Term
| What did the center of disease control issue in 2007 that revised mandatory regulations in which most of our study guide is taken from |
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Definition
| guidelines for isolation prevention:preventing transmission of infecious agents in healthcare setting |
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Term
Health-care associated infection
(HAI) |
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Definition
| and infection aquired in the healthcare setting in a previously uninfected patient |
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Term
| Health care associated infections are also called |
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Definition
noscomial infections
noso- meaning disease
komiean- to take care of |
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Term
| its estimated that --- to ---% of hospital patients experience HAI's and ---- a year; with ---- dying from them a year; about --- of all HAI result from failure to use mandatory prevention control practics such as proper had hygeine |
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Definition
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Term
| what percent of HAI infections are antibiotic resistant |
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Definition
| 70%; and 70% are preventabl |
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Term
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Definition
| if patients aquires infection outside of the hospital ( getting cut by a nail, school infection) |
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Term
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Definition
| a microorganism capable of causing disease |
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Term
| MANy body tissues , body surfaces and wounds can be colonized without being infected |
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Definition
| true, but if they are colonized they are more likely to be infected |
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Term
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Definition
| proliferaton of microorganisms on or within body sites without detectable host/ or immune responce |
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Term
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Definition
| the absence of disease causing agents, our effort to keep the patients free of microbes as possible |
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Term
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Definition
| clean techinique: cleansing ( removal of microbes from an object) , disinfecting (killing pathogens) |
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Term
| three common disinfectants |
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Definition
| isopropyl alcohol, betadine, glutaraldehyde |
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Term
| what did the CDC require in 2007 about surfaces likely to be contaminted with pathogens (surface disinfectants) |
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Definition
| be disinfected by cleaning personal more frequently than other object ; bedrails, door knobs, over tables, toliets |
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Term
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Definition
| is used for sensative medical equipment used in diagnostic procdures that cant be sterilized because steralizing equipment would damage it; usually only special trained nurses can do this |
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Term
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Definition
| not sharing certan items between patients |
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Term
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Definition
| locating patients with similar diagnosis are on a hospital unit to prevent spread of their infection to those not infected |
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Term
| what is the most basic and important technique in preventing/ contolling transmission of infection |
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Definition
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Term
| hand hygeine should be done with what unless what |
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Definition
| alcohol based cleanser unless hand are visibly soiled |
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Term
| if hands are visibly soiled makes sure to use |
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Definition
| soap and water, doesnt matter if it is antibacterial or just plain soap |
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Term
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Definition
| wet hands before applying soap, so you dont wash soap down the drain before you get lathered up , also undiluted hand can irritate the skin; use warm water cold chaps hands and warm water opens up pores where bacteria can hide; vigorously rub for 15 seconds |
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Term
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Definition
- after eating
- after you take your gloves off
- before and after patient contact
-after any contact with blood, mucous, fluids, non intact skin
-when mving from contaminated to clean site
-when visibly soiled |
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Term
| does lotion help prevent skin irritation which can lead to bacterial growth |
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Definition
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Term
| do alcohol- based hand cleansers promote developmental drug resistant organisms |
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Definition
| no, the mechanism in which alcohol kills microbes is different from them becoming resistant |
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Term
| should nurses wear clean or sterile gloves |
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Definition
| clean; when they are at ris for infection |
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Term
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Definition
when nurses have scratches
when inserting needles
when there is a high resk for comming into contact with patient body fluids |
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Term
| what are the 3 things that the CDC requires health care providers to tell their patients about respiratory hygeine/ coughing ediquette |
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Definition
- to post signs at enteranes and strategic places (elevators, cafeterias), with instructions to patients with respirtory infections to cover their mouth/ nose when sneezing or coughing, to properly dispose tissue, and perform hand hygeine when hands have been in contact with secretion
- provide tissues and non touchable disposals
-post signs on how to properly wash hands, place alcohol dispensers everywhere |
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Term
| you must wear gloves when transporting laboratory specimen containers, and use biohazard containers for transporting laboratory samplestaken from patient |
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Definition
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Term
| what are the two specific infection precautions in patient care |
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Definition
tier 1 standard precautions
tier 2 transmission precautions |
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Term
| Tier 1 standard precautions |
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Definition
| based on the assumptions that all patients are potentially infected, so patients are treated as if they were |
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Term
| 5 precautions to take if it is considered tier 1 |
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Definition
-handwashing
-gloving when necessary but not for perspiratin
-masks, eye protection, or face shield whenever patients are likely to generate body splashes
- gown - if clothes are likely to be spoiled
-all needles need to go in a non puncture container without recapping after an injection |
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Term
| CDC tier 2 (transmission precautions) |
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Definition
| often called isolation, use when patients are known to hae infection. involves the use of persona protection equipment (PPE),gloves, masks, eye protection, gowns |
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Term
| 3 types of tier 2 precautions |
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Definition
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Term
| contact precautions are used when |
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Definition
-patients are infected with a multidrug resistant organisms (MDRO's), which are organisms some what impervious to antibiotcs
-also for major wound infections, certain intestinal infections, and all infections caused by highly contagious organisms ( even if they arnt multidrug resistant) |
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Term
| contact precautions require the nurse to |
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Definition
| put on glove and gown before entering the patients room, and discarding them into a biohazard container before stepping out of the door way |
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Term
| what is the only exception to alcohol based waterless cleansers |
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Definition
| when patient has clostridium difficile ( spore forming ) |
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Term
| in study what percent of hospital staff have C-diff on their hands |
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Definition
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Term
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Definition
| methicillin - resistant staphylococcus Aureus |
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Term
| in 2006 CDC estimates that were --- MRSA infections ( about -- out of every -- hositalized patient); with -- deaths |
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Definition
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Term
| can MRSA be normally controlled with standard precautions |
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Definition
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Term
| MRSA transmission requires |
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Definition
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Term
| on about --% of all MRSA infections are aquired in the community |
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Definition
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Term
| often when infected doesnt necessarily mean death but doe require |
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Definition
| weeks to months of intravenous antibiotics |
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Term
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Definition
| droplet nuclei are microscopic particles that are dried residue of evaporated drops produced when a person sneezes, coughs, shouts, radius at about 3 ft and are greater than 5 microns |
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Term
| what are some infections responsible for droplet |
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Definition
| pseudomonas,wooping cough, meningitis, mumps |
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Term
| droplet infected patients require a |
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Definition
private room and cohorts only if patients have te same organism
- a standard mask when transported |
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Term
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Definition
more stingent than droplet precautions
less than 5 microns in size, travel more than 3 feet and remain in the air longer |
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Term
| 4 organisms that are responsible for airborne transmission |
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Definition
| measles, chicken pox, meningities, pulmonary TB |
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Term
| patients with airborne transmission infections have to be put in a |
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Definition
airborne infection isolation room AAIR
it has a negative air flow so organisms can not creep out
have to have at least 6 air exchanges per hour ( now they have 12 )
have to be tested by smoke tubes or flutter strips to makes sure air is moving in the right direction, and to do a pressure check
air is either vented to the outside or has a heppa filter
DOOR MUST BE KEPT SHUT
-health care provider must wear a N-95 mask |
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Term
| N-95 mask and Standard mask |
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Definition
N-95- filters air comming into the mask
standard mask -filters air going out of the mask |
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Term
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Definition
revrse isolation - protect patient from healthcare provider
flowers are prohibites in this enviroment |
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Term
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Definition
| sterile technique, procedures designed to totally eliminated organisms |
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Term
| in medical asepsis something is considerd contaminated when-- and in surgical asepsis something is considered contaminated when |
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Definition
an object is suspected of harboring a disease
when an object touches an unsterile object |
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Term
| surgical asepsis is used in |
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Definition
| surgury, or inserting cathaders or anything when the first line of defense is down, suctioning lungs, certain dressing changing |
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Term
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Definition
| a sterile surface for working |
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Term
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Definition
-only touch sterile objects
-do not remove your eyes from sterile object
-if sterile object goes below belt not sterile anymore
-no sneezing / coughing over sterile field
-create sterile working enviroment
-if pemeables steril field comes in contact with unsterile obect BAD
-1 inch unsterile edges of sterile field to carry it
-lipping the lip of an open bottle of sterile water pour 1-2 mL out
-only touch inside of gloves
-set cap of bottle facing up |
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Term
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Definition
tissue loss
without tissue loss |
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Term
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Definition
primary intention healing
secondary intention healing
tertiary intension healing |
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Term
| primary intention healing |
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Definition
| acute wounds without tissue loss, skin edges are approxamate and easily pulled together ( staples, sutures, steri-strips), heal in orderly and predictable fasion, all at once, usually 14 days, scaring minimal, risk of infection low |
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Term
| secondary intention healing |
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Definition
| tissue is lost, wound edges ca not be pulled together, heal from the bottum up with gradulation tissue, healing takes a long time, burns pressure ulcers, dermis never replaced and huge scar. new epithelial tissue covers gradual tissue |
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Term
| tertiary intention healing |
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Definition
delayed primary closure
a wound where the edges could be pulled together and be closed sutures or staples but need to remain open for 3-5 days due to excessive drainage, hemmorage, or infection in the wound before it is closed |
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Term
| what are the 4 types of wound drainage |
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Definition
-serous- clear and watery
-serosanginous- pale red and watery type of drainage ( some red blood cells in it)
-sanguinous- drainage that is primarily composed of actual bright red, thick drainage, if amount of blood if huge then its called hemmorage.
purulent- "pus" liquified nuercrotic tissue, usually not always indicates infection |
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Term
| occationally hematoma can form in closed wounds |
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Definition
| a collection of blood beneath the surface of the tissue producing swelling TRUE |
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Term
| respiratory infection is the most common type of health associated infection and second is wound care |
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Definition
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Term
| infected wounds usually drain-- and -- |
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Definition
| purulent material ( yellow,green brown depending on causative organism), usually have an odor |
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Term
| even in the absences of drainage all wounds have some bacteria on their surface |
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Definition
| true, many are heavily contaminated / colonized but that doesnt mean actual infection is present . Wound should be cultures to see wheathe bacteria have actually invaded the tissue |
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Term
| what indicates the presence of infection |
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Definition
| edema, redness, excessively warm peri-wound skin, increased pain, and the development of tunnels (sinus tract) in the wound |
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Term
| what are the four wound complications |
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Definition
dihiscence-
evisceration
fistula
enterocutaneous fistula |
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Term
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Definition
| partial seperation of wound layers atthe surface of wounds . most occurs with abdominal wounds; usually occurs 3-11 days after surgery; |
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Term
| what patients are at high risk for dihiscence |
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Definition
| obesity patients because of constaint strain of the wound and fatty tissue heals pourly |
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Term
| what are signs of dihiscence |
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Definition
| if serosanguinous drainaige occurs more than 48 hours after a wound is closed if this happens place the patient in low fowlers with knees bent to decrease tension on wounds |
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Term
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Definition
| total seperation of all layers of a wound with profusion of abdominal organs. MEDICAL EMERGENCY REQUIRES SURGICAL REPAIR, if occurs cover wound with sterile cloths or dreesings soaked in sterile saline ( prevents bacteria from getting in and organs from drying out) |
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Term
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Definition
| an abnormal passageway connecting one epithelial surface with another epithelial surface |
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Term
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Definition
| an abnoramal passageway connecting an epithelial surface with an organ, a passage might go from small intestine to the skin surface which means CRAP comes out of your tommy, once they form a stoma they have to be surgically removed |
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Term
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Definition
| purposeful surgical connection made between an artery and vein to gain vascular access for hemodialysis. |
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Term
| what are three types of drains |
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Definition
-penrose(passive, tube comes out to drain)
-Jackson-Pratt(hand grenade adominal surgeons use the most)
-Hemovac-oreo cookie orthopedic surgeons use mask |
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Term
| Wounds should always be cleaned via |
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Definition
| irrigation; unless otherwise specifically ordered |
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Term
| what is the purpose of irrigating wounds |
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Definition
| the intent is to gently wash away debris ( dead tissue) from the wound surface |
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Term
| what are the four rules of cleaning |
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Definition
| - sterile solutions are used with low pressure. Normally sterile saline is used when dressing ointments, but when the ointment has silver in t ( which is a bacterialcidal it will disrupt it ) so we use sterile water |
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Term
| irrigate or clean from the least to most contaminated part of the wound |
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Definition
| true; the wound is less contaminated than surrounding skin |
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Term
| flow pressure for non-infected wounds, pressure and equipment |
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Definition
4-15 pounds per square inch(psi)
-use bulb syringe
-pistol syringe with no needle
-single-use plastic saline ampule
or gravity drip through IV drippping
(all deliver 2-4 psi |
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Term
| flow pressure should be no more than --psi for non-infected wounds |
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Definition
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Term
| For infected wounds you need a about --of pressure; and what equipment |
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Definition
| 35cc syringe with 19 gauge needle is often used -it delivers about 8psi |
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Term
| do you clean around the wound |
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Definition
| 1" of the skin surrounding the wound (peri-wound skin) |
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Term
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Definition
| means removal of dead tissue; promoted healing by removing dead tissue and providing a clean inviroment for wound to heal properly |
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Term
| what are the two types of necrotic tissue |
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Definition
-slough-loose, stringy, hydrated tissue that is usually yellow like pizza chees
-eschar-dehydrated, thick, leathery tissue that is usually black.
they prevent wound healing) |
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Term
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Definition
1. mechanical-removal by direct pressure or force
2.autolytic-covering wound with transparent occlusions
3.chemical-application of topical enzyme that breaks down dead tissue
4.biological- maggot
5.surgical(sharp)-using a scapel to remove it |
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Term
| three types of mechanical debridment |
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Definition
-wet to dry dressing
-pulsed low pressure ( requires special equipment
-whirlpool treatment-not used alot now to rough for grandule tissue
and pseudomas can ive in watery pipes |
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Term
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Definition
| covering wound with transparent occlusion synthetic dressing such as tegaaderm or opt site. It seals the wound keeps it moist , and allows the dead tissue to be self absorbed by the body |
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Term
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Definition
topical enzyme ointment that eats away at dead tissue; acts slowly (SO CANT USE ON PATIENT WITH SEPSIS). they work in the presense of moisture, make sure wound is moist apply damp saline dressing if necessary
-selective wont harm grandulane tissue as long asnot left on more than 24 hours |
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Term
| two types of chemical debridement |
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Definition
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Term
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Definition
| sterile maggots from the lab, tapped in place with occlusion dressing no more than 24-48 hours, debride gently eat ONLY neucrotic tissue |
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Term
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Definition
transparent film
dry sterile dressing
dry gauze w/ topical ointment
moistened gauze
hydrocolloids
hydrogels
alginate |
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Term
| transparent film dressing |
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Definition
either tegaderm op site
is good for superficial wounds with little drainage
not absorbant
used fo autolytic debridement
allows wound to be seen
served as a secondary dressing over gauze |
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Term
| dry sterile dressing (DSD) |
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Definition
sterile 4*4 gauze taped in place
covers surgical incisions, keeps them clean, absorbs small amounts of drainage
24-48 hours lasts |
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Term
| dry gauze w/ topical ointment dressing |
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Definition
used for infected wounds
gauze absorbs drainage but not occlusive allows air to pass through. |
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Term
| when dry gauze is used to pack the wound |
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Definition
| you should pack light but full, to tight can prevent wound closure |
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Term
| moistend gauze ( wet-dry) |
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Definition
| not used alot any more, you put wet gauze in wound let it dry pull it out with dead tissue stuck to dry gauze it can harm grandule tissue and leave gauze debri in the wound |
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Term
| moistened gauze (wet-wet) |
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Definition
| do not let it dry out purpose is to keep wound hydrated |
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Term
| moistened gauze in general |
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Definition
| only be changes twice daily, make sure you maintain normal temp at wound surface most of the day because it reduces vasoconstrivtion, and enhances cellular activity, do not get intact skin around wound wet |
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Term
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Definition
| duo-derm, available ad wafers in many forms, and as pastes and powders, they are an occlusive type dressing water resistant, and oxygen. good for partal and full thickness wounds with minimum to moderate drainage ( not very good absorbant), can be left on 3-5 days CAN NOT BE PUT ON INFECTED WOUNDS |
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Term
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Definition
| available as sheets,impregnanted gauze, or gels. They keep dry wounds moist, soothe and cool. not absorbant, often used with therma burns and painful wounds. need to be held in place with secondary dressings and changed daily because the can hurt the peri-wound skin |
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Term
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Definition
| made up of highly absorbant material manufactored from seaweed, can absorb up to 40 times their own weight in fluid. good fro draining wounds change 2 1/2 to 3 days. BE AWARE NOT ALL HAVE BEEN TESTED ON KIDS< INFANTS |
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Term
| Negative Pressure Wound Therapy |
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Definition
| NPWT - like a wound vac , wound packed with foam like substance and a occlusive dressing and it is sucked out. The negative pressure also stimulates capillary and grandulation tissue growth which helps wound edges draw together |
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Term
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Definition
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Term
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Definition
| increased risk of being invaded by pathogens |
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Term
| impaired and risk for impaired skin integrity |
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Definition
| at risk for altered epidermis and dermis |
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Term
| ineffective tissue perfusion |
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Definition
| decrease in blood circulation that may comprimise health |
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Term
| impaired tissue integrity |
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Definition
| damage to mucous membrane, corneal, integrumentry,subQ tissue |
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