NUR 342 Exam 1 Study Guide with Questions and Complete Solutions

NUR 342 Exam 1 Study Guide with
Questions and Complete Solutions
Chain of infection ✅1. Infectious agent → bacteria, virus, fungi, parasites

2. Reservoir → natural habitat of the organism (humans, animals, soil, food, water)

3. Portal of exit → point of escape for the organism (respiratory or gastrointestinal tract,
blood)

4. Means of transmission → how an organism is transmitted from its reservoir (direct
contact, indirect contact, respiratory droplets, airborne)

5. Portal of entry → point at which organisms enter a new host (skin, urinary tract,
respiratory tract, gastrointestinal tract)

6. Susceptible host → infectious agent must overcome resistance mounted by host's
defense

How as a nurse you can break chain of infection ✅HAND HYGIENE
· Infectious agent to Reservoir
O Hand hygiene, sterilization, antibiotics/antimicrobials

· Reservoir to Portal of Exit
O Transmission-based precautions, sterilization or use of disposable supplies

· Portal of Exit to Mode of Transmission
O Dry intact dressing, hand hygiene, wear gloves if contact with body fluids, cover nose
and mouth when sneezing

· Mode of Transmission to Portals of Entry
O Hand hygiene, use of pesticides to eliminate vectors, adequate refrigeration

· Portals of Entry to Susceptible Host
O Hand hygiene, wear gloves, use masks and appropriate protective gear, proper
disposal of needles/sharps

· Susceptible Host to Infectious Agent
O Immunizations, screen health care staff

Risk factors for infection: ✅· Integrity of skin and mucous membranes
· ph levels of GI and GU tracts
· Integrity and number of body's WBC

,· Age (infants and elderly)
· Immunizations
· Level of fatigue, nutrition and general health status (including pre-existing conditions)
· Stress level
·Use of invasive or indwelling medical devices
· Lack of immunizations, natural or acquired

Methods of infection transmission ✅· Direct Contact
Infections spread by contact, such as touching, kissing, or sexual intercourse
MRSA

· Indirect Contact
Infections spread by no direct human-to-human contact
Contaminated surfaces or objects (fomite)
Tick, rodent (vector)

· Respiratory droplets
Infections spread by large-particle droplets
Influenzas, mumps, diphtheria, and rubella

· Airborne
Infections spread through the air
Tuberculosis, varicella, rubeola, COVID

Differences between medical and surgical asepsis ✅Medical asepsis → a.k.a "clean
technique," practices that assist in reducing the risk of infection
· Goal → PREVENT SPREAD of microorganisms
VS.


Surgical asepsis → a.k.a "sterile technique," practices to render and keep objects free
from microorganisms; more stringent
· Goal → DESTROYS ALL microorganisms, including spores

Principals surgical asepsis (objects touching each other, when is it consider
contaminated, what do you do, what's no sterile in a field. ✅9 Principals of Surgical
Asepsis

1. A sterile object remains sterile only when touched by another sterile object
2. Only sterile objects may be placed on a sterile field. All items on a sterile field must
be sterile
3. A sterile object or field out of the range of vision is considered contaminated
4. A sterile object or field becomes contaminated by prolonged exposure to air
5. When a sterile surface comes in contact with a wet, contaminated surface, the sterile
object or field becomes contaminated by capillary action
6. The outer 1 inch edge of a sterile field is considered contaminated

, 7. Hold sterile objects and position tables with sterile drapes above the level of the
waist. Anything below the waste is considered contaminated
8. Movement in and around the sterile field must not compromise or contaminate the
field
9. If sterility is questioned, the item(s) are considered contaminated


O Sterile solutions are only considered sterile 24 hours after they are opened

Purpose of precautions ✅· Used in the care of ALL hospitalized patients regardless of
diagnosis or possible infection status to protect both the patient and health care worker

· Infection Control

Standard precautions: how and why ✅Standard Precaution:, did not exist pre HIV, are
used in the care of ALL hospitalized patients regardless of diagnosis or possible
infection status to protect both the patient and health care worker

· Wear clean nonsterile gloves when touching blood, body fluids, excretions or
secretions, contaminated items, mucous membranes and non-intact skin

· Wear PPE during procedures or care activities likely to generate splashes or sprays of
blood or body fluids

· Follow respiratory hygiene and cough etiquette

· Safe injection practices (avoid recapping needles, dispose in sharps, etc.)

· Wear a face mask in high risk procedures (i.e. Epidural)

· Handle equipment soiled with bodily fluids with care

PPE, steps ✅DONNING:
Hand hygiene --> gown --> mask--> eyewear or goggles --> gloves

DOFFING:
Gloves --> gown --> hand hygiene--> goggles --> mask --> hand hygiene

Principles of sterile glove donning ✅· After the gloves are on, only sterile items may be
handled with the sterile-gloved hands.

· Careful removal of the gloves reduces any hand contact with contaminated materials.

· Good hand hygiene technique before and after putting on sterile gloves is