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Stress of Infection


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immunoglobin produced by the body in response to a specific antigen
foreign material, usually a bacteria, capable of inducing a specific immune response
absence of disease producing microorganisms; being free of infection
person or animal who is without signs of illness but who has pathogens on or within body that can be transferred to others
Centers for Disease Control (CDC)
U.S. government agency whose responsibilities include investigation, identification, prevention and control of disease
harmless growth of microorganisms in or on the body
convalescent period
stage of an infection that represents recovery from the infection
substance, usually intended for use on inanimate objects, that destroys pathogens, but generally not spores
process by which pathogens, but not spores, are destroyed
infection in which the causative organisms comes from microbial life the person himself harbors
exit from reservoir
point of escape or organisms from a reservoir
infection in which the causative organism is acquired from another person
inanimate object other than food that can absorb and transmit infectious material
full stage of illness
stage of an infection characterized by the presence of specific signs and symptoms
animal or person on which or within which microorganisms live
iatronic infection
infection that occurs as a result of a treatment or diagnostic procedure
immune response
specific reactions in the body as it responds to an invading foreign protein such as bacteria, or even in some cases, the body's own protein
incubation period
stage of infection that includes the interval between the invasion of the body by the pathogen and the appearance of symptoms of infection
disease state resulting from pathogens in or on the body
inflammatory response
localized response of the body to injury or infection; protective mechanism that eliminates invading pathogens and allows for tissue repair to occur
protective procedure designed to prevent the transmission of specific microorganisms; also called protective aseptic technique and barrier techniques
localized symptoms
symptoms that are limited or restricted to a discrete area
medical asepsis
practices designed to reduce the number and transfer of pathogens; synonym for clean technique
normal flora
microorganisms that normally inhabit various body sites and are part of the body's natureal defense system
nosocomial infection
hospital acquired infection
disease producing microorganism
portal of entry
point at which an organism enters a host
prodromal stage
stage of an infection when a person is most infectious. Eary signs and symptoms of a disease are present but are vague and non-specific
natural habitat for the growth and multiplication of microorganisms
resident flora or bacteria
microorganisms that normally live on a person's skin
(1) the process by which all microorganisms, including spores are destroyed; (2) surgical procedure performed to render a person infertile
surgical asepsis
practices that render and keep objects and areas free from microorganisms; synonym for surgical technique
degree of resistance of a host to a pathogen
systemic symptoms
symptoms manifested throughout the entire body
transient flora or bacteria
microorganisms picked up on the skin as a result of normal activites which can be removed readily
non-human carrier; usually an anthropoid that transfers pathogens from one host to another
means for transmitting organisms
ability to produce disease
cell-mediated immunity
T lymphocytes meet antigen and release lymphokines
an inactive protein in blood that is activated when antigen and antibody bind together
humoral immunity
stimulates B lymphocytes which result in the formation of antibodies
natural immunity
acquired immunity
a protein that interferes with the ability of viruses to multiply
4 stages of infection
incubation period
prodromal stage
illness stage
convalescence stage
Body's Defense Mechanisms
The body has unique defenses against infection
Conditions that impair an organ's specialized defense increases the susceptibility of infection
Body's Defense Mechanisms: Skin
First line of defense
Intact multi-layered surface
Shedding of the outer layer
Sebum contains fatty acids - kill some bacteria
Body's Defense Mechanisms: Mouth
Intact multi-layered mucosa
Saliva washes away particles
Body's Defense Mechanisms: Respiratory Tract
Cilia line the upper airways
Macrophages engulf and destroy
Body's Defense Mechanisms: Urinary Tract
Flushing action of urine flow
Intact multi-layered epithelium
Body's Defense Mechanisms: Vagina
Normal flora cause vaginal secretions to achieve lower pH
pH inhibits growth of microorganisms
Body's Defense Mechanisms: GI Tract
Acidity of gastric secretions
Rapid peristalsis in small intestine
Body's Defense Mechanisms: Normal flora
Microbes that normally reside on and in the body
Body's Defense Mechanisms: Inflammatory response
Protective reaction that neutralizes pathogens and repairs body cells
Immune Response: Types of immunity (Cell-mediated immunity)
T lymphocytes meet antigen and release lymphokines
Immune Response: Types of immunity (Complement)
An inactive protein in blood that is activated when antigen and antibody bind together (causes bacteria to be killed)
Immune Response: Types of immunity (Humoral immunity)
Stimulates B lymphocytes which result in the formation of antibodies
-natural immunity
-acquired immunity (immunizations)
Immune Response: Types of immunity (Interferon)
A protein that interferes with the ability of viruses to multiply
Chain of Infection - The "LINKS" in the Chain of Infection
Portal of Entry
Infectious Agent
Portal of Exit
Mode of Transmission
Chain of Infection: Infectious Agent
Microorganisms (Pathogens)
Potential for organisms to cause disease depends on
Number of organisms
Virulence (strength)
Ability to enter and survive
Susceptibility of the host
Chain of Infection: Reservoir
Organisms need a proper environment to thrive
Chain of Infection: Portals of Exit
Infectious organisms leave the reservoirs of the host through the following body secretions
-Skin and Mucous membranes
-Respiratory tract (coughing, sneezing)
-Reproductive tract (semen and vaginal secretions)
-Additionally, urine (contaminated), stool, saliva and tears
Chain of Infection: Mode of Transmission
Spread of the infectious organism
Chain of Infection: Portal of Entry
Enter through the same routes they exit
-Breaks in the skin
-Respiratory tract
-GU tract
-GI tract
-Circulatory system
Chain of Infection: Susceptible Host
-Degree of resistance
-Immune system
-More virulent the organism the greater the susceptibility
-Antibiotic resistant organisms
The Chain of Infection
It is crucial for nurses to follow infection control practices to break the chain
4 Stages of Infection: Incubation Period
Interval from entrance to appearance of illness (generally you're not aware of this)
4 Stages of Infection: Prodromal Stage
First symptoms appear (onset of non-specific symptoms)
Microorganisms grow and multiply
Disease is more likely to be spread
4 Stages of Infection: Illness Stage
Full stage of illness - S&S specific to illness
4 Stages of Infection: Convalescence Stage
Symptoms start to disappear
Techniques to Interrupt the Chain of Infection: Hand Hygiene
Most basic and important technique in preventing and controlling the transmission of infections
Contaminated hands are the primary cause of cross infection
10-15 seconds of vigorous, rubbing together of hands using soap will remove most transient organisms from the skin (CDC)
Alcohol-based waterless antiseptics are recommended when hands are not visibly soiled (CDC)
Techniques to Interrupt the Chain of Infection
Client and staff education
-Airflow control
-Aseptic technique
-Control of excretions and secretions
-Disinfection/sterilization methods
-Environmental sanitation
-Employee health services
-Proper food handling
-Rapid and accurate identification of organisms
-Recognition of high risk clients
-Trash and waste disposal
-Treatment of underlying diseases
Barrier Techniques: Gowns
protects against soiling clothing
Must be long enough to cover all garments
For visitors coats, hats, and gloves need to be removed before donning gown
Cross gown in back and tie
Barrier Techniques: Masks
Prevents inhalation of microorganisms
Clients on respiratory precautions
Mask discourages wearer from touching eyes, nose and mouth
Properly applied fits snugly
Talking should be kept to a minimum
Moist masks are ineffective
When discarding place inner surfaces together
Can cause feeling of smothering
Barrier Techniques: Gloves
Single use disposable gloves
Pull cuffs of gloves over cuffs of gown
Change and reapply if they become soiled and explain this to visitors
Not a substitute for hand washing
Prevent the transmission of pathogens by direct and indirect contact
Barrier Techniques: Private room
Keep door closed (negative pressure)
Post a sign outside the door
Needs to have bathing, hand washing, and toileting facilities
Personnel and visitors need to wash hands before entering and after leaving the room
Supplies are stored on a cart outside the room
May double bag linen and other contaminated articles
A disposable container for sharps
Avoid taking in equipment that is to be reused outside the isolation room
Psychological Implications
Deprives the client of normal social relationships which can be psychologically harmful
Client's body image may be altered
Standard Precautions
CDC recommends that health care workers consider all clients as potentially infected and general principles should be followed as standard precautions
Droplet Precautions
Private room placement or in room with a client with same infection
Wear mask and stay within 3 feet of patient otherwise you're at risk of infection
Limit transport of client from room
Airborne Precautions
Private room
Negative pressure
Mask or Respiratory Protection Device
Special masks N95 respirators-need to be fit-tested to mask (gain or lose weight or shave facial hair - mask would require refitting)
Client to wear mask when transported
Contact Precautions
Private room or a room with a client who has the same infection
Wear gown and gloves
Limit transport and maintain precautions at all times
Use disposable equipment when possible
Wash hands after glove removal and before leaving the client's room
Specimen Collection
Be sure to use disposable gloves and/or sterile equipment
Seal all containers tightly
Label properly (label the actual container)
Bagging articles
Prevents accidental exposure to contaminated articles
Leftover food placed in plastic bag with disposable tray and paper/plastic ware
Dispose of dressings and other contaminated articles properly
Double bagging can be used
Adaptive (favorable outcome)
-Resolution of infectious process with the client returning to baseline
-Wound disruption (delayed healing)
-Generalized systemic infection that can be life threatening and lead to system failure
Nursing Diagnosis
Risk for or infection
Social isolation
Diversional activity deficit
Risk for injury
Disturbed body image
Risk for or impaired skin integrity
Imbalanced nutrition: less than body requirements
Planning (goals may include)
Client will:
-identify signs of infection by ...
-relate the need to be isolated until noninfectious by ...
-demonstrate appropriate cleansing and disinfecting techniques by ...
-describe mode of transmission of disease by ...
Nursing Interventions
Use strict aseptic technique
Encourage adequate fluid intake
Ensure adequate nutritional intake
Maintain appropriate isolation precautions
Encourage adequate rest
Immunizations to protect client from invasion of pathogens
Assessment and documentation of goals for reducing or preventing infection
Interventions may need to be changed if goals were unmet
Clear documentation of client's baseline
Infection Control Nurse (QA)
Keeps all statistics on nosocomial infections
Checks culture reports
Reports all communicable diseases to the Board of Health
Assists with special precautions
Resource person

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