chapter 26

Normal Flora
- Definition: Microorganisms that live in or on the body but do not cause disease.
- Function: Inhibit pathogenic microorganisms from colonizing healthy individuals.
Inflammatory Response
- Definition: Local response to cellular injury or infection.
- Protective Mechanisms:
- Dilation: Blood vessels widen to increase blood flow.
- Infiltration: White blood cells move to the site of infection.
- Increase in Temperature: Aids in neutralizing, controlling, and eliminating invading pathogens.

Immune Response
- Innate Immunity
- Definition: Provides immediate defense against foreign antigens.
- Adaptive Immunity
- Definition: Provides long-term immunity when the body is exposed to an antigen.
- Types:
  - Humoral Immunity
  - Cellular Immunity
  - Immunologic Memory

Other Body Systems
- Skin: Acts as a barrier that is impermeable to most infectious microorganisms.
- Respiratory System: Contains cilia and mucus that trap foreign bodies, decreasing the risk for infection.
- Gastrointestinal System: The flora and low pH prevent the colonization of pathogenic microorganisms.

Chain of Infection
- Infectious Agents: Pathogens, including bacteria, viruses, fungi, parasites.
- Source of Infection: Reservoir or host.
- Portal of Exit: Route by which an infectious organism leaves its host.
- Mode of Transmission:
- Types:
  - Contact
  - Airborne
  - Vehicle
  - Droplet
  - Vector-borne
- Portal of Entry: Route through which the pathogen enters the host.
- Susceptible Host: Individual likely to contract the infection.

Susceptible Host
- Characteristics:
- Immunosuppressed
- Trauma
- Surgery
- Chronically ill
- Elderly
Portal of Entry
- Routes include:
- GI tract
- GU tract
- Non-intact skin
- Respiratory tract
- Mucous membranes
Infectious Agent
- Types include:
- Bacterium
- Virus
- Parasite
- Fungus
Mode of Transmission
- Types:
- Contact
- Airborne
- Vehicle
- Droplet
- Vector-borne
Source
- Examples:
- Animal or insect
- Inanimate object
- Human being
Portal of Exit
- Common ports include:
- Respiratory tract
- GI tract
- GU tract
- Blood
- Skin/mucosal surfaces

Health Care–Associated Infections (HAIs)
- Definition: Infections acquired in a health care facility.
- Impact: Leads to prolonged recovery, disability, and increased costs.
Drug Resistant Organisms
- Factors contributing to resistance:
- Overprescribing antibiotics for nonbacterial infections.
- Use of inappropriate antibiotics for the infecting microorganism.
- Incomplete courses of antibiotics.

Blood-borne Pathogens
- Key pathogens include:
- Hepatitis B
- Hepatitis C
- HIV
Signs and Symptoms of Infection
- Types:
- Localized symptoms
- Systemic symptoms

Health History
- Assessment of:
- Effects of infection on the body’s defense system
- Acute and chronic infection presence
- Symptoms
- Vital signs
- Nutritional status
- Risk assessment
- Laboratory and diagnostic tests

Examples
- Risk for Infection
- Supporting Data:
  - Surgical break in skin integrity.
  - Chronic disease such as diabetes mellitus.
  - Left hip incision with skin around it warm, red, and tender to touch.
  - Chronic Foley catheter usage.
- Lack of Knowledge
- Supporting Data:
  - Lack of knowledge about causes of infection.
  - Patient not washing hands after toileting or before meals.
- Impaired Skin Integrity
- Supporting Data:
  - Prolonged bed rest.
  - Inadequate diet.
  - Open area on the coccyx.

Infection Control and Aseptic Interventions
- Hand Hygiene:
- Techniques include:
  - Handwashing with soap and water.
  - Use of alcohol-based sanitizer.
  - Surgical hand scrub.
- Precautions and Isolation:
- Types include:
  - Standard precautions.
  - Transmission-based precautions:
  - Airborne
  - Droplet
  - Contact

Infection Control and Aseptic Interventions
- Personal Protective Equipment (PPE):
- Includes:
  - Gloves
  - Masks
  - Goggles
  - Face shields
  - Gowns
  - Caps
  - Shoe coverings
- Immunization:
- Definition: Process by which an individual develops immunity against a specific agent.
- Protection against specific communicable diseases through vaccination.

Infection Control and Aseptic Interventions
- Medical Asepsis (Clean Technique):
- Techniques include:
  - Handwashing
  - Wearing gloves
  - Gowning
  - Disinfecting
- Surgical Asepsis (Sterile Technique):
- Used in:
  - Surgical procedures
  - Invasive procedures such as catheterization
  - Procedures that invade the bloodstream or break the skin
  - Dressing changes and wound care
- Disinfection:
- Definition: Removal of pathogenic microorganisms; typically destroys all pathogenic microorganisms except spores.
- Sterilization:
- Definition: Destruction of all microorganisms, including their spores.

Infection Control and Aseptic Interventions in the Home
- Education for patients, families, and caregivers on procedures.
- Modifications required for home environments.
Evaluation
- Determine if goals for reducing or preventing infection were met.
- Document the patient's response before and after an infection control measure.
- Assess the patient’s knowledge related to infection.