2A03 final review

bacteria is classified according to

shape and divisional grouping

cocci

round bacteria

bacillus

rod-shaped bacteria

spirillia

spiral

what form does fungi exist in

yeasts(unicellular) and moulds(multicellular)

viruses are

minute microorganisms

virus genetic mater is either

DNA or RNA never both

virus genetic material is protected by

outer protein coat

parasites are

organisms that exist on or in another organism

large number of parasites that can produce disease are classified as

protozoa and helminths

protozoa

complex one celled micoorganisms and move by action of cilia

helminths

parasitic worms that can live int eh human intestinal tract

what is the chain of infection

germs, where germs live, how germs get out, germs get around, how germs get in, next sick person

what are the 2 modes of transmission according to the chain of infection

contact and droplets

break the chain of infection with

proper handwashing, PPE, cleaning/disinfecting. eliminating the risk

nosocomial infections

infects acquired in the course of medical care

endogenous nosocomial infection

When a person acquires an infection in health care \n setting as result of an overgrowth of normal flora ( caused by microorganisms of the patient's microflora)

exogenous nosocomial infections

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Infection caused by microorganisms that are not \n normal flora (from the patients environment)

external factors that increase risk of nosocomial infections

* environment
* equipment
* contamination
* therapeutic regimen

patient related factors that increase risk of nosocomial infections

* age
* heredity
* nutrition
* stress/lifestyle
* health history
* inadequate defenses

universal precautions (standard precautions)

set of strategies developed to prevent the transmission of blood borne pathogens and select bodily fluids

routine practices major components

risk assessment, hand hygiene, PPE, environmental, administrative controls

4 moments for hand hygiene

before initial patient contact, before aseptic procedure, after body fluid exposure risk, after patient contact0

barrier

protects hospital workers and other patients from contagious microorganisms

reverse barrier

protects patient from microorganisms of other patients and hospital workers

airborne precautions

private room, mask (TB- particulate mask, N95), surgical mask on patient when transporting

droplet precautions

private room, surgical mask for any procedure less than 3 feet of patient

medical asepsis

microorganisms have been eliminated as much as possible through soap, water, friction and various chemical disinfectants

surgical asepsis

microorganisms and their spores have been completely destroyed by means of heat or chemical process

common methods of sterilization

steam under pressure, chemical sterilization, ethylene oxide

steam under pressure

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Items are double wrapped and placed \n in an autoclave.

chemical sterilization

Referred to as low temperature \n sterilization. An antimicrobial and sporicidal agent is used

ethylene oxide

used for items that can not withstand moisture and high temperatures

purpose of surgical scrub

remove as many microorganisms as possible from the skin of the hands and lower arms by mechanical and chemical means and running water before a sterile procedure commences

sterile

free from all live bacteria or other microorganisms and their spores

pharmacology

study of drugs

drugs are

chemical substances not normally required for bodily function

all drugs produce

biologic effect in an organism

pharmacokinetics

what the body does to a drug

pharmacodynamics

the actions of drugs on the body

process of pharmoacokinetics

absorption, distribution, metabolism, elimination

absorption depends on

pH, surface area, blood flow, route of administration

bioavailability

the amount of drug that actually reaches the systemic circulation

first pass effect

partial metabolism of drug before it reaches systemic \n circulation, larger oral doses

oral drug route through the body (first pass)

stomach, small intestine, mesenteric vascular system, portal vein, liver, systemic circulation

metabolism

The process by which the body alters the chemical structure of the drug, mostly done in the liver

elimination

the process of removing a drug and its metabolites from the body, primarily through the kidneys

routes of drug administration

enteral, parenteral, topical

enteral routes

buccal, sublingual, oral, rectal

buccal and sublingual enteral routes

absorbed immediately by oral mucosa

oral route

most efficient and cost effective method, when slower absorption and longer duration desired

rectal route

to avoid nausea/vomiting and first pass effect, difficult to achieve correct dosage as absorption rate may be erratic

topical routes

for local treatments of skin ailments and systemic treatments

pulmonary route

administer drugs in form of gases or aerosols, lungs have large capillary network to absorb drugs

parenteral routes

* must be done using a sterile/surgical technique
* intramuscular (IM)
* subcutaneous (SC)
* Intradermal
* intravenous (IV)

intradermal parenteral route

very small doses, used for testing sensitivity to a drug or an antigen, or local anesthesia

subcutaneous parenteral route

small doses, very rapid absorption through capillaries

intramuscular parenteral route

Absorption rate varies – depends on blood flow to muscle

intravenous injection parenteral route

most rapid systemic response as there are no barriers to absorption, also most hazardous due to immediate response rate

drugs may be classified according to

* Physiologic effect on receptors
* Physiologic effects on specific body systems
* Overall physiologic effects

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ionic contrast

high osmolar contrast media

nonionic contrast

low-osmolar contrast media

\-fewer and less sever reactions

osmolarity

the volume of the compound

omsolality

the weight of the ion

vasovagal response

when the patient experiences high anxiety concerning the procedure and results. This type of reaction is to the procedure itself rather than the contrast media

side effect

When an unintended effect is expected to occur and is essentially not harmful

toxic reaction

Unwanted effect that is not an adverse reaction or an allergic reaction

MSI

musculoskeletal injury

regulator valves on oxygen tanks

One valve shows what is left in tank and the other measures rate of oxygen flow through the tubing

corrugated air tube

larger diameter than regular tubing, condensation builds up inside

nasal cannula

short and long term use, low flow system, flow rate should not exceed 4L/min

simple mask

low flow system, tight to face, flowmeter should be set to deliver 6-10L/min

non rebreathing mask

high flow system, flow rate of 10-15L/min

venturi mask

mixes oxygen with room air, high flow system

humidifier/aerosol masks

Oxygen humidified when possible- on wards, longer ER stay, high flow system

ventolin administration

pyrexia

fever

hypothermia

below normal body temperature

tachycardia

pulse more than 100

bradycardia

pulse less than 60

carotid pulse

palpate just below angle of mandible using light pressure

radial pulse

Using index and middle finger, lightly press on radial artery and count # of pulses per minute

pulse oximeter

Used to measure oxygen saturation of hemoglobin, normal values are 95-100%

respiration

the rhythmic rise and fall of the chest in response to one inspiration and one expiration

cyanosis

will result with less than 10 breaths in a minute

blood pressure

pressure of the blood as it moves through the arteries, mmHg, systolic pressure over the diastolic pressure, healthy is typically 120/80 mmHg

systolic pressure

pressure of the blood as a result of contraction of the ventricles, that is, the pressure of the height of the blood wave.

diastolic pressure

pressure when the ventricles are at rest. Diastolic pressure, then, is the lower pressure, present at all times within the arteries

pulse pressure

difference between diastolic and systolic pressures

blood flow

volume of blood that moves through a level of the vascular system per minute

resistance

anything that opposes or impedes blood flow

competing

assertive and uncooperative

* does whatever to get their way
* best for urgent situations

collaborating

assertive and cooperative

* works with the other party and tries to find an outcome that works for themselves and the other person
* takes time and effort

compromising

assertive and cooperative

* quick outcome that partially satisfies both sides
* when urgent

avoiding

unassertive and uncooperative

* when issue is unimportant or more trouble than its worth

accommodating

unassertive and cooperative

* neglects themself to satisfy others

peripheral arterial line (PAL)

* ”art line”
* Used for acute measurement of blood pressure or regular blood monitoring

peripheral intravenous lines (PIV)

small flexible catheter inserted into the vein

* for administering fluids and/or necessary medications

central venous catheters (CVC) or central lines

Deliver:

* long-term medication •
* frequent blood transfusions
* • total parenteral nutrition (TPN) •
* Fluids that may cause damage to the intima of peripheral veins
* inserted into large peripheral vein to SVC just above the right atrium

peripherally inserted central catheter (PICC)

* can have 1-3 lumens and can be power rated
* from antecubital insertion point