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Chap 27

Infection Control
by

Elizabeth E

on 15 October 2013

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Transcript of Chap 27

Chapter 27
Asepsis and Infection Control (Taylor)
I. Infection
A. Infection Cycle
1. Infectious Agent
-bacteria, fungus, viruses
-normal flora can be oppurtunistic
2. Reservoir
-can be object/person
-carriers do not show s/s
3. Portal of Exit
4. Mode/Means of Transmission
-contact
-airborne
-nuclei droplet (VERY SMALL)
-**stay suspended in air**
-cough, sneeze, laugh
-droplet
-large, drops to the floor
-vector
-animal, mosquito
5. Portal of Entry
6. Susceptible Hosts
-compromised immune system
-stress adaptation
-chronic illnesses
-nutritional status
-fluid intake
-close proximity
-surgery (skin)

B. Stages of Infection

1. Incubation Period
-the incubation period is the interval b/w the pathogens invasion of the body and the appearance of symptoms of infection
-organisms are growing and multiplying

2. Prodromal Stage
-person is most infectious
-pt does not know he or she is contagious
-vague symptoms

3. Full Stage of Illness
-presence of specific s/s r/t illness

4. Convalescent Period
-recovery period
-s/s disappear

example
Varicella stages:

incubation: exposed by someone with postules

prodromal: cold-like symptoms

full stage: postules/blisters

convalescent: recovery
C. The Body's Defense Against Infection
1. Normal Flora
2. Inflammatory Response
-prepares site for tissue repair

-The CARDINAL SIGNS OF ACUTE INFECTION
redness
heat
swelling
pain
loss of function
-vascular and cellular stages
3. The Immune Response
D. Factor's Affecting the Risk for Infection
integrity of the skin
pH levels
WBC's
age, sex, race
-neonates and older adults are more
vulnerable to infection

nutritional status
health status
meds
stress
use of invasive or indwelling devices
sexual practices
Special Considerations for Older Adults
The elderly have atypical s/s:
confusion
disorientation
lethargy
anorexia
delayed fever response
falls
incontinence
failure to thrive
select all that
apply!
II. The Nursing Process for Infection Control and Prevention
A. Assessing
-predisposing factors for nosocomial
infections
-surgey, tubes, foleys

-
Lab Data Indicating Infection BOX 27-1

+elevated WBC count= normal value 5000 to 10,000/mm3
+increase in specific types of WBC's:
(Never Let Monkeys Entertain Babies)

Neutrophils: 60-70%
Lymphocytes: 20-40%
Monocytes: 2-8%
Eosinophils: 1-4% (parasitic infection)
Basophil: 0.5-1%

Q:What is an elevated erythrocyte sedimentation rate indicative of?

A: It indicates that an inflammation is present



B. Diagnosing
C. Outcome Id/ Planning
D. Implementing


1. Medical Asepsis
-reduce # of pathogens
-HANDWASHING is #1
*most effective way to help prevent
the spread of infectious agents**
-if not visibly soiled, use alcohol-
based handrubs
-wash for at least 15 sec
Antibiotic-Resistant Organisms
MRSA
(Methicillin-Resistant Staph Aureus)


-normally found on the skin, nasal mucous
membranes, and in the resp and GI tracts

-most at risk: children, elderly, HIV/AIDS pts

-etiology: transmitted through direct contact
-S/S: BOILS, postules on skin*****
-if it's in lungs ->purulent, thick sputum

DRUG: Vancomycin, Zyvox

pt will be on standard precautions
hand hygiene
sometimes PPE

*
STANDARD PRECAUTIONS

-used in the care of all hospitalized pts
-apply to blood, all body fluids, secretions, and
excretions except sweat, nonintact skin, and
mucous membranes

Wear gloves
PPE
Avoid RECAPPING NEEDLES
Cough etiquette
Transmission-Based
Precautions
AIRBORNE:
-TB, chicken pox (varicella), rubeOla (measles), SARS
-private room, negative air pressure
-keep door closed
-WEAR N95 or HEPA mask with TB pts***
----------------------------------------------
DROPLET
-rubella, mumps, diphtheria, adenovirus
-private room
-KEEP VISITORS 3 FEET AWAY FROM
INFECTED PERSON***
----------------------------------------------
CONTACT
-Multidrug-Resistant Organism
-private room if possible
-PPE
TB
-in the lungs
-transmitted via airborne
-the risk for transmission is reduced
after the infectious person has
received proper drug therapy for 2
to 3 weeks
-BCG vaccine= positive skin test
(evaluate pt with chest x-ray)
- S/S: calcification in lungs
fatigue, anorexia, night sweats
sputum

-Diagnostic Assessment:
PPD test -> 10mm or higher=TB (exposure or dormant)
Evaluate site at 72 hours (preferably)
If positive do a chest x-ray

-Interventions:

isoniazid (INH) and rifampin
Nurse's role: stress the importance of taking
each drug regularly, as prescribed, for as long
as it is prescribed. This will ensure the disease
stays supressed.
Also, tell the pt that sputum specimens are
needed usually every 2 to 4 weeks once drug
therapy is initiated. WHEN THE RESULTS OF THREE CONSECUTIVE SPUTUM CULTURES ARE
NEGATIVE, the pt is no longer infectious.







DRUGS
Anthrax: Ciprofloxacin

C Diff: metronidazole (Flagyl)

Meeting Needs of Pts Requiring Infection-Control Precautions

-sensory deprivation and loss of self-esteem
-make sure to check in on the pt
-teach visitors about the importance of transmission-based precautions
by: Elizabeth Espinoza
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