitor?
In which instance would a Gram stain be performed?
In which instance would a Gram stain be performed?
The nurse is teaching a client about measures to prevent healthcare-associated infections (HAIs). Which statement indicates effective teaching?
The nurse is teaching a client about measures to prevent healthcare-associated infections (HAIs). Which statement indicates effective teaching?
Which of the following is an example of a vehicle-borne transmission?
Which of the following is an example of a vehicle-borne transmission?
Which best describes the difference between an epidemic and a pandemic?
Which best describes the difference between an epidemic and a pandemic?
The most appropriate time to collect a specimen for culture and sensitivity is:
The most appropriate time to collect a specimen for culture and sensitivity is:
In which of the following situations is the use of an alcohol-based hand sanitizer least appropriate?
In which of the following situations is the use of an alcohol-based hand sanitizer least appropriate?
Which of the following is a common risk factor for healthcare-associated infections (HAIs)?
Which of the following is a common risk factor for healthcare-associated infections (HAIs)?
What is the primary reason for monitoring medication peak and trough levels when administering certain antibiotics?
What is the primary reason for monitoring medication peak and trough levels when administering certain antibiotics?
A client diagnosed with tuberculosis (TB) is being admitted to the hospital. Which infection control measures must the nurse implement?
A client diagnosed with tuberculosis (TB) is being admitted to the hospital. Which infection control measures must the nurse implement?
A client presents with signs and symptoms suggestive of sepsis. Which of the following assessment findings would indicate sepsis?
A client presents with signs and symptoms suggestive of sepsis. Which of the following assessment findings would indicate sepsis?
Which of the following is the most effective way to prevent the spread of Ebola virus?
Which of the following is the most effective way to prevent the spread of Ebola virus?
The nurse admits a client diagnosed with infectious mononucleosis. Which clinical manifestation would the nurse expect?
The nurse admits a client diagnosed with infectious mononucleosis. Which clinical manifestation would the nurse expect?
The nurse is providing education to a client taking trimethoprim sulfamethoxazole (Bactrim). Which instruction is most important for the nurse to include?
The nurse is providing education to a client taking trimethoprim sulfamethoxazole (Bactrim). Which instruction is most important for the nurse to include?
A nurse is caring for a client with neutropenia. Which intervention is most important for the nurse to implement?
A nurse is caring for a client with neutropenia. Which intervention is most important for the nurse to implement?
Which of the following signs and symptoms would be expected in a client with a systemic infection?
Which of the following signs and symptoms would be expected in a client with a systemic infection?
A client is prescribed Ciprofloxacin. Which instruction is most important to include?
A client is prescribed Ciprofloxacin. Which instruction is most important to include?
If a patient is prescribed PO Vancomycin, the route of elimination is through the:
If a patient is prescribed PO Vancomycin, the route of elimination is through the:
What is the best response by the nurse when a client states, "I feel fine now, so I can stop taking my antibiotic, right?"
What is the best response by the nurse when a client states, "I feel fine now, so I can stop taking my antibiotic, right?"
A nurse is assessing a client with a wound infection. Which laboratory parameter most accurately indicates the presence of infection?
A nurse is assessing a client with a wound infection. Which laboratory parameter most accurately indicates the presence of infection?
Which of the following is categorized as a helminth?
Which of the following is categorized as a helminth?
Which of the following situations poses the highest risk for transmitting infection?
Which of the following situations poses the highest risk for transmitting infection?
A client with MRSA asks the healthcare provider how they contracted the infection. Which answer is best?
A client with MRSA asks the healthcare provider how they contracted the infection. Which answer is best?
A client receiving amphotericin B should be monitored for which electrolyte imbalance?
A client receiving amphotericin B should be monitored for which electrolyte imbalance?
A researcher is investigating new strategies to combat antibiotic resistance. Which approach shows the most promise in preventing the spread of resistance genes among bacteria?
A researcher is investigating new strategies to combat antibiotic resistance. Which approach shows the most promise in preventing the spread of resistance genes among bacteria?
What step ensures that infection control measures for novel and emerging pathogens are as effective as possible?
What step ensures that infection control measures for novel and emerging pathogens are as effective as possible?
During which phase of the infection process does an organism leave the reservoir?
During which phase of the infection process does an organism leave the reservoir?
Which of the following interventions is MOST crucial in preventing the transmission of Clostridioides difficile (C. diff)?
Which of the following interventions is MOST crucial in preventing the transmission of Clostridioides difficile (C. diff)?
A client with a known allergy to penicillin is prescribed ampicillin. Which nursing action is MOST important?
A client with a known allergy to penicillin is prescribed ampicillin. Which nursing action is MOST important?
Which of the following factors poses the LEAST risk for the development of a healthcare-associated infection (HAI)?
Which of the following factors poses the LEAST risk for the development of a healthcare-associated infection (HAI)?
Consider a scenario where an elderly client, residing in a long-term care facility, exhibits subtle behavioral changes such as increased confusion and withdrawal, but no fever. Given the client's age and atypical presentation, which of the following actions should the nurse prioritize to assess for a potential infection?
Consider a scenario where an elderly client, residing in a long-term care facility, exhibits subtle behavioral changes such as increased confusion and withdrawal, but no fever. Given the client's age and atypical presentation, which of the following actions should the nurse prioritize to assess for a potential infection?
Flashcards
What is a pathogen?
What is a pathogen?
An organism that can cause disease in a host.
What is colonization?
What is colonization?
Pathogenic microbes present without causing symptoms or immune response.
What is an active infection?
What is an active infection?
When a microbe multiplies and causes an immune response.
What is a subclinical infection?
What is a subclinical infection?
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What are the six links in the chain of infection?
What are the six links in the chain of infection?
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What are infectious agents?
What are infectious agents?
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What is bacteria?
What is bacteria?
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What is a virus?
What is a virus?
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What is a reservoir?
What is a reservoir?
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What is the portal of exit?
What is the portal of exit?
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What are the two modes of transmission?
What are the two modes of transmission?
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What is the portal of entry?
What is the portal of entry?
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What makes someone a susceptible host?
What makes someone a susceptible host?
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Examples of defense mechanisms?
Examples of defense mechanisms?
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What are common Risk Factors for Infection?
What are common Risk Factors for Infection?
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What are key signs and symptoms of infection?
What are key signs and symptoms of infection?
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What are common Laboratory Assessments for Infections?
What are common Laboratory Assessments for Infections?
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What is an epidemic?
What is an epidemic?
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What is a pandemic?
What is a pandemic?
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What is immunity?
What is immunity?
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What is Herd Immunity?
What is Herd Immunity?
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What causes COVID-19?
What causes COVID-19?
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How does Ebola spread
How does Ebola spread
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What causes infectious mononucleosis?
What causes infectious mononucleosis?
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What are organizations that can help control infections in the community?
What are organizations that can help control infections in the community?
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What is a community acquired infection?
What is a community acquired infection?
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What is a health care associated infection (HAI)?
What is a health care associated infection (HAI)?
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What is the single most effective way to control and prevent the spread of infections?
What is the single most effective way to control and prevent the spread of infections?
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What is medical asepsis?
What is medical asepsis?
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What is surgical asepsis?
What is surgical asepsis?
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What are standard precautions?
What are standard precautions?
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What are transmission-based precautions?
What are transmission-based precautions?
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What are common HAIs?
What are common HAIs?
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How many antibiotic-resistant organisms are there?
How many antibiotic-resistant organisms are there?
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MRSA
MRSA
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What are antibiotic-resistant infections?
What are antibiotic-resistant infections?
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What do bactericidal antibiotics do?
What do bactericidal antibiotics do?
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bactericidal antibiotic examples?
bactericidal antibiotic examples?
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bactericidal antibiotic examples (continued)?
bactericidal antibiotic examples (continued)?
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What do bacteriostatic antibiotics do?
What do bacteriostatic antibiotics do?
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Macrolides
Macrolides
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What are examples of antifungal medications?
What are examples of antifungal medications?
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What causes antibiotic-associated diarrhea?
What causes antibiotic-associated diarrhea?
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What causes Clostridioides difficile (C diff)?
What causes Clostridioides difficile (C diff)?
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Key components of nursing process?
Key components of nursing process?
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What is a host?
What is a host?
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Bacterial shapes?
Bacterial shapes?
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Reservoir types?
Reservoir types?
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Portals of entry?
Portals of entry?
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Infection Symptoms: Older Adults?
Infection Symptoms: Older Adults?
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Laboratory Assessments types?
Laboratory Assessments types?
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Patient has upon admission to facility - Type?
Patient has upon admission to facility - Type?
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Frequency of Standard Precautions?
Frequency of Standard Precautions?
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MRSA spread?
MRSA spread?
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Bactericidal goal?
Bactericidal goal?
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Treatment of infections - GOAL ?
Treatment of infections - GOAL ?
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Medication Classes Used to Treat Bacteria?
Medication Classes Used to Treat Bacteria?
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Antibiotic-Associated Diarrhea - Why?
Antibiotic-Associated Diarrhea - Why?
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C Diff is caused by____?
C Diff is caused by____?
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Study Notes
Nursing Care of Patients with Infections: Updated Study Notes
Infection Terminology
- A host is an infected person.
- A pathogen is an organism causing disease in a host.
- Colonization occurs when pathogenic microbes are present without causing symptoms or an immune response.
- Infection happens when a microbe multiplies in a host, causing an immune response.
- Subclinical infection involves an immune response without any symptoms.
Infection Process
- The six key components are: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.
- Breaking the chain of infection at any point can prevent the spread of infection.
Infectious Agents
- Microorganisms cause infection and include bacteria, viruses, fungi, protozoa, helminths, prions, and normal flora.
Bacteria
- Bacteria are single-celled organisms.
- They are named based on shape, such as spherical (coccus), rod (bacillus), or spiral (spirillum).
- Bacteria are classified by staining: Gram-positive (purple), Gram-negative (pink after alcohol wash), and acid-fast (retain purple when acid is applied).
- Bacteria can be aerobic (need oxygen) or anaerobic (live without oxygen).
- Antibiotics treat bacterial infections.
Viruses
- Viruses are smaller than bacteria.
- They rely on host cells to live and reproduce.
- Viruses can trigger immediate disease or remain dormant for years, e.g., chicken pox becoming shingles.
- Antiviral drugs can treat viruses by decreasing viral load and symptoms, but antibiotics are ineffective against viruses.
Fungi
- Most fungi are non-pathogenic.
- Yeasts and molds are types of fungi.
- Antifungal medications are used for treatment.
- Thrush is an example of a fungal infection.
Helminths
- Helminths are worm-like parasites, including roundworms, flatworms, tapeworms, and pinworms.
- Transmission occurs through skin penetration of larvae or ingestion of eggs from raw or undercooked meats.
Protozoa
- These parasitic organisms live in soil.
- Fecal-oral contamination, ingestion of contaminated food or water, direct contact, or insect bites cause transmission.
- Gastroenteritis is an example of a protozoal infection.
Prions
- Prions cause abnormal folding of normal brain proteins.
- Prion diseases are rapidly progressive and fatal.
- Creuzfeldt-Jakob disease is an example of a prion disease.
Normal Flora
- Normal flora occur naturally in or on a body part.
- These are usually harmless and help the host, like intestinal flora that assist with vitamin K production for blood clotting.
- If normal flora bacteria get into other parts of the body, they can become pathogens and cause disease.
Reservoir
- A reservoir is an environment where infectious agents live, multiply, and reproduce.
- Animate reservoirs include people, insects, animals, and plants.
- Inanimate reservoirs include water, soil, and medical devices.
Portal of Exit
- It is the path the infectious agent uses to leave the reservoir.
Mode of Transmission
- Direct transmission involves contact or droplet spread.
- Indirect transmission can be vehicle-borne (bedding, equipment) or vector-borne (fleas, mosquitoes), or airborne (tuberculosis, measles, chicken pox).
- The mode of transmission determines the PPE required, such as N95 masks for airborne transmission and gowns and gloves for contact transmission.
Portal of Entry
- The means by which an infectious agent enters the host can include the GI tract, GU tract, mouth, mucous membranes, skin/placenta, and respiratory tract.
Susceptible Host
- Compromised defense mechanisms in the body increase the possibility of infection.
- Factors that affect the host defense include burns, chronic diseases, immunocompromised state, invasive procedures, malnourishment, stress, and age.
Defense Mechanisms
- Intact skin
- Mucous membranes
- Cilia in the respiratory tract
- Gastric acid
- Antibodies (immunoglobulins)
- Leukocytes and macrophages (WBCs)
- Lysozymes in sweat, saliva, and tears
- Interferon
- Inflammatory response
- Immune system
- If any of these break down, infection can result.
Risk Factors
- Increased age
- Chronic diseases (diabetes)
- Dysphagia
- Environment
- Immobility
- Immunocompromised state
- Smoking
- Incontinence
- Instrumentation (ET tubes, central lines, IVs, catheters)
- Invasive procedures
- Malnutrition
- Medications (antibiotics, corticosteroids)
Signs and Symptoms of Infection
- Local infections show pain, localized edema and swelling, redness, warmth, and fever.
- Systemic signs include elevation in WBCs (leukocytosis), tachycardia, hypotension, and decreased urine output with sepsis.
- Other signs are adventitious breath sounds, and change in level of consciousness.
- Older adults may not always have a fever, which can delay treatment.
- Other signs may include behavioral changes, pacing, irritability, and confusion.
Laboratory Assessments
- Gram staining can identify bacteria.
- Culture and sensitivity tests determine antibiotic sensitivity and should be drawn before starting antibiotics.
- Antibody tests show exposure to an antigen, but not necessarily active infection.
- CBC shows elevated WBCs.
- ESR indicates inflammation.
- Imaging helps identify abscesses.
- Skin tests can test for tuberculosis.
Terminology
- Epidemic: Rapid rise in cases of a specific infection.
- Pandemic: Impacts high numbers of populations, spreading across a continent
- Immunity: Ability to protect self from illness
- Natural immunity is species-specific.
- Innate immunity is genetic/present from birth.
- Acquired immunity occurs when active or passive exposure happens through vaccines, antibodies, or in utero.
- Herd immunity occurs when many people are vaccinated, protecting those who are not.
Infectious Disease Examples
- COVID-19
- Ebola
- Infectious Mononucleosis
- Zika
- HIV
- Hepatitis
- Respiratory infections
COVID-19
- It is caused by severe acute respiratory syndrome coronavirus 2.
- Transmission occurs through droplets, airborne particles, and vehicles.
- Symptoms include fever, cough, diarrhea, fatigue, headache, loss of smell or taste, nausea, and shortness of breath.
- Diagnosis involves new-onset fever, dyspnea, cough, new-onset oxygen requirements, and close contact.
- Diagnostic tests include antigen (anterior nasal swab) and PCR (nasal or throat swab).
- Treatment is supportive care and prevention.
Ebola Virus
- Contracted through direct contact transmission.
- Ervebo is an available vaccine.
- Use hand hygiene and specialized PPE.
- Symptoms appear within 2 to 21 days and include fever, hemorrhage, headache, diarrhea, vomiting, abdominal pain, muscle pain, and unexplained bruising.
- Care is supportive, and joint/vision problems may occur.
Infectious Mononucleosis
- It is caused by the Epstein-Barr virus.
- It is contagious through saliva ("kissing disease").
- Symptoms are most evident in teens/young adults.
- Main symptom is extreme fatigue along with other signs/symptoms: anorexia, chills, headache, high fever, red sore throat, and white coating on tonsils.
- Supportive care is the main form of treatment.
Zika Virus Disease
- It is transmitted by infected mosquitoes.
- Use hand hygiene and contact precautions.
- Symptoms include fever, headache, rash, muscle/joint pain, and conjunctivitis.
- Care is supportive with acetaminophen, rest and fluids.
- Guillain-Barré syndrome and birth defects may occur.
Infection Control in the Community
- Global monitoring and virology surveillance identifies potential pandemic viruses.
- Organizations involved are the World Health Organization and the Center for Disease Control and Prevention.
- Local health departments and immunization programs play a key role.
Infection Control in Health Care Agencies
- Community-acquired infection is present upon admission.
- Health-care-associated infection develops during a health care agency stay
- Risk factors include debilitation, malnutrition, immunocompromised state, burns, dialysis, neonates, oncology patients, invasive procedures, and LTC facilities.
- Pathogens found are E. coli (UTI), Staph (surgical wound infections), and Pseudomonas (pneumonia).
Hand Hygiene
- It is the single most effective way to control and prevent the spread of infections.
- Proper hand hygiene involves before patient contact, before aseptic tasks, after body fluids exposure, after patient contact, and after contact with patient surroundings.
- Soap and water should be used in place of alcohol-based sanitizers.
Asepsis
- Medical asepsis (clean technique) reduces the number of pathogens and prevents transmission through hand washing, PPE, and disinfectants.
- Surgical asepsis (sterile technique) eliminates all microorganisms and spores through sterilizing equipment.
Standard Precautions
- Used for all patients, assuming everyone is infectious regardless of diagnosis.
- Standard precautions apply to blood, secretions, excretions, open skin, mucous membranes, and all body fluids except sweat.
- PPE is required.
- Transmission-based precautions, offer additional protection based on diagnosis like contact, droplet, or airborne.
Healthcare-Associated Infections (HAIs)
- Respiratory infections are a type of HAI that presents a high risk through endotracheal, nasotracheal, or tracheostomy tubes, causing ventilator-associated pneumonia.
- Genitourinary tract infections (CAUTIs) are another type of HAI.
- Surgical wound infections are monitored for signs and symptoms.
Antibiotic-Resistant Infections
- Eighteen organisms show antibiotic resistance.
- Infections are difficult or impossible to treat and easily spread.
- MRSA (Methicillin-Resistant Staphylococcus aureus) can be spread even without symptoms.
- Symptoms include painful, warm, red bumps, fever, and drainage.
- Precautions involve contact precautions.
- VRE (Vancomycin-resistant Enterococci) spreads through direct or indirect contact.
- Risk factors: use of urinary catheters, central lines, immunocompromised state, use of multiple antibiotics, and surgical patients.
- PPE involves contact precautions.
- Treatment includes combination antibiotic therapy.
Treatment of Infections
- Medication choice must destroy or control the identified pathogens.
- Antibiotics: Bactericidal kill bacteria directly while bacteriostatic inhibit or slow bacterial growth and the immune system completes destruction.
- Antivirals help antivirals against viruses.
- Antifungals treat fungal infections.
Bactericidal Antibiotic Examples
- Penicillins include amoxicillin, ampicillin, penicillin G, and ticarcillin, treat gram-positive bacteria, and require allergy monitoring.
- Carbapenems, like doripenem, ertapenem, imipenem, and meropenem, treat moderate to severe infections and require seizure monitoring.
- Cephalosporins, with five generations, are used with proper administration routes, such as cefazolin, ceftriaxone, cefepime, and cefazoline.
- Aminoglycosides treat gram-negative bacteria with drugs such as amikacin, gentamicin, and tobramycin, are nephrotoxic.
- Fluroquinolones, such as ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin treat, but must be taken with water on an empty stomach, and cannot be taken with antacids.
- Nitroimidazoles, such as Metronidazole, for STIs.
- Glycopeptides like vancomycin, dalbavancin, oritavancin, and telavancin target gram-positive cocci; PO vancomycin for C diff.
Bacteriostatic Antibiotic Examples
- Tetracyclines, including tetracycline hydrochloride, doxycycline, and minocycline hydrochloride, treat both gram-positive and gram-negative bacteria, are contraindicated in pregnancy, and should be taken without dairy or antacids, sun protection.
- Macrolides, such as azithromycin, clarithromycin, erythromycin, and fidaxomicin, are effective against gram-positive and gram-negative bacteria, and should be taken on an empty stomach.
- Lincomycins include clindamycin.
- Sulfonamides, like trimethoprim sulfamethoxazole, treat gram-positive and gram-negative bacteria mainly in UTIs, and require proper hydration and sun protection, empty stomach.
- Oxazolidinones, like linezolid, require avoiding tyramine consumption.
Antifungal Examples
- Amphotericin B requires kidney damage and reaction monitoring.
- Triazoles, like fluconazole, itraconazole, posaconazole, and voriconazole, target yeast and fungus, monitor renal function.
- Echinocandins, like anidulafungin, caspofungin, and micafungin, affect liver function.
Antiviral Examples
- Includes antiretrovirals, anti-influenza viruses, anti-hepatitis viruses.
- Anti-herpes viruses like acyclovir, cidofovir, famciclovir, foscarnet, and valacyclovir.
Antibiotic-Associated Diarrhea
- Antibiotics disrupt the natural balance of the intestinal microbiota.
- Ampicillin, cephalosporins, and clindamycin are most common.
- Harmful bacteria can increase, resulting in inflammation and watery stool.
Clostridioides Difficile (C Diff)
- Infection caused by gram-positive bacteria.
- It often occurs after antibiotic therapy and is the most serious cause of antibiotic-associated diarrhea.
- Symptoms include 20 or more stools daily, fever, bloating, and abdominal pain.
- Spreads through fecal-oral route from touching contaminated surfaces.
- Handwashing is essential, as sanitizers are not effective, and bleach disinfects equipment.
- Treatments involve fidaxomicin, vancomycin, trial vaccines, or fecal microbiota transplantation.
Nursing Process
- Data collection involves early detection of signs and symptoms and monitoring labs.
- Standard and transmission-based precautions are essential.
- Anti-infective medications are administered as ordered, with monitoring of peak and trough levels and for allergies or side effects.
- Emotional support and patient education are vital, emphasizing taking all medication as prescribed.
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