foundation exam 1

true or false

Examples of situations needing contact precautions include infected draining wounds and their dressings

True

true or False

An N95 respirator mask is required for anyone entering the room of a patient with an airborne illness

True

True orFalse

Trash removed from the room of the person on contact precautions should be triple bagged

False

* double bagged

True or False

Touching a bedstand with fresh droplets can cause transfer of microorganisms

True

True or False

Only sterile gloves should be used when touching the skin of someone with contact precautions

False

* regular gloves are fine

True or False

Hand hygiene should take place before entering and upon leaving the room of any patient, regardless of known infections

True

True or False

Fanning of the sheets, shaking out of towels, and sweeping the floor can transmit airborne illness

True

True or False

A mask should be worn by patients on droplet precautions if they are transported outside the room

True

True or False

Airborne precautions should be used to control the spread of infections that are transmitted by air currents

True

True or False

Patients may be in pain, even if they don't "act like" they are

True

True or False

To accurately assess pain, you must ask your patient, then believe what the patient says

True

Examples of nonpharmacological pain interventions

no chemicals involved

* heating pad
* watching funny movies
* weekly massage

True or False

Acute and chronic pain have the same intensity for all people

False

* everyone is different

True or False

Agitation is a type of pain response you may see in your patients

True

True or False

Pain assessment should take place on admission, even if it is not anticipated that your patient will be having pain

True

True or False

On the numerical rating scale, 1 is the worst pain imaginable

False

\- pain scale is 0-10, where 0 is no pain and 10 is the most pain the pt has ever felt

True or False

Most patients are very verbal about expressing pain

False

* everyone is different and unique

True or Fasle

Pain can interfere with all aspects of life, such as sleep, good nutrition, relationships, and overall quality of life

True

True or False

If you medicate your patient with an opioid pain medicine, it is important to check back with the patient after you have given the medicine.... even if they are sleeping

True

True or Flase

Gloves should be applied first when applying PPE for a patient with contact precautions

False

\-gloves go on last when donning PPE

bacteria with spores and requires handwashing for removal

C. Diff

pandemic

worldwide epidemic

epidemic

a widespread occurrence of an infectious disease in a community at a particular time.

endemic

regularly expected infection in localized areas

surgery patients are...

most at risk for infection

infection definition

when microorganisms capable of producing disease invade the body

the spread of infection- 6 links

1. infectious agents
2. reservoir
3. petal of exit
4. mode of transmission
5. portal of entry
6. susceptible host

the spread of infection - 1. infectious agents

normal flora that become pathogenic

* pathogens = bacteria, virus, fungi, parasites

the spread of infection - 2. reservoir

any place where pathogens live and multiply

* living reservoirs
* nonliving reservoirs

the spread of infection - 3. portal of exit

body's natural response to foreign objects is to EXPEL them.

* sneezing, coughing, feces, seeping wounds, body fluids
* drainage tubes, IV lines

the spread of infection - 4. mode of transmission

\-contact (direct, indirect)

* droplet
* airborne

the spread of infection - 5. portal of entry

eyes, nares, mouth, urethra, vagina, cuts, wounds, surgical sites, bite from vector

the spread of infection - 6. susceptible host

* a person with inadequate defense
* virulence
* organisms ability to survive in host’s environment
* number of organisms
* host defenses

living reservoir examples

humans, animals, insects (vectors)

nonliving reservoirs examples

food, floors, contaminated water, equipment, toilets

contact mode of transmission (indirect)

contact with a fomite (object) or a vector (insect)

contact mode of transmission (direct)

touching, kissing, sexual contact

fomite

A physical object that serves to transmit an infectious agent from person to person.

Vector of infection

An insect or any living carrier that transports an infectious agent from an infected individual or its wastes to a susceptible individual or its food or immediate surroundings. Both biological and mechanical transmissions are encountered.

droplet mode of transmission

sneezing, coughing, talking

airborne mode of transmission

via air conditioning, sweeping

* NEED A N95 MASK (TB, smallpox, covid)

4 factors to a susceptible host

* virulence (strength)
* organisms ability to survive in hosts environment
* number of pathogens
* host defenses

sterile

non living microbes

* no pathogens

aeseptic

clean

* method of handling microbial cultures, patient specimens, and other sources of microbes in a way that prevents infection of the handler and other who may be exposed

stages of infection

* incubation
* prodromal
* illness
* decline
* convalescence

incubation stage of infection

from the time the pathogen successfully invaddes and the first appearance of symptoms

* can infect and transmit to others
* highest risk of spreading to others

prodromal stage of infection

appearance of vague symptoms

* not all diseases have this stage
* highest risk of spreading to others

illness stage of infection

signs and symptoms are present

decline stage of infection

number of pathogens decline due to immune response and/or medical therapies

\-symptoms fade

convalescence stage of infection

tissue repair, return to health

classifications of infections

* location in the body
* whether it is the patient’s first infection
* duration

location in the body- classification of infection

* local
* systemic

local infection

occurs in a limited region/location in the body (UTI)

systemic infection

spread via blood or lymph and impacts many regions

endogenous

Produced within the body

primary infection

patients first infection that occurs

secondary infection

patient's second infection

* it followed the primary infection

duration infection terms

* acute
* chronic
* latent

acute infection

comes on rapidly, with severe but short-lived effects

* ex: common cold

chronic infection

slow development, long duration (ex: osteomyelitis)

latent infection

infection present with no discernible symptoms (e.g., HIV/AIDS)

carrier

a person or animal who harbors an infectious organism and transmits the organism to others while having no symptoms

colonization

the presence and multiplication of infectious organisms without invading or causing damage to the tissue

Healthcare-associated infection (HAI)

an infection acquired as a result of healthcare in any setting (not just hospital)

* leading cause of healthcare complications and death in the U.S.
* preventable with use of aseptic technique

nosocomial infections

specifically hospital-acquired infections

preventing HAIs

= first line of defense for adverse outcomes

\
* hand washing
* consistent use of personal protective wear (gloves, mask, and gown)
* Environmental sanitization
* equipment sterilization
* limiting patient transport
* single patient equipment use
* patient isolation (as needed)

exogenous healthcare-related infections (HAIs)

pathogen acquired from the healthcare environment

endogenous healthcare-related infections (HAIs)

normal flora multiply and cause infection as a result of treatment

lines of defense against infection

* primary
* secondary
* tertiary

primary line of defense against pathogens/infection

anatomical features limit pathogen entry

* skin, mucous, pH

secondary line of defense against pathogens/infection

* White Blood Cells, inflammation
* biochemical process activated by chemical released by pathogens
* phagocytosis, complement cascade, fever

tertiary line of defense against pathogens/infection

antibodies and destruction

* immunity against an infection is acquired and achieved through the presence of antibodies that neutralize or destroy toxins or pathogens

types of antibodies (tertiary line)

* active
* passive
* humoral immunity
* cell-mediated immunity

active antibodies

takes time, your body made them

* from having the disease or vaccine

passive antibodies

Come from a source outside the body- get from someone who has the antibodies

\
Natural: mother to fetus or infant

\
Artificial: injected, made in lab

humoral immunity/antibodies

the antibody response (B-cell)

cell-mediated immunity/antibodies

"destroyers", T-cells

factors that increase infection risk

* developmental stage (kids get sick when in school)
* breaks in the skin
* illness/injury, chronic disease
* smoking, substance abuse (cilia destroyed)
* multiple sex partners
* environmental factors
* medications that inhibit/decrease immune response
* nursing/medical procedures

factors that support host defenses (5)

* adequate nutrition
* balanced hygiene
* rest/exercise
* reducing stress
* immunizations

adequate nutrition

To manufacture cells of the immune system

balanced hygiene

sufficient to decrease skin bacterial count

* not overzealous; causes skin cracking

preventing infection: implementing medical asepsis

A state of cleanliness that decreases the potential for the spread of infections

Promoted through:

-Maintaining a clean environment

-Maintaining clean hands

-Following Centers for Disease Control (CDC) guidelines

medical asepsis is promoted through:

-Maintaining a clean environment

-Maintaining clean hands

-Following Centers for Disease Control (CDC) guidelines

nonsurgical hand washing guidelines

15 seconds

remove jewelry and clean beneath fingernails

when to use bactericidal solution

-60% alcohol or higher

-when hands are not visibly soiled

when to wash your hands

when your hands are visibly soiled

hand washing

warm water

soap to already wet hands

friction to get rid of spores (C.Diff)

rinse soap

towel dry from fingertips to wrist (not back up again, get new paper towel)

standard precautions

first tier of protection