Nursing Fundamentals Chapter 16

A(n) ____ is the entry of an infectious agent, a microorganism, into the body that multiplies and causes tissue damage.

Infection

Infection

Left untreated, a(n) \____ may result in illness and disease.

Microorganisms capable of causing disease are called \____.

Pathogens

Non-pathogenic organism that are prevalent on and off the body are called

Normal flora

\___ are single-cell microorganisms lacking a nucleus that reproduce from every few minutes up to several weeks.

Bacteria

\____ are classified according to their need for oxygen, their shape, and their Gram-staining properties.

Bacteria

\____ bacteria need oxygen to grow and thrive.

Aerobic

anaerobic

\____ bacteria grow only when oxygen is not present.

positive

Those bacteria retaining the stain are gram \_____.

negative

Those bacteria losing the stain and taking up the counter stain are gram \____.

cocci

Round shaped bacteria.

bacilli

Rod shaped bacteria.

spirochetes

Spiral shaped bacteria.

culture

Final identification involves chemical testing of the bacteria by performing a \____.

antibiotic

Sensitivity tests are then performed to determine which \_____ is most effective against the bacteria.

MRSA, VRE, ESBL, C. diff

List the four most common multidrug-resistant organisms.

streptococcus pneumoniae

Another example of a drug resistant organism is penicillin-resistant \_____ which causes a form of pneumonia that can be difficult to treat.

antimicrobial

Patients must be educated about the correct use and possible misuse of \____ agents.

prions

\____ are protein particles that lack nucleic acids and are not inactivated by usual methods for destroying bacteria or viruses. They do not trigger an immune response, but cause degenerative neurologic disease such as variant Creutzfeldt-Jakob disease.

viruses

\_____ are extremely small and can be seen only with an electron microscope. They are composed of particles of nucleic acids, either DNA or RNA, with a protein coat and sometimes a membranous envelope.

True

Viruses can grow and replicate only within a living cell.

False

Virus' survival and multiplication is not necessarily dependent upon host tissue.

protozoa

\____ are one-celled microscopic organisms belonging to the animal kingdom. Some examples are plasmodium (causes malaria), entamoeba histolytica (causes dynsentery), and other strains capable of causing diarrhea.

rickettsia

\____ are small round or rod-shaped microorganisms that are transmitted by the bites of lice, ticks, fleas, and mites that act as VECTORS. Example: Rocky Mountain spotted fever and typhus.

True

Rickettsia multiply only in host cells.

fungi

\____ are tiny, primitive organisms of the plant kingdom that contain no chlorophyll. Examples include yeasts and molds. They feed on living plant, animals, and decaying organic material.

false (by means of spores)

Fungi reproduce by means of photosynthesis.

helminths

\____ are parasitic worms or flukes belonging to the animal kingdom. Pinworms, which mostly affect children, are the most common helminths worldwide. Roundworms and tapeworms are examples.

mycoplasmas

\____ are very small organisms without a cell wall. They cause infections of the respiratory or genital tract.

chlamydia

\____, another type of organism, affects the genitourinary and reproductive tracts and has become more common in the past 20 years.

continuous chain

The process by which an infection is spread from one person to another can be thought of as a \____ \____.

causative agent

A \____ \____ is any microorganism or biologic agent capable of causing disease. These include bacteria, viruses, protozoa, prions, rickettsia, fungi, and helminths.

virulence

Characteristics that affect \____ are ability to (1) adhere to mucosal surfaces or cell walls, (2) penetrate mucous membranes, (3) multiply in the body, (4) secrete harmful enzymes or toxins, (5) resist phagocytosis, and (6) bind with iron.

phagocytosis

The destruction of white blood cells.

lungs

The \____ can be a reservoir. (A specific organ)

reservoirs

\____ are places where microorganisms are found. Examples: infected wounds, human or animal waste, animals and insects, contaminated food and water, or a person with an infection.

sterile

Using \____ technique is another effective method. It is used to insert and indwelling urinary catheter to help prevent the transfer of normal flora from the skin and mucous membranes into the sterile bladder, where it could cause an infection.

hand hygiene

Good \___ \____ is one of the most effective ways to prevent the spread of microorganisms.

portal of exit

The \____ __ \____ is the route by which a pathogen leaves the body of its host. Examples are the GI tract, the respiratory tract, skin, and mucous membranes.

modes of transfer

\____ __ \____ of pathogens include (1) direct personal contact with body excretions or drainage such as from an infected wound; (2) indirect contact with contaminated inanimate objects; (3) vectors such as fleas, ticks, mosquitoes, and other insects that harbor infectious agents and transmit infection to humans through bites and stings; (4) droplet infection, (5) spread of infection from one part of the body to another.

fomites

Contaminated inanimate objects such as needles, drinking and eating utensils, dressings, and hospital equipment.

pathogens

\____ can enter the body through the mucous membranes of the eyes, nose, mouth, trachea, or skin.

sterile and clean

Using only \____ __ \____ items when caring for patients reduces the entry of pathogens. Barrier precautions, safe handling of food and water, good personal hygiene, avoidance of high-risk behaviors, and protection from insect bites and stings can prevent entry of microorganisms.

host

A human \____ may be susceptible by virtue of age, state of health, or broken skin. Measures are used to prevent exposure to infectious agents and to improve a person's health by teaching good health and hygiene habits. Immunization to help protect against influenza or pneumococcal pneumonia is another means of decreasing susceptibility.

Poor nutrition, inadequate hygiene, impaired mobility, chronic illness, physiological changes

List 5 factors that increase the risk of disease in the elderly.

first line of defense

Intact skin serves as a \____ \____ __ \____ against harmful environmental agents.

lysozyme

Secretions from the mucous membranes lining the respiratory, gastrointestinal, and reproductive tracts contain an abundance of the enzyme \_____, which is bactericidal.

Respiratory function

\____ \____ is the area in which elderly susceptibility to infection is encouraged by coughing.

urinary tract

\___ \____ is the area in which elderly susceptibility to infection is fluid intake encouraged to keep urine dilute.

cilia

These hair-like objects line the respiratory tract.

Kupffer

The \____ cells in the liver destroy bacteria that enter the portal liver circulation.

gastric secretions

\____ \____ such as hydrochloric acid destroy ingested pathogens.

second line of defense

The body's \____ \_____ __ \____ helps destroy pathogens that escape the first line of defense. This includes the mechanisms of fever, leukocytosis, phagocytosis, inflammation, and the action of interferon (biologic response modifier that affects cellular growth).

leukocytes

\____, which are WBCs, are released in response to microorganisms, particularly bacteria, entering the body.

phagocytes

Located in the lymphatic tissue, the alveoli of the lungs, the gastrointestinal system, the spleen, and the liver, \____ work to destroy or stop their invasion.

tissue macrophages

Some phagocytes are called \____ \___; others, which are concerned with immunity, are the lymphocytic cells.

phagocytosis

\____ is part of the inflammatory response, another defense mechanism of the body.

monocytes, monocyte

A large increase in the percentage of \_____ often indicates a bacterial infection. If the neutrophil count is decreased on the differential WBC count, while the \_____ count and lymphocyte counts are elevated, the cause of infection is probably viral.

interferons

These stimulate antiviral proteins that prevent replication of viruses.

inflammation

\____ is a localized protective response brought on by injury or destruction of tissues.

neutralize and destroy harmful agents, limit their spread to other tissues in the body, and prepare the damaged tissues for repair

List the three basic purposes of the inflammatory responses.

third line of defense

The immune response is the \_____ \____ __ \____ against pathogenic organisms.

passive

\____ acquired immunity occurs when a person is given an antitoxin or antiserum that contains antibodies or antitoxins that have been developed in another person.

naturally

\____ acquired passive immunity occurs when the fetus receives antibodies from the mother through placental blood before birth and can be acquired through breastfeeding an infant.

artificially

\____ acquired immunity is achieved through injection of vaccines or immunizing substances that contain dead or inactive microorganisms or their toxins. Examples: vaccines against polio, measles, hepatitis B, influenza, tetanus, and diphtheria.

artificially...passive

\____ acquired \____ immunity is provided by injection with antibodies derived from the infected blood of people or animals.

asepsis

\____ is the practice of making the environment and objects free of microorganisms.

medical asepsis

The practice of reducing the number of organisms present or reducing the risk for transmission of organisms. It prevents infection of the patient and the spread of infection from person to person.

clean technique

Medical asepsis is referred to as \___ \____ because most, but not all, microorganisms are destroyed. This is confined to the patient's room.

surgical asepsis

\____ \____ is the practice of preparing and handling materials in a way that prevents the patient's exposure to living microorganisms.

sterile technique

Surgical asepsis is referred to as \____ \____. It involves sterilization of all instruments and inanimate equipment as well as sterile supplies. Most microorganisms are destroyed in this process.

hand hygiene

\____ \___ is one of the most effective ways to reduce the number of microorganisms on the hands, thereby preventing the transfer of microorganisms from one object to another or from person to person by the nurse.

gloves

\____ should be used to prevent contact with any blood or body fluids.

health care workers

\____ \____ \____ must perform hand hygiene before and after giving care to a patient.

visibly soiled

When hands are \____ \___, the CDC recommends wetting the hands; adding soap, performing at least 15 seconds of vigorous rubbing to aid in spreading the soap over the hands, fingers, and wrists; rinsing the hands under warm running water; and drying the hands thoroughly.

True

You should not wear jewelry when you are providing patient care.

spores

If in contact with \____ (C. diff, Candida albicans, or Bacillus anthracis), wash hands with soap and water. This is because alcohols, chlorhexidine products, iodophors, and other antiseptic agents have poor activity against them.

Standard precautions

What has the CDC developed to facilitate breaking the chain of infection?

Hand hygiene

Gloves

Mask or eye protection

Gown

Patient care equipment

Occupational health and blood borne pathogens

What are the CDC standard precaution guidelines ?

Patient placement

The nurse and the patient

Who do standard precautions protect ?

Hand hygiene and PPE

What two main standard precautions that are to be used for every patient contact ?

Gown

*Wear a \________ that is impermeable to water and other fluids when there is a chance of being splashed with blood, body fluid, or other potentially infectious materials, or when these fluids may be aerosolized. Remove after use.

Surgical face mask

What do you apply before entering the room if there is a chance that you will be in contact with airborne pathogens larger than 5 microns such as influenza or meningitis?

False

There are several styles

True or false

There are only a few styles of regular and respirator masks.

N95 respirator mask

What do you wear when entering an area airborne microorganism sleds than 5 microns in size such as tb?

Elastic bands or ties

*When removing makes what is the only part of the mask you can handle ? Discard after use and do not leaving them hanging around or in pocket

Protective eyewear such as goggles, face shield, or glasses with side and top pieces

What do you wear to prevent fluid from entering the eye area and coming in contact with the mucosa or surface of the eye through splattering or aerosolization ?

Eyewear

* Wear \_____________ for performing oral, nasotracheal, or endotracheal suctioning( unless a closed system is used ) for performing wound irritations.

Cap or head cover

What do you place on the head if there is danger of contamination of the hair or if microorganism a resident in the hair might endanger the patient?

Shoe covers

What are used so that pathogens are not carried out of the rooms be are removed when exiting the room in the same manner as a head cover?

Gloves

What reduces the possibility of transmission of microorganism a between the nurse and the patient ?

Hand hygiene

What should you preform before gloving and immediately after removing the gloves because no glove is a 100% effective ?