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Medical Surgical Ch. 8

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Transcript

  • 1. Chapter 8
    • Nursing Care of Patients with Infections
  • 2. Infectious Process
    • Chain of Infection Required
    • Six Links in the Chain
    • Treatment Breaks the Chain
  • 3. Chain of Infection
  • 4. Link 1: Reservoir
    • Environmental Home for I nfectious Agents
    • Animate: People, Insects, Animals, Plants
    • Inanimate: Water, Soil, Medical Devices
  • 5. Link 2: Causative Agents
    • Bacteria
    • Virus
    • Fungi
    • Protozoa
    • Helminth
    • Prion
  • 6. Key Terms
    • Normal Flora : Microbes Occurring Naturally in a Body Part
    • Pathogens : Disease-causing Microbe
  • 7. Link 3: Mode of Transmission
    • Direct Contact
    • Indirect Contact
    • Airborne
  • 8. Direct Contact
    • Direct Contact
      • Touching
      • Biting
      • Kissing
      • Sexual Contact
      • Droplet Spray
  • 9. Direct Contact (cont’d)
    • Prevention
      • Hand Hygiene
      • Aseptic Technique
      • Personal Protective Equipment (Gloves, Surgical Masks, Goggles, Gowns, Shoe Covers)
  • 10. Personal Protective Equipment
  • 11. Indirect Contact
    • Vehicle-borne Transmission by Contact with Contaminated Object
      • Prevention
        • Hand Hygiene, Excellent Cleaning
        • Stethoscope Cleaning
        • Clean Water/Food
  • 12. Indirect Contact (cont’d)
    • Vector-borne Transmission by Living Source Other Than Humans
      • Prevention
        • Insect Repellants
        • Rodent Control
  • 13. Airborne
    • Transmission by Particles Floating in Air
    • Inhaled or Deposited on Mucous Membranes
    • Prevention
      • High-efficiency Particulate Air (HEPA) Respirators
  • 14. Link 4: Portal of Entry
    • Entry into Susceptible Host
  • 15. Portals
    • Respiratory Tract
    • Skin
    • Mucous Membranes
    • Gastrointestinal Tract
    • Genitourinary Tract
    • Placenta
  • 16. Link 5: Susceptible Host
    • From Defense Breakdown
  • 17. Increased Risk
    • Very Young or Old Age
    • Malnourishment
    • Immuno-compromised
    • Chronic Disease
    • Stress
    • Invasive Procedures
  • 18. Link 6: Exit Portal
    • Route Infectious Agent Uses to Leave
    • Host Who Has Become Reservoir for
    • Infection
  • 19. Body’s Defense Mechanisms
    • Skin and Mucous Membranes
    • Cilia
    • Gastric Juices
    • Immunoglobulins
    • Leukocytes and Macrophages
    • Lysozymes
  • 20. Body’s Defense Mechanisms (cont’d)
    • Interferon
    • Inflammatory Response
  • 21. Inflammatory Response
    • Vascular Response
    • Inflammatory Exudate
    • Phagocytosis and Purulent Exudate
  • 22. Immune System
    • Body’s Final Defense Against Infection
    • Immune Cells and Lymphoid Tissue
  • 23. Infectious Disease
    • Results When Immune System Protection Fails
  • 24. Localized Infection
    • Microbes in One Area
    • Pain, Redness, Swelling, Site Warmth
  • 25. Generalized Infection
    • Systemic Involvement
    • Signs and Symptoms
      • Headache, Muscle Aches, Fever, Anorexia
    • Sepsis
      • Infection That Has Spread to Bloodstream
  • 26. Laboratory Assessment
    • Gram’s Staining
    • Culture and Sensitivity
    • Antibody Test
    • CBC with D ifferential
    • Erythrocyte Sedimentation Rate
  • 27. Immunity
    • Ability of Body to Protect Itself from Disease
  • 28. Immunity (cont’d)
    • Natural Immunity
    • Innate Immunity
    • Acquired Immunity
  • 29. Example of Infectious Disease
    • Mononucleosis
  • 30. Mononucleosis
    • Epstein-Barr Virus
    • Contagious (“Kissing Disease”)
    • Extreme Fatigue, Anorexia, Chills
    • Red Sore Throat, Headache, High Fever, Tonsils with a White Coating
    • Supportive Care
  • 31. Community Infection Control
    • World Health Organization
    • Centers for Disease Control and Prevention
    • Local Health Departments
    • Home Health Nurse
  • 32. Infection Control in Health-Care Agencies
    • Community-acquired Infection
    • Nosocomial Infection
    • Hand Hygiene
  • 33. Nosocomial Infections
    • Infection from Stay in Health-care Agency
    • Risk Factors
      • Host’s Condition
      • Multiple Antibiotic Therapy
      • High-risk Units
  • 34. Nosocomial Infections (cont’d)
    • Common Pathogens
      • Escherichia coli (E. coli)
      • Staphylococcus aureus
      • Pseudomonas aeruginosa
  • 35. Hand Hygiene
    • Before and After
      • Patient Contact
      • Glove Use
  • 36. Hand Hygiene (cont’d)
    • Wet Hands, Soap, Lather 15 Seconds
    • Interlace Fingers
    • Clean Nails Against Palms
    • Rinse with Fingertips Downward
    • Dry with Paper Towels
    • Turn off Faucet with Towel
  • 37. Asepsis
    • Freedom from Organisms
    • Medical Asepsis
      • Clean Technique
    • Surgical Asepsis
      • Sterile Technique
  • 38. Infection Prevention
    • Standard Precautions
      • Assume All Patients Infectious
      • Blood, Body Fluids, Body Substances
      • Hand Hygiene, Gloves, Gowns, Masks, Goggles, Face Shields
  • 39. Infection Prevention (cont’d)
    • Transmission-based Precautions
      • Specific Communicable Diseases
      • Used with S tandard Precautions
  • 40. Example: Vancomycin-Resistant Enterococci
  • 41. Respiratory Tract Infection Prevention
    • Risk Factors
      • Invasive Tubes
    • Prevention
      • Oral Hygiene
      • Coughing and Deep Breathing
      • Ventilator-associated Pneumonia Bundles
  • 42. Genitourinary Tract Infection
    • Risk Factors
      • Urinary Catheters
  • 43. Genitourinary Tract Infection Prevention
    • Appropriate Use of Urinary Catheters
    • Intermittent Catheterization
    • Strict Aseptic Technique
    • Secure Tubing to Leg
    • Closed System
    • Drainage Bag Below Bladder Level
  • 44. Surgical Wound Infection Prevention
    • Sterile Technique for Dressing Changes
    • Monitor Wound
  • 45. Septicemia Prevention
    • Sterile Technique for Catheters
    • Uncontaminated Solutions
    • Report Indications Promptly
  • 46. Septicemia Indications
    • Fever
    • Tachypnea
    • Tachycardia
    • Hypotension
    • Elevated White Blood Cell Count
  • 47. Septicemia Treatment
    • Blood Cultures
    • Antibiotics
    • IV Drotrecogin alfa (Xigris)
      • Severe Sepsis
  • 48. Antibiotic-Resistant Infections
    • Methicillin-resistant Staphylococcus aureus (MRSA)
      • Difficult to Treat
      • High Mortality Rate
      • Treatment: Vancomycin Hydrochloride
  • 49. Antibiotic-Resistant Infections (cont’d)
    • Vancomycin-resistant Enterococci (VRE)
      • Difficult to Treat
      • Combination Antibiotic Therapy
      • Treatment
        • Quinupristin/Dalfopristin (Synercid)
        • Linezolid (Zyvox)
  • 50. Treatment of Infectious Diseases
    • Type of Organism Guides Drug Selection
      • Antibiotics: Bacterial Infections
      • Antivirals: Viral Infections
      • Antifungals: Fungal Infections
  • 51. Nursing Responsibilities
    • Check Allergies
    • Monitor Side Effects
    • Signs of Superinfection
  • 52. Patient Education
    • Take All Medication
    • Report Side Effects
  • 53. Nursing Diagnoses
    • Risk for Infection
    • Acute Pain
    • Imbalanced Nutrition
    • Ineffective Protection
    • Deficient Knowledge
  • 54. Respiratory Tract Infections
    • Assessment
      • Signs and Symptoms
      • Sputum Culture
    • Nursing Diagnosis
      • Risk for Infection
  • 55. Gastrointestinal Tract Infections
    • Assessment
      • Signs and Symptoms
      • Dehydration
      • Stool Culture
    • Nursing Diagnosis
      • Risk for Infection
  • 56. Genitourinary Tract Infections
    • Assessment
      • Signs and Symptoms
      • Urinalysis
      • Urine Culture
    • Nursing Diagnosis
      • Risk for Infection