Chapter 16

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Chapter 16
2014-01-10 20:26:48

Nursing Fundamentals
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  1. Name the 5 infection control Agencies
    • CDC
    • FDA
    • OSHA
    • EPA
    • CLIA
  2. tracks course of disease and recommends treatment
  3. Federal food and drug administrationthat requires labels be accurate and drugs tested for side effects 
  4. Occupations Safety and Health administration -enforces safety for workers and work environment
  5. EPA
    Environmental Protection Agency
  6. CLIA
    Clinical Labratory Improvement Act- regulates the handling of specimens/ lab safety
  7. Infection
    entry into the body of an infectious agent (a microorganism)that then multiplies and causes tissue damage
  8. Pathogens
    microorganisms capable of causing disease
  9. microorganisms produce and release what?
    toxins and endotoxins
  10. Infection may result in what?
    illness and disease
  11. disease/infection
    change in tissue/cell functionthat can be detected by exam or tests
  12. virulence
    strength of pathogen
  13. Can be transmitted from one person to another
  14. Normal Flora
    • -reside on skin
    • -body cavities
    • -intestines
    • harmless but can become pathogenic if destroyed
  15. Organism that can cause illness or disease
  16. Pathogenic
    able to produce disease or damage
  17. pathogen that would probably not cause major problem in healthy person, but will in a compromised, susceptible person
  18. What can become pathogenic if homeostatis is disrupted?
    any bacteria
  19. Microorganisms
    these are the ones that are given an antibiotic to treat (e-coli,staph, strep, pseudomonas)
  20. Organisms causing pathology
    • Bacteria
    • Prions
    • Viruses
    • Protozoa
    • Rickettsias
    • Fungi
    • Helminths
    • mycoplasmas
    • Chlamydia
  21. Bacteria
    • Single-cell microorganisms lacking a nucleus
    • Reproduce every few minutes up to several weeks
    • Classified according to need for oxygen, shape, and Gram staining
    • have a need for oxygen
  22. Aerobic
    need oxygen to grow and thrive
  23. Anerobic
    can grow only without oxygen
  24. (Bacteria)Gram staining
    • Gram-positive bacteria retain the stain
    • Gram-negative bacteria take up couterstain
  25. (Bacteria) Shape
    • round
    • rod-shaped
    • spiral or corkscrew shaped
  26. Bacteria
    • Identified by growing a cultue CBC
    • Snsitivity testeing determines which antibiotic can kill the organism
    • some are drug resistant
  27. Multidrug resistant organisms
    • Methicillin-MRSA
    • Vancomycin-VRE
    • Extended-ESBL, ghonorrhea and CDIF
    • Penicillan resistant- Strep
  28. Prions
    • protein particle
    • lack nucleic acids
    • do not trigger an immune response
    • cause degenerative neurological disease such as Mad cow disease
  29. Mad cow disease is called?
  30. Viruses
    • extremely small
    • can only be seen with an electron microscope
    • composed of  particles of nucleic acid
    • DNA or RNA with a protein coat
    • grow and replicate only with a living cell
    • survival and replication depend on the host
    • smallest of organisms and can lay dormat and reactivate
  31. Microorganisms
    • some are minore like a cold
    • some like hepatitis and HIV can be serious and lead to death
    • require anti-viral medication-do not respond to antibiotics
  32. Portozoa
    Plasmodium species?
    Entamoeba histolytica?
    • One-celled
    • belong to the animal kingdom
    • malaria
    • amebic dysentery
  33. Rickettsia
    • small round or rod shaped organism
    • transmitted by bites of fleas,lice,mites, and ticks
    • can multiply only in the host cells
    • causes Rocky Mounted Spotted Fever and typhus
  34. Fungi
    • tiny primitive organismsof the plant kingdom that contain no chlorophyll
    • include yeast and mold
    • feed off living animals and decaying matter
    • Reproduce by use of spores
    • cause candidiases and tinea pedis (athletes foot)
  35. Helminths
    • Parasitic worms or flukes
    • belong to animal kingdom
    • Pinworms(which mostly affect children)
    • Roundworms and tapeworms
  36. Mycoplasms
    • very small organism without a cell wall
    • cause infections of respiratory or genital tract
  37. Chlamydia
    Affects the genitourinary and reproductive tracmore common in the past 20 years
  38. Parasite
    • live in or on other organisms
    • ex.-tick with lyme disease
    • include helminths-infectious worms like tapeworm, that lay eggs
  39. Process of Infection
    An infectious disease is spread from one person to another; a continuous chain
  40. Process of Infection chain links
    • Causative Agent (link 1)
    • Reservoir (link 2)
    • Portal of Exit (link3)
    • Mode of Transfer (link4)
    • Portal of Entry (link5)
    • Susceptible host (link6)
  41. Types of Infection
    sudden, short, limited to expected
  42. Types of Infection
    gradually increase over long period of time or lasts much longer than expected
  43. Types of Infection
    presence of microorganism in or on host in large number with no active disease s/s. can cause infection given the right circumstances
  44. Types of Infection
    • Acquired in a health care setting.
    • resp. for millions of dollars of health care costs per year
  45. (Link 1) Causitive Agent
    • adhere to mucous surfaces or skin
    • penetrate mucous membranes
    • mutliply once in the body
    • secrete harmful enzymes or toxins
    • resist phagocytosis
  46. (Link 2) Reservoir
    infected wounds, waste or infected/ contaminated food or water
  47. Precautions that prevent the spread of microorganisms
    • good hand hygiene
    • sterile technique
  48. (Link 3) Portal of Exit
    route by which pathogen leaves its host
  49. Gastrointestinal tract
    Feces may transport typhoid bacillus from an infected person
  50. Respiratory tract
    • microorganisms are released by coughing or sneezing
    • Measles,Mump,  respiratory pulmonary tuberculosis  can be transmitted via exiting the respiratory system
    • skin and mucous membranes
    • open wound
  51. Modes of transfer (Link 4)
    • Direct contact of excreta drainage from an ulcer, or infected wound, boil, chancre
    • indirect contact with contaminated inanimate objects such as needles, eating utensils,and dressings
    • vectors, such as mosquitos,that harbor infectious agents
    • droplet infection-ex. sneezing or coughing
    • Spread of infection from one body part to another
    • vehicle-contaminated equipment such a comb or food
  52. Portal of Entry (Link 5)
    enter body through eyes,mouth, nose, trachea,skin, mucous membranes,needle punctures, thru placenta to baby
  53. cont. Link 5
    How do you prevent entry of microorganisms?
    • Use only sterile and clean items
    • use barrier precautions (gloves, masks, condoms)
    • safely handle food and water
    • use good personal hygiene
    • avoid high risk behaviors
    • use protection from insect bites and stings
  54. Susceptible Host (link 6)
    A human host may be susceptible due to what factors?
    • age
    • state of health
    • broken skin
    • chemotherapy
    • transplant
    • burns
  55. cont. Link 6
    Susceptibility can be reduced by doing what?
    • teaching good health and hygiene habits
    • Immunizations
    • Hydration/Nutrition
    • No fresh fruit or flowers
    • Limit outside contact especially with the flu
  56. Thing that make you more susceptible to infection
    • prolonged stress=decreased anti-inflammatory response
    • sedentary lifestyle
    • poor hygiene (body and oral)
    • Illness=anything that weakens the immune system
    • nutritional status
    • medications
    • presence od catheter,pacemaker
    • age
    • newborns
    • adolescents=std's
  57. what factors make the elderly more susceptible to infection?
    • poor nutrition
    • immobility
    • poor hygiene
    • chronic illness
    • physiologic changes such as thin skin
  58. What are the bodys defenses against infection?
    • skin
    • mucous membranes
    • cilia
    • kupffer cells in liver
    • gastric secretions
  59. What is the bodies second line of defense?
    • fever= slows the growth of pathogens
    • leukocytes= engulf the invader
    • phagocytosis= remove cellular debris
    • inflammation
    • interferons=stimulate antiviral preteins
  60. continued body secretions
    • body secretions=tears,saliva,vaginal secretions
    • inflammatory response
  61. what happens in the inflammatory response?
    signs and symptoms
    • body is increasing the wbc and blood flow and metabolism
    • s/s heat redness,swelling, pain, decreased movement and function
    • b and t cells
  62. b lymphocytes
    produce antibodies
  63. T lymphocytes
    • kill and destroy
    • when b and t cells are not working immunity is compromised
  64. specific body defenses
    • antigen-foreign things that cause response in the body
    • antibodies
  65. Auto immune diseases do what?
    what are some examples?
    • body makes antibodies against/ and attacks itself
    • lupus, sarcoidosis, myasthenia gravis, chronic fatigue
  66. Laboratory data
    • WBC + Leukocyte differential -part of cbc
    • WBC count greater than 11,000 usually indicates a bacterial infection or sever trauma
    • differential indicates stage and severity of infection
  67. Lab data
    • ESR red blood cell count and protein reactive
    • when elevated= inflammatory process
    • C&S= culture and sensitivity-shows the organism and medication that will be effective against
  68. Inflammatory response
    • localized protective response brought on by injury or destruction of tissue
    • blood vessels dilate, bring more blood to the area causing edema and redness and purpose
    • artificially acquired immunity- immunizations
    • passive artificially acquired immunity -injecting antibodies derived from serum of infected person or animal
  69. asepsis
    making the environment and object free from microorganisms
  70. medical asepsis
    reducing number of organisms or reducing the risk of of transmission of organisms
  71. PPE
    (Personal protective equipment)
    • prevents the spread of infection 
    • disinfecting contaminated items
  72. sepsis
    infection-spread throughout the body-can result in organ failure 50% fatality rate when septic
  73. hand hygiene
    this is one of the most effective ways to reduce the number of microorganisms on the handsgloves should be worn to prevent contact with body fluidshand washing before and after patient care
  74. Hand washing should be performed for how long?
    15-20 seconds
  75. When scrubbing in for surgery ?
    • 2 to 5 min
    • water flow down towards elbows
  76. standard precautions include?
    • hand hygiene
    • gloves
    • mask, eye protection,face shield
    • gown
    • patient care equipment
    • environmental control
    • linens
    • occupational health and blood borne pathogens
    • patient placement
  77. dakins solution
    1 part chlorine to 10 parts water
  78. sterilization technique
    warm water with air dry