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Basic Nursing Skills-Exam 1
Terms in this set (100)
Chemical substance that can kill or alter the growth of bacterial microorganisms. Sensitivity tests are used to determine which of these is most effective against the bacteria
Killing or suppressing growth of microorganisms
A chemical compound that is used on skin or tissue to inhibit the growth of or to eliminate microorganisms
The practice of making the environment and objects free of microorganisms
Free of microorganisms
Single-cell microorganisms lacking a nucleus that reproduce from every few minutes up to several weeks
Dead tissue or foreign matter
Solutions containing chemical compounds such as phenol, alcohol, or chlorine to kill or inactivate nearly all microorganisms
Tiny, primitive organisms of the plant kingdom that contain no chlorophyll
Parasitic worms or flukes belonging to the animal kingdom
The body's reaction to substances interpreted as nonself
Biologic response modifier that affects cellular growth
A hospital acquired infection
The practice of reducing the number of organisms present or reducing the risk for transmission organisms
Organism only visible with the microscope
Microorganisms capable of causing disease
Personal protective equipment (PPE)
A precaution that protects both the nurse and the patient and are to be used for every patient contact; includes gloves, gowns, masks, protective eyewear, shoe covering, and hair covering
Protein particles that lack nucleic acids and are not an activated by usual methods for destroying bacteria or viruses. They do not trigger an immune response, but cause degenerative neurologic disease such as Creutzfeldt Jacob disease (mad cow disease)
One celled microscopic organisms belonging to the animal kingdom
Small round or rod shaped Microorganisms that are transmitted by the bites of lice, ticks, fleas, and mites that act as vectors or carriers
facilitate breaking the chain of infection. these precautions protect both the nurse and the patient and are to be used for every patient contact. they include the use of hand hygiene and PPE
Without pathologic organisms
A method used in the process of destroying all microorganisms, pathogens, or pathogenic products
The practice of preparing and handling materials in a way that prevents the patients exposure to living microorganisms. referred to as a sterile technique
Extremely small and can be seen only with an electron microscope
Ahead of time or preparing for
How is bacteria classified?
According to their need for oxygen, their shape, and their gram staining properties
Need oxygen to grow and thrive
Grow only when oxygen is not present
A laboratory technique called Gram staining is performed to help in classifying:
Bacteria's outer cell surface
Gram staining's identification process also helps determine:
The most effective method to use in a limiting the microorganism
Explain gram-positive stain
The specimen that retains the stain is gram-positive and is the color purple
Explain gram-negative stain
The specimen losing the stain and take up the counterstain is gram-negative and is pink
What are the four most common multidrug-resistant organisms?
1) Methicillin resistant staphylococcus aureus (MRSA)
2) vancomycin-resistant Enterococcus (VRE)
3) extended-spectrum beta-lactamase-producing (ESBL) (Klebsilla pneumoniae or E. coli)
4) Clostridium difficile (C. diff)
What are the 6 characteristics that affect virulence
1) ability to adhere to mucosal surfaces or cell walls
2) penetrate mucous membranes
3) multiply in the body
4) secrete harmful enzymes or toxins
5) resist phagocytosis (destruction by white blood cells)
6) bind with iron (essential to bacterial growth)
What is the most effective means for destroying viruses and all other kinds of microorganisms?
Expose them to a high temperature for a specified amount of time; The temperature should be at least 250 degrees F (121C) for 20 to 30 minutes if using a steam sterilizer, and at least 320°F (160°C) for 90 minutes to 3 hours if using a dry sterilization. You can do this by using an autoclave
What are the modes of transfer of pathogens and how can the mode of transmission be interrupted?
(1) direct personal contact with body excretions or drainage such as from infected wound
(2) indirect contact with contaminated inanimate objects (called fomites), such as needles, drinking and eating utensils, dressings, and hospital equipment
(3) vectors such as fleas, ticks, mosquitoes, and other insects that harbor infectious agents and transmit infections to humans through bites and stings
(4) droplet infection, or contamination by the aerosol route through sneezing and coughing
(5) spread of infection from one part of the body to another
-The mode of transmission can be interrupted by effective hand hygiene, proper disinfection and sterilization of medical equipment, use of aseptic (free of microorganisms) technique in performing procedures and diagnostics tests, and use of Standard precautions to prevent contamination
What are the factors that can place the elderly person at higher risk of infection
Poor nutrition, inadequate hygiene, impaired mobility, chronic illness, and physiologic changes
After the body first defends itself from the invasion of pathogens, what second line of defense helps destroy these organisms?
The mechanisms of fever, leukocytosis, phagocytosis,, inflammation, and the action of interferon
Summarize the basic purposes of the inflammatory response
-neutralize and destroy harmful agents
-limit their spread to other tissues in the body
-prepare the damaged tissues for repair
How does medical asepsis differ from surgical asepsis?
-medical asepsis is the practice of reducing the number of organisms present or reducing the risk for transmission of organisms. Medical asepsis is referred to as clean technique because most, but not all, microorganisms are
-surgical a sepsis is the practice of repairing and handling materials in a way that prevents the patient's exposure to living microorganisms. Surgical asepsis is referred to as sterile technique
List the items that are included as personal protective equipment (PPE)
Gloves, gowns, mask, protective eyewear, shoe covering, and hair covering
Explain airborne infection isolation precaution
Used in addition to standard precautions for patients with known or suspected serious illnesses transmitted by airborne droplet nuclei.
-examples of such diseases are measles, varicella, pulmonary tuberculosis
Used for illnesses easily transmitted by direct patient contact or by contact with items in the patient's environment.
-examples include gastrointestinal, respiratory, skin, or wound infection, enteric infection, diaper and incontinence, RSV, parainfluenza, skin infections that are highly contagious, viral or hemorrhagic conjunctivitis or infection
This is the recovery period that begins when the symptoms begin to subside and extends until the patient has returned to normal state of health
Explain droplet precautions
Used with patients known or suspected to have serious illnesses transmitted by large particle droplets
-this includes influenza type B, including meningitis, pneumonia, and epiglottis. sepsis and other serious bacterial respiratory tract infections, including diphtheria, pertussis, strep, pharyngitis, scarlet fever, adenovirus, mumps, parvovirus and rubella
Define healthcare associated infections (HAIs)
-infections transmitted to a person while receiving healthcare services
Define human immunodeficiency virus (HIV)
The causative agent for AIDS.
Moisture or particle proof; not allowing passage
Define incubation period
The period that begins when the organism first enters the body and last until the onset of symptoms.
In many viral diseases the virus is transmitted during this period
Define infection prevention and control
The use of medical and surgical asepsis and standard precautions to prevent or control the spread of microorganisms
a means of preventing contact between the patient and others to prevent the spread of infection. Emphasis is placed on containing organisms and preventing their spread
Increased white blood cells
Not feeling "right"
Define the prodromal.
the short time from the onset of vague, nonspecific symptoms to the beginning of specific symptoms of infection. The patient may be irritable and experience fatigue malaise and elevated temperature. This period lasts a few hours to a few days. Microorganisms are most likely to be spread during this highly infectious stage
Define transmission based precautions
This is based on interrupting the mode of transmission by identifying the specific secretions, body fluids, tissues, or excretions that might be infective. The different types may be used alone or in combination but they are always using addition to the standard precautions
Name and describe the stages of the infectious process
There are four stages
1) The incubation period which begins when the organism first enters the body and last until the onset of symptoms
2) The prodromal phase phase is the short time from the onset of vague, nonspecific symptoms to the beginning of specific symptoms of infection. the patient may be irritable and experience fatigue, malaise, and elevated temperature. Lasts a few hours to a few days
3) The illness period Is when localized and systemic signs and symptoms appear. the individual may have fever, headache, and malaise. Other specific signs of infection may be detected, such as rash, swollen lymph nodes, leukocytosis, diarrhea, and vomiting
4) The convalescent period begins when the symptoms begin to subside and extends until the patient has returned to normal state of health. This can take days to weeks
What are the two premises underlying the current system of isolation?
1) infection may be present before the diagnosis is made
2) The greatest risk of transmitting infection for most organisms comes from direct contact by the caregivers hands or equipment and supplies that have been soiled by blood, body fluids, and other potentially infectious materials
Why are the elderly at greater risk for infection?
-Because their immune system is not as active as that of a younger person
-an elderly person hospitalized for one infection has an increased risk of developing a second infection because the bodies available defenses are already working to fight the first infection
When treating patients, when do implement standard precautions and transmission based precautions?
Standard precautions delineate methods for avoiding direct contact with body secretions except sweat, whether or not visible blood is present. this includes the mucous membranes and all non-intact skin. Transmission based precautions are based on interrupting the mode of transmission by identifying the specific secretions, body fluids, tissues, or excretions That might be inffective
According to the CDC guidelines, in what order do you don personal protective equipment?
Gown, followed by the mask or respirator, then goggles or face shield, and finally gloves
What is the sequence for removing PPE?
gloves, followed by face shield or goggles, then the gown, and finally the mask respirator
Summarize the guidelines for specimen preparation and transportation
Before collecting, verify the physicians order and fill laboratory requisition form. Next, label the specimen container. Place label on the container. Don gloves, explain to the patient what is needed, and collect the specimen without contaminating the outside of the container. Apply the lid. Clean and disinfect containers that are visually contaminated before placing in the labatory transport bag. Place secured laboratory specimen container in a plastic bag and close the bag lock seal. Complete the laboratory requisition form and place it in the envelope pocket on the outside of the transport biohazard bag before leaving the patient's room
When transporting the isolation patient, what precautions are recommended?
Give the patient a standard mask to wear while out of the room. For a patient under droplet precautions, take measures to prevent soiling of the environment. Notify the unit receiving the patient ahead of time that a patient under this particular type of transmission based precautions is coming to the area. Share information about any additional precautions required with those receiving the patient
While a patient is in transmission based isolation, how can you prevent sensory deprivation?
-learning the patients interests and provide appropriate activities
-allow periods of rest between activities
List the three main mode of occupational exposure to blood borne pathogens
1) puncture wounds from contaminated needles or other sharps
2) skin contact, allowing blood, body fluids, and other potentially infectious materials to enter through damaged or broken skin
3) mucous membrane contact, allowing infectious materials to enter through the mucous membranes of the eyes, nose, and mouth
What must you do when it becomes apparent that a break in surgical asepsis has occurred?
You must rectify the error
Low red blood cell count
Withdrawal of fluid or cells
Surgical excision of a small amount of tissue
The inspection of the entire large intestine for polyps, areas of inflammation, and malignant lesions
The growing of Microorganisms in or on a medium designed for their growth
The visual inspection of the interior of the bladder for the collection of biopsy specimens, collection of urine separately from each ureter, and treatment of various conditions
Define electroencephalogram (EEG)
The tracing of brain waves. It is done to localize and diagnose brain lesions, scars, epilepsy, infection, blood clots, and abscesses
An instrument used to view inside a body cavity.
The visual inspection of the upper digestive tract and the stomach to obtain specimens of gastric contents and perform a biopsy on the stomach tissues
collection of clotted blood
Yellowness of the skin, sclera, mucus membranes, and excretions resulting from hyperbilirubinemaand disposition of bile pigments; also called icterus
Group of tests
Growths protruding from a mucous membrane
Application of secretions and cells on the slide
Wand emitting the sound waves
Define Venti puncture
Puncture of the vein with a needle
List the seven commonly performed diagnostics test
1) chemistry test
5) stress test
Why are blood chemistry test performed in what information they provide?
-To detect changes in biochemical reactions in the body and to determine a diagnosis
-they provide information about the electrolyte balance, about the body's ability to metabolize nutrients, the function of organs, and the presence or accumulation of toxic substances
Give examples of common serology tests
-Agglutination tests for specific organisms
-blood typing: ABO groups and Rh
-carcinoembryonic antigen (CEA) assay
-C-reactive protein antiserum
-Heterophil antibody titer
-tests for syphilis
-Enzyme-linked immunosorbent assay antibody test for human immunodeficiency virus
Identify and describe the different classifications of urine specimens
1) single, catheterized, or random specimens that can be collected at any time, with no special preparation required (A specimen of the first voiding in the morning is preferred because it is more concentrated)
2) midstream specimens, in which the external genitalia are cleansed, a small amount of urine is passed, and then a midportion of avoiding is collected in a sterile container and used for a culture
3) Timed, long-period specimens, in which all urine is collected over a 12 or 24 hour period And placed in a container containing some type of preservative
Define ultrasonography explain how it is used
-it is a noninvasive method of visualizing soft tissue structures of the body
-The sonogram is a recording of the reflection of the ultrasonic waves directed into the tissues. The procedure is used to diagnose many pathologic conditions of the female reproductive organs, prostate, heart, kidney, pancreas, gallbladder, lymph nodes, liver, spleen, thyroid, eye, and peripheral blood vessels
What is fluoroscopy, and how is cineradiography used in this diagnostic procedure?
used to examine movement, x-rays are passed to the body part and projected onto a fluorescent screen. Dense tissues project dark shadows on the film, soft tissues appear white
How does computed tomographic (CT) differ from magnetic resonance imaging (MRI)?
CT scans of various organs and parts of the body are used to confirm a diagnosis, plan treatment, evaluate the effects of treatment, and guide needle placement for biopsy or aspiration. Most CT scans are not invasive, but consent may be required for scans using a contrast medium. CT scans requires that the patient be in one position for 10 to 45 minutes
-MRI is a noninvasive method of differentiating normal from abnormal tissue in the body. MRI is commonly used for the brain, knee joint, spine and spinal cord, and abdominal organs. The procedure takes up to 1 1/2 hours
Explain how a cardiac catheterization is performed
A complex procedure in which a long catheter is passed through an artery or vein to the heart to obtain information about defects, valves, patency of coronary artery's, pressures, and blood specimens
How does Gastroscopy differ from colonscopy?
Gastroscopy is the visual inspection of the upper digestive tract and the stomach to obtain specimens of gastric contents and perform a biopsy on the stomach tissues.
-A colonoscopy is the inspection of the entire large intestine for polyps, areas of inflammation, and malignant lesions
Summarize the role of the nurse during an aspiration procedure
-Read page 422
-what is its purpose of the blood chemistry test?
-what is its prep? -what is the nursing implication
-no nursing implications
-what is the purpose of the urinalysis?
-for a clean catch/ midstream sample, clients medius; obtain sample midway through stream
-what is the purpose of an ultrasound?
-Visualizes soft tissue; can differentiate solid tumor from fluid filled cyst
-for abdominal ultrasound's patient must drink a liter of water prior to start procedure
-assist patient in removing gel after procedure
-Purpose for MRI?
-any nursing implications?
-differentiates normal from abnormal tissue
-R/F claustrophobia; takes up to 1.5 hours to complete; patient must lie very still, may require premedication
-Premedicate patient has ordered; thorough assessment for metal. Metal should be removed prior to test
-purpose of stress test?
-any prep needed?
-any nursing implications?
-measures CV response to exercise
-May inject Thallium
-assess CV status
-purpose for colonoscopy
-any prep needed?
-any nursing implications?
-inspection of intestines
-requires bowel cleansing; premedication
-no sooner than 10 to 14 days after barium enema; check CBC/clotting times. ASA, iron and NSAIDS held for three days prior to
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