Week 1 Engage Funds

- Infection Control and Isolation

Name the Chain of Infection

The order is as follows, any break in chain can prevent development of infection

1. Infectious Agent

2. Reservoir aka habitat: (ex. Table, Bed)

3. Portal of Exit aka means of which agent can leave reservoir (ex. Wound drainage, GI Tract)

4. Mode of transmission (ex. Contact)

5. Portal of Entry (Ex. Mouth, nose) aka body opening

6. Susceptible Host (Client with suppressed immune system)

What are the three main modes of Transmission?

1. Contact (Transmitted via infected object or person)

   • Direct contact: transmission occurs between two hosts

   • Indirect contact: transmission occurs via infected object

2. Droplets (big infectous droplets come in contact with mucosa of host)

   • Sneezing, coughing, singing, and talking are causes of spread

3. Airborne (small infectous particles travel long distances in air and can linger)

   • Patients must be placed in private room with negative air pressure

What are vehicle and vector-borne transmissions?

1. Vehicle (transmission from contaminated items to multiple persons)

   • ex. contaminated food or water (E. Coli)

2. Vector-borne (transmission of infection via animals)

   • ex. rats and mosquitos

What are the 3 specific body defenses to fight off pathogens?

1. Physical and Chemical Barriers

   • Skin is the primary physical defense system (reduces loss of water, abrasion & micro-organism protection, permable barrier against environment)

   • Mucous membranes (protects delicate tissue, drying and cracking can lead to portal of entries)

2. Nonspecific Immunity:

   • WBCs: neutrophils and macrophages work as phagocytes (eat and destory microorganisms, released during inflammatory response)

3. Specific Immunity: work of Antibodies and lymphocytes

   • Bind to infectious agents and activate WBCs

What is the inflammatory response and it’s basic steps?

Body’s natural defense when body is injuried, foreign substances present, or when infectous agent attacks

Pathway:

1. Pattern receptors on cell surfaces recongize harmful stimuli

2. Inflammatory pathways activated

3. Inflammatory markers released

4. Inflammatory cells recruited

What are the inflammatory response triggers for infectous and noninfectous?

Infectous triggers:

• Viruses

• Bacteria

• Other micro-organisms

Noninfectous triggers:

• Physical: burns, frostbite, injuries, foreign bodies, trauma, radiation

• Chemical: glucose, fatty acids, toxins, alcohol, irritants

• Biological: Damaged cells

• Physiological: excitement

What are the stages of Infection?

1. Incubation, infection enters host and begins to multiply

2. Prodromal, Symptoms start to develop

3. Acute illness (invasive stage), manifestations specific to the disease develop

4. Decline, degree of infectious disease decreases, manifestations wane

5. Convalescence, client returns back to healthy state

Local vs systemic infections

Local infections: confined to one bodily area, can be treated with topical and oral antibiotics

Systemic Infections: start as local infections before spreading to bloodstream, infecting entire body

Medical Asepsis vs Surgical Asepsis

Medical Asepsis: efforts to REDUCE the number, growth, and spread of micro-organisms (Clean technique)

Surgical Asepsis: Usage of precise practices to ELIMINATE ALL micro-organisms from an object or area, prevents contamination at any cost (sterile techniques)

Standard Precautions vs Contact Precautions

Standard precautions: infection prevention practices applied to all clients whether or not they are known to have an infectious agent

Contact precautions: client has an infectous agent that can be transmitted directly or indirectly with body secretions, minimum of gown and gloves worn prior to interactions

What is cohorting?

Clients who require contact precautions should be placed in a private room (single client). If limited space, clients can be placed together in same rooms only with the same pathogens.

Droplet vs Airborne Precautions

Droplet Precautions: Nurse dons a surgical mask prior to entering private room and at least 3 feet of separation. clients leaving room must also wear surgicial mask (PPE: Gown, Gloves, Mask)

Airborne Precautions: Client is assigned to private negative pressure room. Nurse must wear an n-95 mask (PPE: Gown, Gloves, N-95 mask, Face shield)

What are the health care associated infections?

1. Central line-associated bloodstream infections

2. Catheter associated urinary tract infections

3. Surgical site infections

4. Ventilator assisted pneumonias

What is blood pressure and its expected range?

BP is the measurement of force/pressure of blood circulation in blood vessels. Expected range is less than both 120/ 80

What are the altercations of BP? Hypertension and Hypotension

Hypertension: high bp

Elevated: 129-120/ less than 80

Hypertension stage I: 130 to 139 / OR 80 to 89

Hypertension stage II: 140 to greater/ OR 90 to greater

Hypertensive Crisis: S greater than 180 and/or D greater than 120

Hypotension: low bp

Systolic pressure less than 90mm Hg or diastiolic pressure less than 60 mm Hg

Interventions for hypertension and hypotension

Hypertension: lifestyle interventions such as excerise, stress reduction, low sodium diet, weight loss. If needed, antihypertensive medications prescribed

Hypotension: Increase in fluids, place in upright position, change positions slowly, avoid extremes in temperature, stay well hydrated

What is the expected range for Pulse? Grading pulses?

Expected range is 60 to 100 bpm

Grading:

• 0 = pulse that is absent/nonpalpable

• +1 = pulse that is weak/diminished

• +2 = pulse that is normal

• +3 = pulse that is increased/strong

• +4 = pulse that is bounding

What are the Pulse Altercations?

Tachycardia: Pulse greater than 100 bpm

Causes: excerises, anxiety, certain medications, caffeine and nicotine, heart abnormalities

Bradycardia: Pulse less than 60 bpm

Causes: expected in athletes, cardiac abnormalitites, heart failure, heart muscle damage, hypothyroidism

What is the expected range for body temperature? Altercations?

Expected body temperature is in between 36 to 38 Celcius, (96.8 F and 100.4 F) average temp is 37 Celcius (98.6 F)

Hyperthermia: Body temp above 38 Celcius (100.4 F)

• commonly caused by infections

• symptoms: flushed face, diaphoresis, hot skin, tachycardia, increases respiratory rate

Treatments:

• drink cool fluids and remove excess clothing

• Medications: antipyredtics to reduce fever or antibiotics when infection is present

• Place client in cooler environment

Expected rate for Respiration? Altercations?

Expected range: 12 to 20 breaths a minute

Tachypnea: Greater than 20 breaths a minute

• Physical activity, anxiety, pain, Health conditions (asthma)

Symptoms:

• Dizziness, Tingling in hands

Bradypnea: less than 12 breaths a minute

• health conditions, medications: opioids, sedatives

Symptoms:

• Dizziness, fatigue, weakness, confusion, impaired coordination

What is Oxygen Saturation? Expected Range? Altercations?

Amount of oxygen bound to hemoglobin, direct reflection of a client’s respiratory status

• Expected reference range is 95% to 100%

Altercations: Less than 95%

• Caused by health conditions (ex. pneumonia, chronic lung disease, pulmonary edema, poor cardiac output)

• Symptoms: Decrease in mental alertness, confusion