What are the 6 components of the infection cycle?
1. Pathogen
2. Reservoir or Source
3. Exit portal
4. Route of Transmission
5. Entry portal
6. Susceptible host
Which of the following is the most significant and commonly found infection-causing agent in health-care institutions?
Bacteria
What is the smallest of all organisms?
Viruses
Name the 4 factors affecting an organism's potential to produce disease.
1. Number of organisms
2. Virulence
3. Competence of person's immune system
4. Length and intimacy of contact between a person and microorganism
During which stage of infection is the patient most contagious?
Prodromal Stage
Name the factors affecting host susceptibility:
-intact skin and mucous membranes
-normal pH levels
-Body's white blood cells
-Age, sex, race and hereditary factors
-Immunizations (natural or acquired)
-Fatigue, climate, nutritional & health status
-Stress
-Use of invasive or indwelling medical devices
What are the 5 cardinal signs of inflammation?
#NAME?
What are 5 moments for hand hygiene?
1. Before touching a patient
2. Before clean or aseptic procedure
3. After body fluid exposure
4. After touching a patient
5. After touching patient's surroundings
What is the most common nosocomial infection?
Urinary Tract Infection
Cause: Catherizations
(T/F): Soaps and detergents are considered adequate for routine mechanical cleansing of the hands and removal of most transient microorganisms.
TRUE
Define and give an example of medical asepsis:
Clean technique; handwashing
Define and give an example of surgical asepsis:
Sterile technique; operating room
What are 8 factors to consider when examining a patient's skin?
Cleanliness, color, temperature, turgor, moisture, sensation, vascularity and evidence of lesions
If a patient is on an anticoagulant, what type of razor should be used?
Electric shaver
What are some reasons for providing a back massage?
#NAME?
Which gum disease manifests as a marked inflammation of the gums that also involves degeneration of the dental tissues and bone?
Periodontitis
Which oral problem involves an ulceration of the lips usually caused by vitamin B complex deficiencies?
Cheilosis
Define stomatitis:
inflammation of oral mucosa
What is the proper way of washing a patient's eyes?
From inner to outer canthus.
(T/F): Pediculosis (lice) can be spread directly by contact with the infested areas or indirectly through contact with clothing, bed linens, brushes or combs:
TRUE
(T/F): Monthly douching is recommended to control odor in the perineal area:
FALSE
Ways to ensure bedside safety:
#NAME?
What does the kidneys and ureters do?
Maintain composition and volume of body fluids, filter and excrete blood constitutes not needed and retain those that are needed, and excrete waste products.
Bladder
Serves as reservoir for urine
Urethra
Conveys urine from bladder to exterior
Steps to emptying the bladder:
1. Detrusor muscle contracts
2. Internal sphincter relaxes and urine enters posterior urethra
3. Muscles or perineum and external sphincter relax
4. Muscles of abdominal wall contract slightly
5. Diaphragm lowers and micturition occurs
Which term describes a condition in which 24-hour urine output is less than 50mL?
Anuria
(T/F): Diuretics causes increased urine production, resulting in the need for increased urination and possibly urge incontinence.
TRUE
What are cholinergic medications?
Medications that stimulate contraction of detrusor muscle, producing urination
What color would your urine be if you are taking:
-Anticoagulants:
-Diuretics:
-Phenazopyridine:
-Amitripyline:
-Levodopa:
#NAME?
(T/F): Normal fresh urine has ammonia smell.
False; normal fresh urine has aromatic odor while urine with bacteria action has ammonia odor
(T/F): A urine specimen from a patient with an indwelling catheter should be obtained from the collection receptacle.
False; specimen should be obtained from catheter itself.
What is the difference between an intermittent (straight) catheter and a indwelling (foley) catheter?
Straight: used to drain the bladder for a period of time
Foley: used when catheter is to remain in place for continuous drainage
(T/F): There are no interventions effective for preventing urinary incontinence:
FALSE
LARGE INTESTINE:
-Purpose:
-Position
-Function:
#NAME?
Which food is recommended for an older adult who is constipated?
Fruit, vegetables, bran
(T/F): When collecting stool, using the technique "timed specimen" the nurse should consider the first stool passed by the patient as the start of the collection period.
TRUE
What direct visualization test uses a long, flexible, fibrotic-lighted scope to visualize the rectum, colon and distal small bowel?
Colonoscopy
What does an esophagogastroduodenoscopy examine?
esophagus, stomach and upper duodenum using an optic scope
What does a sigmoidoscopy examine?
distal sigmoid colon, rectum and anal canal through a flexible or rigid sigmoidoscope
oil retention enemas:
lubricate the stool and intestinal mucosa, easing defacation
carminative enemas:
help expel flatus from the rectum
Medicated enemas:
provide medications absorbed through the rectal mucosa
anthelmintic enemas:
destroy intestinal parasites
(T/F): An older technique of auscultation of air injected into a NG tube has proved a reliable indicator of tube placement.
FALSE
Ostomy
a surgically formed opening from the inside of an organ to the outside
Stoma:
the part of the ostomy that is attached to the skin, is formed by suturing the mucosa to the skin
Ileostomy
allows liquid fecal content from the ileum of the small intestine to be eliminated through the stoma
Whats a normal white blood cell count?
5000 to 10000 mm3
What are the stages of infection?
incubation period, prodromal phase, invasive period, decline phase, convalescence period
What are the MAIN functions of the kidneys and ureters?
FILTER and EXCRETE blood constituents not needed; RETAIN those that are needed
What do nephrons do in urine?
Nephrons remove the end products of metabolism and regulate fluid balance.
Whats another term for urination?
micturition
Define anuria
synonymous with kidney shutdown or renal failure
define dysuria
painful or difficult urination
define glycosuria
presence of sugar in the urine
pyuria
pus in the urine
Developmental considerations for children with elimination
recognizing bladder fullness & communicate the need to void
Developmental considerations for older people with elimination
fewer nephrons, Loss of muscle tone of the bladder>>reduce the capacity of the bladder to hold urine, insufficient emptying of the bladder, diminished ability to concentrate urine
How can Lasix effect urination
It is a type of diuretic, so it can increase urintation... meaning it should be given during the day, instead of before bed
what physical aspects of urine should you assess
color, odor, clarity, and sediment
what should you document about the use of a bedside commode
the patient's tolerance and Unusual urine or stool characteristics
how long are intermittent or straight catheters used for
5 to 10 minutes
whats expected after removing an indwelling catheter
Patient voids a minimum of 250 mL of urine within 6 to 8 hours of catheter removal... and skin will remain clean, dry, and intact
Urinary function as the problem would be...
Incontinence-Pattern alteration-Urinary retention
Urinary function as the etiology would be...
Anxiety-Caregiver role strain-Risk for infection
functional urinary incontinence is...
caused by factors outside the urinary tract
stress urinary incontinence is...
caused by increased abdominal pressure, e.g., sneezing or coughing�
treatment for preventing urinary incontinence
Behavioral-Kegel exercise or bladder training, Pharmacological, Mechanical-device or surgery
whats the bodys first line of defense
healthy skin
whats turgor
when you pinch the skin and it stays up, the turgor is low
what are important bathing needs for patients with dementia
comfort, safety, privacy, warmth, face and hair last
what is one of the most important and most overlooked part of basic nursing care?
oral hygiene
whats a Complication of diarrhea
dehydration... ex. low turgor and dark urine
prevention to constipation
liquids, fiber, exercise
What system deals with peristalsis
the nervous system
bowel elimination variable
food and fluid, activity, lifestyle, psychological factors such as nursing home
Why is fecal occult blood test preferred
its not invasive unlike a colonoscopy
who is at high risk for constipation
patients on bed rest, constipation meds, reduced fluids or bulk
when should you answer a call bell
immediately
Purpose of nasogastric tubes
decompress/drain stomach fluids, allows gastrointestinal tract to rest, and monitors gastrointestinal bleeding
who is Florence Nightingale
she challenged prejudices against women and elevated the status of all nurses
who founded the American red cross
Clara barton
who is Dorothea dix
she established the nurse core in the army even though she was not a nurse
who is Lillian wald
founder of public health nursing
what are a nurses aims
to promote and restore health, prevent illness, and help in coping with death