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IAHCSMM Infection Prevention and Control
Exam 1 Practice Questions and Answers
100% Pass | Graded A+
David Mungai [Date] [Course title]
IAHCSMM Infection Prevention and
Control Exam 1 Practice Questions and
Answers 100% Pass | Graded A+
Infection - Answer>> invasion of a susceptible host by pathogens or microorganisms, resulting in disease Colonization - Answer>> occurs when a microorganism invades the host but does not cause infection Communicable infectious disease - Answer>> transmitted from one person to another Symptomatic pathogens - Answer>> multiply and cause clinical signs and symptoms Non-symptomatic pathogens - Answer>> multiply but clinical signs and symptoms are not present Hand hygiene is... - Answer>> the most important technique used in preventing and controlling transmission of infection Chain of infection - Answer>> - infectious agent or pathogen
- reservoir or source for pathogen growth
- portal of exit
- mode of transmission
- portal of entry
- susceptible host Immunocompromised - Answer>> an impaired immune system
- stress, HIV/AIDS, age, etc. Virulence - Answer>> the ability to produce disease
Modes of Transmission: vehicles - Answer>> - contaminated items
- water
- drugs, solutions
- blood
- food (improperly handled, stored, or cooked; fresh or thawed meat) Modes of Transmission: vector - Answer>> - external mechanical transfer (flies)
- internal transmission such as parasitic conditions between vector and host such as: mosquito, louse, flea
- tick A patient is admitted to a medical unit for a home-acquired pressure ulcer. The patient has Alzheimer's disease and has been incontinent of urine. The nurse inserts a Foley catheter. A link in the infection chain is A. restraints B. Poor hygiene C. Foley catheter bag D. Improper positioning - Answer>> Answer: C Four stages of infectious process - Answer>> incubation period, prodromal stage, illness stage, convalescence Incubation period - Answer>> Interval between entrance of pathogen into body and appearance of first symptoms
Prodromal stage - Answer>> intervals from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms (During this time microorganisms grow and multiply, and patient may be capable of spreading disease to others.)
- herpes simplex begins with itching and tingling at the site before the lesion appears Illness stage - Answer>> Interval when patient manifests signs and symptoms specific to type of infection.
- strep throat is manifested by sore throat, pain, and swelling; mumps is manifested by high fever, parotid, and salivary gland swelling Convalescence - Answer>> Interval when acute symptoms of infection disappear (Length of recover depends on severity of infection and pt's host resistance; recovery may take several days to months.) localized infection - Answer>> affects local region systemic infection - Answer>> affects entire body Normal flora - Answer>> microorganisms that reside on or in the body that do not usually cause disease when residing in their usual area of body but instead participate in maintaining health Suprainfection - Answer>> new infection that appears during the course of treatment for a primary infection
Types of HAI infections: Endogenous - Answer>> when the patient's flora becomes altered and an overgrowth results Risk Factors for HAIs - Answer>> - Number of health care employees with direct contact with the patient
- Types and numbers of invasive procedures
- Therapy received
- Length of hospitalization Major Sites for HAI Infection: Urinary Tract - Answer>> - unsterile insertion of urinary catheter
- improper positioning of the draining tubing
- open draining system
- catheter and tubing becoming disconnected
- drainage bag port touching contaminated surface
- improper specimen collecting technique
- obstructing or interfering with urinary drainage
- urine in catheter or drainage tube being allowed to reenter bladder (reflux)
- repeated catheter irrigations
- improper perineal hygiene Major Sites for HAI Infection: Surgical or Traumatic Wounds - Answer>> - improper skin preparation before surgery (eg shaving versus clipping hair; not performing a preoperative bath or shower)
- failure to clean skin surface properly
- failure to use aseptic technique during operative procedures and dressing changes
- use of contaminated antiseptic solutions Major Sites for HAI Infection: Respiratory Tract - Answer>> - contaminated respiratory therapy equipment
- failure to use aseptic technique while suctioning airway
- improper disposal of secretions Major Sites for HAI Infection: Bloodstream - Answer>> - contamination of IV fluids by tubing
- insertion of drug additives to IV fluid
- addition of connecting tube or stopcocks to IV system
- improper care of needle insertion site
- contaminated needles or catheters
- failure to change IV access at first sign of infection or at recommended intervals
- improper technique during administration of multiple blood products
- improper care of peritoneal or hemodialysis shunts
- improper assessing an IV port Factors influencing infection prevention and control - Answer>>
- Age
- Nutritional status: illness = increased protein or calorie requirements; impaired intake
- Stress; increased metabolic rate
- Disease process: disease of immune system, inability to produce WBCs; general debilitation and nutritional impairment from disease; treatments that reduce immune responses (chemotherapy) Nursing process - Answer>> Assessment Diagnosis Planning Implementation Evaluation
D. Place the patient on isolation precautions - Answer>> ANSWER: C Nursing Process: Planning - Answer>> - goals of care applicable to patients with infection
- setting priorities
- teamwork and collaboration Planning: Common goals of care applicable to patients with infection often include the following - Answer>> - preventing exposure to infectious organisms
- controlling or reducing the extent of infection
- maintaining resistance to infection
- verbalizing understanding of infection prevention and control techniques (eg hand hygiene) Planning: Setting priorities - Answer>> establish priorities for each diagnosis and for related goals of care Planning: teamwork and collaboration - Answer>> plan care with pt, family and other HCPs Nursing Process: Implementation - Answer>> - Health Promotion
- Acute care Implementation: Health promotion - Answer>> Preventing an infection from developing or spreading
- hygiene
- vaccinations
- nutrition support
- rest, stress-reduction
Implementation: acute care - Answer>> Treating an infectious process includes eliminating the infectious organisms and supporting the patient's defenses
- identify organisms (culture, laboratory)
- promote healing (vitamins, diet)
- support patient's own body defense mechanisms When implementing care, consider: - Answer>> - control or elimination of infectious agents
- control or elimination of reservoirs
- control of portals of exit and entry
- control of transmission (hand hygiene, isolation precautions, medical and surgical asepsis) Asepsis - Answer>> absence of pathogenic (disease- producing) microorganisms Aseptic technique - Answer>> practices/procedures that assist in reducing the risk for infection Medical asepsis (clean technique) - Answer>> includes procedures for reducing the number of organisms present a preventing the transfer of organisms Surgical asepsis (sterile technique) - Answer>> prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery Standard precautions - Answer>> Prevent and control infection and its spread
Surgical asepsis Cough Etiquette - Answer>> Coughing/sneezing into a tissue to prevent microorganisms from spreading to others. Includes properly disposing of tissue into waste receptacle and washing hands as soon as possible. Isolation and Isolation Precautions - Answer>> Isolation is the separation and restriction of movement of ill persons with contagious diseases. -Barrier precautions -Standard precautions -Isolation precautions: airborne, droplet, contact, and protective environment Airborne - Answer>> TB, chickenpox Droplet - Answer>> Flu, whooping cough, bacterial meningitis Contact - Answer>> C. difficile, MRSA, VRE, norovirus, RSV Isolation - Answer>> - psychological implications
- isolation environment
- personal protective equipment
- specimen collection
- bagging of trash or linen
- patient transport Surgical asepsis - Answer>> - patient preparation
- sterile field: free of microorganisms and prepared to receive sterile items
- principles
- performing sterile procedures
Principles of Surgical Asepsis - Answer>> 1. A sterile object remains sterile only when touched by another sterile object.
- Only sterile objects may be placed on a sterile field.
- A sterile object or field out of the range of vision or an object held below a person's waist is contaminated.
- A sterile object or field becomes contaminated by prolonged exposure to air.
- When a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated by capillary action.
- Fluid flows in the direction of gravity.
- The edges of a sterile field or container are considered to be contaminated. Nursing Process: Evaluation - Answer>> See through the patient's eyes:
- have the pt's expectations been met? Patient outcomes
- measure the success of the infection control techniques
- compare the pt's actual response with expected outcomes
- if goals are not achieved, determine what steps must be taken reservoir - Answer>> a place where microorganisms survive, multiply, and await transfer to a susceptible host Ex: humans and animals (hosts), insects, food, water, and organic matter on inanimate surfaces (fomites) frequent reservoirs for HAIs - Answer>> healthcare workers, patients, equipment, and the environment Portal of exit - Answer>> any body opening on an infected person that allows pathogens to leave
Indication of infection:
- decreased in chronic infection Cultures of urine and blood - Answer>> Normal adult values:
- normally sterile, without microorganisms growth Indication of infection:
- presence of infectious microorganism growth Cultures and gram stain of wound, sputum, and throat - Answer>> Normal adult values:
- no WBCs on Gram stain, possible normal flora Indication of infection:
- presence of infectious microorganism growth and WBCs on Gram stain WBC: Neutrophils - Answer>> 55%-70%
- increased in acute suppurative (pus-forming) infection,
- decreased in overwhelming bacterial infection (older adult) WBC: Lymphocytes - Answer>> 20%-40%
- Increased in chronic bacterial and viral infection
- decreased in sepsis WBC: Monocytes - Answer>> 2%-8%
- increased in protozoan, rickettsial, and tuberculosis infection WBC: Eosinphils - Answer>> 1%-4%
- Increased in parasitic infection WBC: Basophils - Answer>> 0.5%-1.5%
- normal during infection Airborne precautions (droplet nuclei smaller than 5 microns) - Answer>> Infection/condition:
- measles, chickenpox (varicella), disseminated varicella zoster, pulmonary or laryngeal tuberculosis Barrier protection:
- private room, negative-pressure airflow of at least 6 to 12 exchanges per hour via high-efficiency particulate air (HEPA) filtration
- mask or respiratory protection device, N95 respirator (depending on condition) Droplet precautions (droplets larger than 5 microns; being within 3 ft of the pt) - Answer>> Infection/condition:
- diphtheria (pharyngeal ), rubella, streptococcal pharyngitis, pneumonia or scarlet fever in infants and young children, pertussis, mumps, mycoplasma pneumonia, meningococcal pneumonia or sepsis, pneumonic plague Barrier protection:
- private room or cohort patients
- mask or respirator required (depending on condition) Contact precautions (direct patient or environmental contact) - Answer>> Infection/condition: