2nd Semester Nursing Exam 1

The presence and growth of organism in a host. This does not cause tissue invasion or damage.

Colonization

This is the invasion of a susceptible host by pathogens or microorganisms, resulting in disease. This can only result if the pathogen multiply and alter normal tissue function.

Infection

This can be directly transmited from one person to another. Can either be symptomatic or asymptomatic.

A communicable disease

What type of transmission is this?

Person to person

Ex. Droplet- coughing, sneezing, talking

Direct contact

What type of transmission is this?

Contact with vehicle of transmission

Airborne, vector borne, and vehicle borne

Indirect contact

What indirect contact is this?

insects transmits disease

Ex. mosquitos transmitting malaria, tics transmits lyme disease

Vector borne

What indirect contact is this?

Inanimate objects that transmit a causative agent (fomite)

Ex. contaminated medical equipment

Vehicle borne

What portal of entry would this affect?

Cellulitis, Herpes, and conjuctivitis (pink eye), MRSA

Skin and mucous membranes

What portal of entry would this affect?

Flu, pneumonia, COVID-19 and TB

Respiratory tract

What portal of entry would this affect?

UTI, Cather-associated UTI

Urinary tract

What portal of entry would this affect?

C.Diff, Norovirus (food poisioning)

GI tract

What portal of entry would this affect?

Chlamydia, Syphilis, Gonorrhea, HPV

Reproductive tract

What portal of entry would this affect?

HIV, Hepatitis A & B, Sepsis, Malaria

Blood

This is residential organisms that resist infection by releasing antibacterial substances and inhibiting multiplication of pathogenic microorganisms. Ex. GI tract

Normal Flora

What specific Immunity is this?

Response to an infection

Natural- from a disease

Artificial- From an immunization

Active (long lasting)

What specific immunity is this?

Receives antibodies

Natural- breast feeding at birth

Artificial- Injection of human globulin antibodies developed in another person or animal

Passive (temporary)

What stage of the infectious process is this?

Exposed to something, will not get sick instantly

Incubation period

What stage of the infectious process is this?

Starting to feel bad but no specific symptoms occur, disease starting taking its toll

Prodromal stage

What stage of the infectious process is this?

Specific signs and symptoms start to occur

Illness stage

What stage of the infectious process is this?

Recovery stage

Convalescence

What type of infection is this?

Pain, redness, edema, loss of functions

Local infection

What type of infection is this?

Vascular symptoms, skin symptoms, headache, muscle aches, fever, anorexia

Systemic infection

What type of HAI (Health Care-Associated Infection) infection is this?

This come from procedures

Iatrogenic

What type of HAI (Health Care-Associated Infection) infection is this?

From microorganisms outside the individual. Ex. environment, healthcare workers, contaminated equipment

Exogenous

What type of HAI (Health Care-Associated Infection) infection is this?

When the patients flora becomes altered and an overgrowth results. Things that are already inside the patient.

Endogenous

A systemic inflammatory response resulting from the body’s response to a serious infection that has spread to the blood, usually bacterial.

Sepsis

What are the nursing interventions for Sepsis?

Blood cultures, Urine output, Fluids, antibiotics, lactate, oxygen (BUFALO)

The inadequate delivery of oxygen and nutrient to support vital organs and cellular function, results in impaired tissue perfusion.

Shock

What change in vital signs indicates a patient in shock?

Tachycardia and hypotension; also poor tissue perfusion

What stage of shock is this?

Restlessness, agitation; increased heart rate, cool and pale skin

Initial stage

What stage of shock is this?

Decreased cardiac output; decreased cerebral perfusion, confusion, decreased urinary output

Systolic BP is under 100mm

Compensatory

What stage of shock is this?

Edema; dysrhythmia

Decreased BP- weak and thready pulse

Progressive

What stage of shock is this?

Profound hypotension; slowed pulse

Prevent Multisystem organ dysfunction syndrome

Refractory/ irreversible stage

What happens to the pulse and blood pressure during shock?

The BP decreases and pulse becomes weaker and weaker

What vaccine is this?

Injection

Assess for allergy to eggs. Do not administer if previous reaction

Anual if >6mos; may take if pregnant

May cause soreness at the site; may take acetaminophen or ibuprofen

Season flu vaccine

What vaccine is this?

Injection; best preventative treatment

Children <5 and adults >50

Two different types recommended to adults; 13-valent and 23-valent

Pneumococal vaccine

What vaccine is this?

Injection

Assess for allergy to gelatin or neromycin

Do not give if patient is pregnant

Transmitted through air (sneezing or coughing)

Vericella vaccine (Chicken Pox)

What vaccine is this?

Reduces the risk of developing shingles

Recommended for healthy adults 50 years and older

do not give to client who are immunocompromised

Zoster vaccine

A process that eliminates many or microorganisms, with the exception of bacterial spores, from inanimate objects

Disinfection

The complete elimination or destruction of all microorganisms including spores

Ex. Steam under pressure, Ethylene oxide gas, and other chemicals

Sterilization

What is the 5 moments for hand hygiene?

Before patient contact, before a clean/aseptic procedure, after body fluid exposure risk, after patient contact, after contact with patient surroundings.

What type of precautions are suggested for use when dealing with all patients?

Standard precautions

What must a patient have for them to be placed in another patients room for transmission based precautions?

Both patients must have the SAME organisms to share the room. Ex would be both patients have a MRSA wound infection

What type of isolation is this?

Skin to skin and physcial transfer of microorganisms

Private room if possible; door can remain open

Gloves at all times, gowns for close contact, limit transports

Sign is green

Contact precautions

What type of isolation is this?

Disease such as Pertussis, Influenza B, Meningitis, and Pneumonia; PIMP

Do not remain suspended, Generally do NOT travel beyond 3 FEET

Private room; negative air flow is not necessary, Must wear surgical mask if caring within 3 feet of patient

Limit transportation and put surgical mask on patient when outside of room

Wear gloves and surgical mask; sign is yellow

Droplet precautions

What type of isolation is this?

Disease such as TB, Measles, and Varicella

Contamination can remain dispersed in air, and may be deposited over longer distances over 3 feet

Needs private room with Negative airflow, door closed, and must wear N95 or HEPA respirator when around patient

Transport only when necesary; place surgical mask on patient

Nurse wears, N95 and gloves; sign is purple

Airborne precautions

What type of isolation is this?

Sign mostly used for C-DIFF; brown sign

Skin to skin and physical transfer of microorganisms

Private room if possible and door can be open

Nurse wears gloves, and gown

Limit transfer of patient

Hand washing with soap and water MUST be done; DO NOT USE HAND GEL

Extended contact precautions

How can Clostridium Difficile (C-DIFF) be treated?

It is treated with FLAGYL or VANC

What type of isolation is this?

Sign is orange and nurse would wear gown, mask, and gloves

Modified precautions

A substance that destroys or inhibits the growth of other microorganisms.

antibiotics

What antibiotic is this?

EX. Amoxicillin-Glavulanic Acid, Ampicillin, Penecillin V or G, Pipercillin/tazobactam, Ampicillin/sulbactam

Used for:

Pneumonia or meningitis, Endocarditis, and GYN infection

Effective against variety of bacteria; Low toxicity, weakens bacteria cell wall

Most common cause of allergy is rash and anaphylaxis

Penicilllin

What causes these signs and symptoms?

Increased HR, Decreased BP, Shock, bronchospasms, swellings and rash

Anaphylaxis

What antibiotic is this?

EX. Cefazolin (Ancef), Cephalexin (Keflex), Ceftriaxone (Rocephin)

May cause GI nausea, diarrhea, increased glucose values, anaphylaxis, nephrotoxicity, thrombocytopenia

Uses:

Urinary infection, Post op infections, Prophylaxis

Do not use if Penicillin allergy; this med is cousins with penicillin

Monitor for superinfection; take on empty stomach

Cephalosporin

What antibiotic is this?

Can use if allergic to penicillin and cephalosporin

EX. Erythromycin (E-mycin), Azithromycin (Zithromax)

Uses:

Legionnaire’s disease, Pertussis (whooping cough), H, Pylori

Use if client has PCN allergy

Can cause GI disturbance, IV site irritation, Reduce activities of med if given fruit juice, liver tests are needed

Macrolide

What antibiotic is this?

Ex. Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim), Co-trimaxozole (Septra)

Uses:

UTI caused by e.coli and PCP (Pneumonia related to impaired immune systems

Encourage fluids (2-3L/day), causes phototoxicity, monitor for steven johnson syndrome

Avoid alcohol- risk for disulfuriam

Can cause; rash, renal toxicity, fever, sore throat, bleeding, fluids galore, anorexia, anemia

Sulfonamides

What antibiotic is this?

EX. Tetracycline hydrochloride (Sumycin), Doxycycline (Vibramycin)

Uses:

Sever acne, lyme disease; rickettsia, Anthrax, STI

DO NOT give during pregnancy or young (Stains teeth)

Can cause sunlight sensitivity, take with full glass of water, avoid antacid iron and milk, put drug on an empyt stomach

Tetracycline

What antibiotic is this?

EX. Ciprofloxacin, Ofloxacin, Levofloxacin

Uses:

Urinary, respiratory, GI, Bone/joint, skin/soft tissue-anthrax, and tendon ruptures

Implementations:

Can cause tingling, dizziness, weakness, psychosis; caution with seizure disorder

Can cause tendon ruptures, joint swelling, prolonged QT interval, chest pain, tachycardia, shortness of breath

Fluoroquinolones

What antibiotic is this?

Gentamicin, Tobramycin sulfate, Neomycin

Uses:

Serious infections, GI pre-op

Can cause neuromuscular blockade, tinnitus

Monitor BUN/CR and PEAK and TROUGH

Can cause NEURO, OTO, NEPHRO side affects/toxicity

Like toxic MICE

Aminoglycosides

What antibiotic is this?

EX. Vancomycin

Uses:

Serious infection (MRSA), Pseudomembranous colitis (caused by C.DIFF)

Causes ototoxicity, Nephrotoxicity (monitor BUN/CR), Red man syndrome, Caution with renal failure patients

Monitor peak and trough levels and Red man syndrome will have red neck, hypotension

Glycopeptide

Highest serum concentraction after the dose has been infused

Testing for toxicity, drawn after the end of infusion

If too high, decrease dose and if too lose increase dose

Dosing

Peak

Lowest serum concentration before the next dose; drawn as close to the next dose as possible

If too high, interval needs to be prolonged and if too low drug therapy is inadequate

Timing

Trough

What kind of med is this?

Ex. Miconazole, Clotrimazole, Fluconazole, Ketoconazole, Nystatin

Uses:

Candidiasis, Ringworm, Yest in skin folds, Athlete’s foot, thrush

Contraindicated in pregnancy, take with food to decrease GI upset

Antifungals

What antifungal is this?

Ex. Amphotericin B

Uses:

Systemic fungal infections

Can cause heart irregularities, Nephrotoxicity, Hypokalemia, and Thrombocytopenia

Amphotericin (Amphoterrible)

What kind of med is this?

Ex. Acyclovir, Valacyclovir, Zidovudine

Uses:

Herpes Simplex I and II, HIV

Can cause nephrotoxicity and thrombocytopenia

Antiviral Meds

The ability of a microorganism, previously sensitive to an antibiotic, to withstand the effects of that drug

Can occur gradually or suddenly

Resistance

What are the treatments for VRE (Vancomycin Resistant Enterococci)

Linezolid (Zyvox)

What agent of bioterrorism is this?

Highest priority/threat to security

Smallpox; botulism; anthrax; ebola

Category A

What agent of bioterrorism is this?

Typhus fever; west nile virus

Category B

What agent of bioterrorism is this?

Influenza Virus; Tuberculosis; Rabies Virus

Category C

How do we DON PPE?

1. Gown

2. Mask

3. Goggles

4. Gloves

How do we DOFF PPE?

1. Gloves

2. Goggles

3. Gown

4. Mask

What precaution is this?

Red Sign

Nurse would wear gown, N95, face shield, goggles, and gloves

This was really used for just COVID

Extended droplet and contact precautions