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NURS110A - Midterm (Infection Control)

Terms in this set (14)

How far can droplets travel?
How long can influenza virus survive outside of the host?
3 FEET

@ room temperature, moderate humidity
24-48 H (steel & plastic)
8-12 H (cloth & tissues)
What nursing interventions would you provide for patients on contact, droplet, and airborne precautions and needs to leave the room for diagnostics tests?
DROPLET:
surgical mask for the patient
> 3 feet distance

AIRBORNE:
surgical mask for the patient

💡Nurses do not need to wear a mask when transporting patients (pre-COVID conditions).
A patient was admitted to the emergency department where he reported nausea, severe abdominal cramping, and diarrhea for the past couple of days. He was admitted to the unit with a diagnosis of dehydration. The client reports weakness and syncope, especially when standing. Skin turgor is fair, and oral mucous membranes appear pale and dry.

VITALS:
38.4 C (101.2 F)
114/76
104 BPM
RR 16/min

Which of the following is most likely portal of exit for this client?
(A) respiratory tract
(B) GI tract
(C) urinary tract
(B) GI tract

Rationale:
Pathogens will most likely spread via stool and emesis.
(cont. from previous question)

A stool culture confirms the presence of salmonella bacteria. While the client continues to have diarrhea, it is less frequent.

Which of the following precautions must you use when providing care? (Select all that apply).
(A) airborne
(B) droplet
(C) contact
(D) standard
(C) contact

(D) standard

Rationale:
Airborne precautions are for measles, varicella, & tuberculosis.
Droplet precautions are for rubella, mumps, pneumonia, & streptococcal infections.
(cont. from previous question)

Which of the following precaution interventions are appropriate? (Select all that apply).
(A) private room
(B) dedicated/ disposable equipment
(C) masks work when w/in 3 feet of patient
(D) hospital gowns, gloves, & masks for visitors
(A) private room

(B) dedicated/ disposable equipment

Rationale:
Private rooms decreases the risk of contamination between two patients.
Disposable equipment decreases the chances of cross contamination.
Hospital gowns will NOT protect against infection. Visitors must wear isolation gown & gloves when entering the room.
(cont. from previous question)

You enter the room and full protective gear, adjust the clients IV fluid infusion, provided them with a bed pan, reposition them after providing perineal care, empty and clean the bed pan, document care you provided the notebook, and you 10 feet away from the sink. Are you removing dispose all of PPE. After appropriate handwashing, you pick up both the notebook and the pen, placed them onto the designated counter, and then leave the room. Within three days, five clients and 14 staff members have infectious diarrhea.

At what point did you fail to maintain appropriate technique to prevent contact transmission?
Picking up the notebook and pen AFTER removing the PPE and performing hand hygiene.

Rationale:
To prevent contamination, you should have picked up the notebook only after removing the PPE and washing your hands.
A patient was admitted to the emergency department with reports of nausea and vomiting over the past 24 hours. The client reports abdominal fullness and burning pain in the upper abdomen that they rate as 7 out of 10. The client says that they have been "drinking a lot" since losing their job for months ago. The client is to be admitted to rule out gastritis.

VITAL SIGNS:
36.8 C (98.2 F)
124/76
88 BPM
RR 16/min

Which of the following of standard precautions are required in this case? (Select all that apply).
(A) Wash hands after client contact.
(B) Wear clean disposable gloves when handling the client's emesis basin.
(C) Place emesis-soiled linen on the floor, well away from the client and any visitors.
(A) Wash hands after client contact.

(B) Wear clean disposable gloves when handling the client's emesis basin.

Rationale:
Linens must be handled, transported, and processed in a manner that prevents contamination.
(cont. from previous question)

The client states, "I feel really sick. I'm going to throw up," and then projectile vomit approximately 150 mL of green emesis that appears to be blood-tinged into an emesis basin and onto their shirt.

Which of the following information is vital to determining how the staff should protect themselves? (Select all that apply.)
(A) The client is experiencing projectile vomiting.
(B) The client is alert and able to use an emesis basin.
(C) The client's vital signs do not support the presence of an infective process.
(D) The emesis appears to be blood-tinged.
(A) The client is experiencing projectile vomiting.

(D) The emesis appears to be blood-tinged.

Rationale:
Knowing that bodily fluids are splashing around is a good indicator to have precautions put in place.
(cont. from previous question)

Which of the following PPE are appropriate to use when caring for this client? (Select all that apply).
(A) single-use, disposable gown
(B) disposable mask
(C) surgical gloves
(D) goggles
(A) single-use, disposable gown

(B) disposable mask

(D) goggles

Rationale:
Surgical gloves are meant to prevent transferring mice-orrganisms to the patient, but that is NOT the main concern in this situation.
(cont. from previous question)

The emergency department technician ops not to use eye protection (goggles) since they already wear glasses.

Was this an appropriate decision on the ED technician's part?

Should the nurse say anything about this decision?
NOT APPROPRIATE.
Glasses do not provide the same level of protection as goggles.

The nurse SHOULD educate the ED technician about the need for goggles.
A patient came to the emergency department reporting a persistent productive cough for three weeks. She also reports night sweats, fever, chills, and profound fatigue. She is admitted to the unit with tuberculosis.

VITAL SIGNS:
101.8 F
124/68
88 BPM
RR 22/min

Breath sounds with rales bilaterally. Productive cough with yellow sputum and hemoptysis noted. Reports chills fatigue and history of night sweats.

What type of precaution should be instituted for this client to prevent the spread of tuberculosis?

What is the correct PPE that healthcare providers should wear prior to entering the clients room?
AIRBORN PRECAUTIONS

gloves
N96 respirator

Rationale:
Tuberculosis particles are less than 5 microns, thus require airborne precautions.

Gloves are required for the productive cough, and the N95 is required for the droplets.
(cont. from previous question)

Which of the following interventions are correct for this client? (Select all that apply).
(A) semiprivate room
(B) negative airflow room
(C) N95 respiratory
(D) surgical asepsis
(B) negative airflow room

(C) N95 respiratory

Rationale:
Patients with tuberculosis require a negative airflow room with HEPA filtration of at least 6-12 exchanges/ hour.
A nurse is about to irrigate a clients open wound. Besides gloves, which of the following personal protective equipment to the nurse where?

(A) sterile gown
(B) goggles
(C) face shield
(D) N95
(C) face shield

Rationale:
A face shield protects the face, mouth, nose, and eyes from any potential splashes. It provides the most appropriate and most adequate protection in comparison to the rest of the options.
To decontaminate they hands with alcohol-based gel, the nurse should rub their hands together until all of the gel has evaporated and their hands are dry. Which of the following is the correct rationale why the hands should be rubbed dry?

(A) drying provides full antiseptic effect
(B) residual alcohol can easily stains clothing
(C) excess gel could transfer to the patient
(D) slippery gel can make the nurse drop supplies
(A) drying provides full antiseptic effect
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