MED SURG 101 - Module IV Study Guide.

Chapter 8
(Nursing Care of Patients with Infection)

The Infection Process
 Pathogen
o Organisms that cause disease in a host (infected person)
 Host
 Colonization
o Reservoir
 Environmental home where infectious agents live, multiply
and reproduce
 Animate (people, insects, animals and plants)
 Inanimate (water, soil, medical devices)
o Causative Agents
 Microorganisms
 bacteria, virus, fungi, protozoa, helminth, prion
o Mode of Transmission
 Direct contact
 Prevention: hand hygiene, PPE
 Indirect contact
 Prevention: hand hygiene, stethoscope cleaning, clean
water & food
 Airborne
 Prevention: HEPA & TB masks
o Portal of Entry
 Respiratory tract, skin, mucous membranes, GI tract, GU tract,
placenta
o Susceptible Host
 Factors that increase: age, malnourishment,
immunocompromised, chronic disease, stress, burns, invasive
procedures
o Exit portal
 Route infections agents use to leave the host who have
become reservoir for infection
 Respiratory tract, skin, mucous membranes, GI tract, GU
tract, blood, open lesions, or placenta

Human’s Body of Defense Mechanisms
 Skin and mucous membranes
o First line of defense, prevents skin dryness and cracking
 Cilia

, o Lines respiratory tract mucous membranes, traps mucous, pus,
dust, and foreign particles
 Gastric juices
o Destroys most organisms that enter the stomach
 Immunoglobins
o Protein found in serum and body fluids, act as antibodies to destroy
invading organisms
o Antigens (stimulates an immune response in the body)
o Antibodies (blood protein that counteracts a specific antigen)
 Leukocytes and Macrophages
o Leukocytes are WBC protect against infection and tissue damage
 Lysosomes
o Bacterial enzymes in WBCs and most bodily fluids such as tears,
saliva and sweat
 Interferon
o Released by WBCs and fibroblasts
 Inflammatory Response
o Occurs when there is injury to the body, infection may not be
present
o Vascular response
 Creates redness and heat, plasma is also increased at the site
to nourish tissue and carry waste and debris away
o Inflammatory Response
 Allows plasma to move in and out of the capillaries, swelling
occurs leading to pain from pressure to nearby nerve endings
o Phagocytosis and Purulent exudate
 Destruction of pathogenic organisms and their toxins by
leukocytes

Infectious Disease
 Results when immune system protection fails
 Localized
o Pain, redness, swelling and warmth (microbes in one area)
 Sepsis
o Immune response to serious infection
o Systemic inflammation response syndrome
o Organ damage
o Septic shock – decreased BP

Laboratory Assessment
 Gram staining
o Better microscopic view for identification

, Culture and sensitivity
o IDs illness causing organisms and determines what type of
antibiotics to use to treat
 Serum antibody test
o Measures reactions to certain antigens
 CBC with differential
o Levels of five leukocytes are measured
 ESR
o Early screening for inflammation, RBCs are heavier (greater
inflammation)
 X-rays, CT, MRI, skin tests

Immunity
 Ability of body to protect itself from disease
 Natural immunity
o Prevents species of contracting illness found in another species
 Innate immunity
o Genetic – immunity a person is born with
 Acquired immunity
o Obtained actively or passively through exposure to an organism,
from vaccine, or injection by immunoglobins or passed from
mother to baby

Types of Infection
 Mononucleosis (Epstein-Barr Virus)
o Caused by Epstein-Barr virus (herpes virus)
o Contagious (kissing disease) spread through intimate contact
with saliva of infected person
o Incubation of 4-6 weeks
 Signs and Symptoms
o Extreme fatigue, anorexia, chills, red sore throat, headache, high
fever, tonsils with white coating
 No specific treatment
o Symptoms are treated – supportive care

Infection Control in Community
 Organizations work closely to control communicable disease
o World health organizations, CDC, local health departments, home
health nurse

, Infection Control in Health-Care Agencies
 Community-acquired infection
o Admitted to hospital or health care agency a patient already has an
infection
 Hospital-acquired infection (HAI)
o An infection that develops as a result of a patients stay in the hospital
o Common pathogens
 E coli (UTIs)
 Staphylococcus aures
 Hand Hygiene
o Proper hand washing
 Wet hands, soap, lather for 20 seconds
o Alcohol based hand rubs
 Asepsis
o Freedom from organisms
o Medical Asepsis
 Clean technique
 Reduce the number of pathogens or prevent transmission of
pathogens from one person to the next
o Surgical Asepsis
 Sterile technique
 Item or area free of microorganisms and spores
o Infection prevention guidelines
 Standard precautions
 Assume all patients are infectious, hand hygiene, gloves,
gowns, mask, goggles and face shields
 Transmission based precautions
 Used with specific communicable diseases
 Used along with standard precautions
o Prevention of respiratory tract infections
 Risk factors: invasive tube
 Prevention: oral hygiene, coughing and deep breathing, ventilator-
associated pneumonia bundles
o Prevention of genitourinary infections
 Most common: UTI
 Risk factors: urinary catheters
 Prevention: strict aseptic technique with insertion, secure tubing
as directed, closed system, drainage bag kept below bladder level
o Prevention of surgical wound infections
 Prevention: sterile technique for dressing changes, monitor wound
 Antibiotic Resistant Infections
o Methicillin-resistant staphylococcus aureus (MRSA)
 Difficult to treat, high mortality rate