If an infectious disease can be transmitted directly from one person to another, it is a:
A) Susceptible host.
B) Communicable disease.
C) Port of entry to a host.
D) Port of exit from the reservoir.
Communicable disease.
Which is the most likely means of transmitting infection between patients?
A) Exposure to another patient's cough
B) Sharing equipment among patients
C) Disposing of soiled linen in a shared linen bag
D) Contact with a health care worker's hands
Contact with a health care worker's hands
Identify the interval when a patient progresses from nonspecific signs to manifesting signs and symptoms specific to a type of infection.
A) Illness stage
B) Convalescence
C) Prodromal stage
D) Incubation period
Prodromal stage
Which of the following is the most effective way to break the chain of infection?
A) Hand hygiene
B) Wearing gloves
C) Placing patients in isolation
D) Providing private rooms for patients
Hand hygiene
A family member is providing care to a loved one who has an infected leg wound. What would you instruct the family member to do after providing care and handling contaminated equipment or organic material?
A) Wear gloves before eating or handling food.
B)
Perform hand hygiene after care and/or handling contaminated equipment or material.
A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention?
A) Provide a dark, quiet room to calm the patient.
B) Reduce th
Explain the reasons for isolation procedures and provide meaningful stimulation.
The nurse wears a gown when:
A) The patient's hygiene is poor.
B) The nurse is assisting with medication administration.
C) The patient has acquired immunodeficiency syndrome (AIDS) or hepatitis.
D) Blood or body fluids may get on the nurse's clothing fro
Blood or body fluids may get on the nurse's clothing from a task that he or she plans to perform.
The nurse has redressed a patient's wound and now plans to administer a medication to the patient. Which is the correct infection control procedure?
A) Leave the gloves on to administer the medication.
B) Remove gloves and administer the medication.
C) Re
Remove gloves and perform hand hygiene before administering the medication.
When a nurse is performing surgical hand asepsis, the nurse must keep hands:
A) Below elbows.
B) Above elbows.
C) At a 45-degree angle.
D) In a comfortable position.
Above elbows.
What is the best method to sterilize a straight urinary catheter and suction tube in the home setting?
A) Use an autoclave.
B) Use boiling water.
C) Use ethylene oxide gas.
D) Use chemicals for disinfection.
Use boiling water.
A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection?
A) It keeps an incontinent patient's skin dry.
B) It can get caught in the linens or equipment.
C) It obstructs the normal fl
It obstructs the normal flushing action of urine flow.
Put the following steps for removal of protective barriers after leaving an isolation room in order:
A) Untie top, then bottom mask strings and remove from face.
B) Untie waist and neck strings of gown. Allow gown to fall from shoulders and discard. Remov
Remove gloves.
Remove eyewear or goggles.
Untie waist and neck strings of gown. Allow gown to fall from shoulders and discard. Remove gown, rolling it onto itself without touching the contaminated side.
Untie top, then bottom mask strings and remove from
Your ungloved hands come in contact with the drainage from your patient's wound. What is the correct method to clean your hands?
A) Wash them with soap and water.
B) Use an alcohol-based hand cleaner.
C) Rinse them and use the alcohol-based hand cleaner.
Wash them with soap and water.
A patient's surgical wound has become swollen, red, and tender. You note that the patient has a new fever and leukocytosis. What is the best immediate intervention?
A) Notify the health care provider and use surgical technique to change the dressing.
B) R
Notify the health care provider and support the patient's fluid and nutritional needs.
While preparing to do a sterile dressing change, a nurse accidentally sneezes over the sterile field that is on the over-the-bed table. Which of the following principles of surgical asepsis, if any, has the nurse violated?
A) When a sterile field comes in
A sterile field becomes contaminated by prolonged exposure to air.
Infection
the invasion of a susceptible host by pathogens or microorganisms, resulting in disease.
Colonization
the presence and growth of microorganisms within a host but without tissue invasion or damage
Carrier
shows no symptoms of illness but has pathogens on or in their body that can be transferred to others
Communicable disease
an infectious disease that is transmitted directly from one person to another
Symptomatic infections
the pathogens multiply and cause clinical signs and symptoms
Asymptomatic infections
clinical signs and symptoms are not present
Chain of infection
An infectious agent or pathogen
A reservoir or source for pathogen growth
A port of exit from the reservoir
A mode of transmission
A port of entry to a host
A susceptible host
Virulence
ability to produce disease
Reservoir
place where microorganisms survive, multiply, and await transfer to a susceptible host
Bacteriostasis
prevent growth and reproduction of bacteria
Bactercidal
A temperature or chemical that destroys bacteria
What are some examples of port of entry/exit?
blood, skin, respiratory tract, GI tract, feces, draining wounds, transplacental, and reproductive tract
Modes of transmission
Contact, air, vehicles, vectors
Contact mode of transmission
Direct (person to person) & indirect (person to inanimate objects)
Air mode of transmission
Airborne (Droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing or carried on dust particles )
Droplet (Large particles that travel up to 3 feet during coughing, sneezing, or talking and come in contact with suscept
Vehicle mode of transmission
Contaminated items, water, drugs, blood, food
Vector mode of transmission
Flies, mosquitoes, louse, fleas, ticks
Course of infection stages
incubation period, prodromal stage, illness state, convalescence stage
Incubation period
Interval between entrance of pathogen into body and appearance of first symptoms (e.g., chickenpox, 10 to 21 days after exposure; common cold, 1 to 2 days; influenza, 1 to 5 days; mumps, 12 to 26 days).
Prodromal stage
Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms. (During this time microorganisms grow and multiply, and patient may be capable of spreading disease to others.) For example, herpes simple
Illness stage
Interval when patient manifests signs and symptoms specific to type of infection. For example, strep throat is manifested by sore throat, pain, and swelling; mumps is manifested by high fever, parotid and salivary gland swelling.
Convalescence stage
Interval when acute symptoms of infection disappear. (Length of recovery depends on severity of infection and patient's host resistance; recovery may take several days to months.)
Suprainfection
Secondary infection usually caused by an opportunistic pathogen. Develops when broad-spectrum antibiotics eliminate a wide range of normal flora organisms, not just those causing infection. When normal bacterial floras are eliminated, body defenses are re
Serous exudate
clear, like plasma
Sanguineous exudate
containing red blood cells
Purulent exudate
containing white blood cells and bacteria
Healthcare Associated Infections
Infection that was not present or incubating at the time of admission to a health care setting.
Iatrogenic infection
type of HAI from a diagnostic or therapeutic procedure.
Exogenous Infection
comes from microorganisms found outside the individual such as Salmonella, Clostridium tetani, and Aspergillus. They do not exist as normal floras
Endogenous Infection
occurs when part of the patient's flora becomes altered and an overgrowth results (e.g., staphylococci, enterococci, yeasts, and streptococci). This often happens when a patient receives broad-spectrum antibiotics that alter the normal floras.
Susceptible Host
most likely to acquire an infection
Immune Senescence
An age-related decline in immune system function
Normal WBC count
5000-10,000/mm3 (Increased in acute infection, decreased in certain viral or overwhelming infections)
Erythrocyte sedimentation rate
Up to 15 mm/hr for men and 20 mm/hr for women
Elevated in presence of inflammatory process
Iron Level
60-90 g/100 mL
Decreased in chronic infection
Cultures of urine and blood
Normally sterile, without microorganism growth
Culture of gram stain of wound, sputum, and throat
No WBCs on Gram stain, possible normal flora
A 51 year old patient is admitted to a medical-surgical unit with a systemic infection. The nurse would expect to see which of the following signs and symptoms in this patient?
A) redness, fever, edema
B) drainage, nausea, fever
C) edema, malaise, and fev
fever, fatigue, nausea
Which U.S. city has the highest rate of patient's with HIV?
NYC
Can blood spill be cleaned with a paper towel and water?
No, must use bleach solution of 1 part bleach and 9 parts water.
How much more expensive are biohazzard bags compared to regular trash bags?
20 times
Asepsis
is the absence of pathogenic (disease-producing) microorganisms.
Medical asepsis
clean technique, includes procedures for reducing the number of organisms present and preventing the transfer of organisms. Hand hygiene, barrier techniques, and routine environmental cleaning are examples
Standard Precautions
Guidelines recommended by the Centers for Disease Control and Prevention (CDC) to reduce risk of transmission of bloodborne and other pathogens in hospitals.
Surgical asepsis
sterile technique prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery. Includes procedures used to eliminate all microorganisms, including pathogens and sp
Cleaning
the removal of all soil (e.g., organic and inorganic material) from objects and surfaces
Disinfection
describes a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects
Sterilization
the complete elimination or destruction of all microorganisms, including spores.
Who do you use Tier One Standard Precautions with?
All patients!
Isolation
the separation and restriction of movement of ill persons with contagious diseases
Contact precautions
Used for direct and indirect contact with patients and their environment. Direct contact refers to the care and handling of contaminated body fluids. An example includes blood or other body fluids from an infected patient that enter the health care worker
Droplet precautions
Focus on diseases that are transmitted by large droplets expelled into the air and travel 3 to 6 feet from the patient. Droplet precautions require the wearing of a surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated-c
Airborne precautions
Focus on diseases that are transmitted by smaller droplets, which remain in the air for longer periods of time. This requires a specially equipped room with a negative air flow referred to as an airborne infection isolation room. Air is not returned to th
Protective Environment
Focuses on a very limited patient population. This form of isolation requires a specialized room with positive airflow. The airflow rate is set at greater than 12 air exchanges per hour, and all air is filtered through a HEPA filter. Patients are not allo
7 Principles of Surgical Aspesis
A sterile object remains sterile only when touched by another sterile object.
Only sterile objects may be placed on a sterile field.
A sterile object or field out of the range of vision or an object held below a person's waist is contaminated.
A sterile o