Chapter 71: Management Of Patients With Infectious Diseases

Front 1

Chain of Infection:

Back 1

Front 2

How do nurses contribute to the prevention of and spread of infection?

Front 3

A host

Back 3

a person who provides living conditions to support a microorganism

Front 4

A carrier

Back 4

a person who carries an organism without apparent signs and symptoms and is able to transmit an infection to others

Front 5

Colonization

Back 5

describes microorganisms present without host inference or interaction

Front 6

Infection

Back 6

indicates host interaction with the organism

Front 7

Disease

Back 7

the infected host displays a decline in wellness caused by the infection

Front 8

Information Resources

Back 8

- World Health Organization (WHO)

- Centers for Disease Control and Prevention (CDC)

- Occupational safety and health administration (OSHA)

- Local agencies

- Hospital and facility infection control specialists and facility policies

Front 9

CDC

Back 9

is a federal agency responsible for monitoring endemic and epidemic disease, recommending strategies to decrease incidence, and developing guidelines to reduce risk to patients and health care workers

Front 10

Isolation Precautions

Back 10

- Guidelines to prevent the transmission of microorganisms in hospitals

- Standard precautions used for all patients

- The primary strategy for preventing HAIs

- Transmission-based precautions are for patients with known infectious diseases spread by airborne, droplet, or contact routes

Front 11

Elements of Standard Precautions

Back 11

- Hand hygiene

- Use of gloves and other barriers

- Needle sticks

- Proper handling of patient care equipment and linen

- Environmental control

- Prevention of injury from sharps and needles

- Patient placement

Front 12

Organisms of HAI Infection Potential

Back 12

- C. diff

- MRSA

- VRE

- Multidrug-resistant gram-negative organisms

How are these treated? Risks that can lead to C. diff, MRSA, VRE and multidrug-resistance gram-negative organisms?

Need to know what type of precautions are used for each of these organisms.

Front 13

Airborne precautions

Back 13

Hospitalized patient should be in negative pressure room with the door closed; health care providers should wear an N-95 respirator (mask) at all times when in the room

Front 14

Droplet precautions

Back 14

Wear a face mask but door may remain open; transmission is limited to close contact

Front 15

Contact precautions

Back 15

Use of barriers to prevent transmission; emphasize cautious technique because organisms are easily transmitted by contact between the health care worker and the patient

Know 3 vectors transmitted by each means

Front 16

Prevention of Infection

Back 16

- HAI bloodstream infections

- Community-acquired infections

- Vaccination programs

- Planning for a pandemic

Need to know. When thinking about vaccines, you must look at the big picture...Need to know and understand why nurses are required to get vaccines, particularly the flu vaccine.

Front 17

Emerging Infectious Diseases

Back 17

- West Nile virus

- Legionnaires disease

- Pertussis

- Hantavirus pulmonary syndrome

- Viral hemorrhagic fevers

- Other resistant bacteria

Nice to know.

Front 18

Reduction of risk to patients (Home-Based Care of Infectious Disease)

Back 18

- Care of equipment

- Patient education

Front 19

Reduction of risk to household members (Home-Based Care of Infectious Disease)

Back 19

- Prevention of transmission

- Education

- Fever and comfort

Front 20

Health care workers (Home-Based Care Measures to Reduce the Risk of Infection)

Back 20

Health care workers should follow standard precautions in the home setting

Front 21

Patient and family education (Home-Based Care Measures to Reduce the Risk of Infection)

Back 21

- Establish an environment that facilitates hand hygiene and aseptic technique

- Family caregivers should receive annual influenza vaccine

- Equipment care

- "Common-sense cleanliness"

- Food preparation and personal hygiene

- Establishment of reasonable barriers to protect family members

Front 22

Nursing Process: The Care of the Patient with an Infectious Disease - Assessment

Back 22

Health history: investigate the likelihood and probable source of infection, associated pathology and symptoms

See questions listed in text (chart 71-5)

Physical exam

Front 23

Nursing Process: The Care of the Patient with an Infectious Disease - Diagnoses

Back 23

- Risk for infection transmission

- Deficient knowledge

- Risk for ineffective thermoregulation

Front 24

Collaborative Problems and Potential Complications

Back 24

- septicemia, bacteremia, or sepsis

- septic shock

- dehydration

- abscess formation

- endocarditis

- infectious disease - related cancers

- infertility

- congenital abnormalities

Front 25

Nursing Process: The Care of the Patient with an Infectious Disease - Planning

Back 25

Major goals may include prevention of spread of infection, increased knowledge about the infection and its treatment, control of fever and related discomforts, and absence of complications.

Front 26

Interventions

Back 26

1. Preventing the spread of infection

- handwashing

- standard precautions (standard: minimal for every patient)

- recognition of mode of transmission and establishment of transmission-based precautions as indicated

2. Education about infectious process and the prevention of the spread of infections

3. Assessment and treatment of fever

Front 27

Diarrheal Diseases

Back 27

1. transmission

2. causes

- bacterial

- viral

- parasitic

Front 28

Nursing Process: The Care of the Patient with an Infectious Disease - Assessment

Back 28

History: recent travel, use of antibiotics, food intake

Hydration status: thirst, dry mucous membranes, weak pulse, loss of skin turgor, sunken eyes, I&O

Front 29

Nursing Process: The Care of the Patient with an Infectious Disease - Diagnosis

Back 29

- Deficient fluid volume

- Deficient knowledge

Front 30

Collaborative Problems and Potential Complications

Back 30

- Bacteremia

- Hypovolemic shock

If the problems are collaborative, what would be included in any treatments?

Front 31

Nursing Process: The Care of the Patient with an Infectious Disease - Planning

Back 31

- Maintenance of fluid and electrolyte balance

- Increase knowledge about disease and risk for transmission

This is the plan, what is the goal? How would you measure if the goal were met?

Front 32

Correction of Dehydration

Back 32

- oral versus intravenous

- mild, moderate, severe dehydration

- oral-goal/ is goal met?

- dehydration-goal/ is goal met?

Front 33

Vaccinations

Back 33

- goal of vaccination program

- table 71-2 impact of vaccines on diseases (need to know)

- nursing education of common vaccine (need to know)

- review and know how varicella vaccine has affected the incidence of chicken pox

- who, at what age and when is a person most susceptible to shingles

Front 34

Immunizations

Back 34

- How have immunizations impacted the United States and infectious disease?

- If you had a parent who refused to immunize their child what would you do?