Infections and Isolation Precautions in the Healthcare Setting

Infection

The invasion and multiplication of microorganisms in the body tissues which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen antibody response

Acute

Resolving in a few days or weeks

Chronic

Infection that lasts longer than 12 weeks and in some cases, is incurable

Localized

Limited to specific body area

Disseminated

Spread of infection from one site to another

Systemic

Infection that affects the whole body

Medical (Clean)

Reduction of the number of disease causing agents and their spread

Surgical (Sterile)

Complete elimination of the disease causing agents and their spores from the surface of an object

Incubation

The interval between the pathogen’s invasion of the body and the appearance of symptoms of infection. Organism is growing ad multiplying

Prodromal Stage

Most infectious during this stage. Early S&S are present but vague like fatigue, malaise, low grade fever

Acute

Presence of infection specific S&S

Convalescent

Recovery from the infection, S&S start to disappear

Lactate

A byproduct of anaerobic metabolism. When the body’s cells are not getting enough oxygen, they switch from aerobic to anaerobic and produce lactic acid

Elevated Serum Lactate is an indicator of

Tissue hypoxia, poor perfusion, severe infection or sepsis, shock states

Cultures….

should be obtained before any antibiotic therapy is initiated

Antipyretics

Acetaminophen and ibuprofen help reduce fever and discomfort

Contact Precautions

Gloves and gown to be worn by caregivers and visitors, private room or room with other patients who have the same infection. HH at all times.

Help protect against Cdiff, impetigo, scabies, MRSA

Droplet precautions

Protect against droplets larger than 5 micrometers and travel 3 to 6 feet. Require private room or room with other clients who have the same disease. Own equipment, masks.

Protect against flu, scarlet fever, pneumonia, pharyngitis

AIrborne Precautions

Protect against droplet infections smaller than 5 micrometers. PRivate room, masks and respiratory devices.

Protect against varicella, measles, TB

Medication Resistant Infection Nursing Actions…

Obtain specimens for culture and sensitivity prior to initiation of antimicrobial therapy

SIRS

A nonspecific inflammatory state that can result from infection or non infectious causes

Sepsis

Life threatening organ dysfunction caused by a dysregulated host response to infection

Known infection and organ dysfunction

Septic Shock

A subset of sepsis where underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality.

Profound tissue hypoperfusion and high risk of death

Systemic Inflammatory Response Syndrome (SIRS)

Potentially life threatening complication that can lead to widespread inflammation, blood clotting, organ failure, and shock.

S&S: Tachycardia, hypotension, tachypnea, elevated WBC, elevated lactate

Septic Shock

Exotoxins released during bacterial growth and endotoxins released during bacterial death damage host cells and start inflammatory response

Increased cap permeability and vasodilation cause hypoperfusion. Cytokines released during inflammatory response that activate the coagulation system

Septic Shock S&S

FLUIDS SHIFT FROM INTRAVASCULAR TO EXTRAVASCULAR SPACE, hypovolemia causes tachycardia and hypotension. CNS compensates for hypotention with constricting and stops blood from non essential organs. Acute systemic hypoperfusion leads to increased heart rate and cardiac contractility

Renal system compensates with vasodilation by hypoperfusion causes oliguria (reduced urine output)

Respiratory system compensates by increasing RR. Decreased cardiac output causes fluid accumulation and edema.

End result can lead to seizures, stupor, and coma