Factors that put a person at risk for infection

• Immuno Compromised • Age • Stress • Fatigue • Medical Devices • Climate • Nutrition • Immunizations

Neutrophils

Think bacterial infection

Lymphocytes

Think viral infection

Culture

Identifies the organism

Sensitivity

What will kill the organism? S: Susceptible I: Intermediate R: Resistant

CAUTI

Catheter-associated (CA) urinary tract infection (UTI)

SSI

Surgical site infection

CLABSI

Central-line-associated bloodstream infection

HAHO

Healthcare-associated Hospital-onset

MRSA

Methicillin-resistant staphylococcus aureus

C. Diff or CDIs

Clostridioides difficile infections

Some nursing diagnosis statements

• Risk for infection • Imbalanced nutrition: less than body requirements • Impaired tissue integrity

Susceptible Host

Who can get sick? • most overcome resistance mounted by hosts defenses

Portal of entry

How does it travel? • point at which organisms enter a new host

Portal of exit

How does it get out? • point of escape

Means of transmission

How does it travel? • direct contact • indirect contact • airborne route

Reservoir

Where does the germ live? • natural habitat of the organism

Infectious Agent

What is the germ? • bacteria • viruses • fungi

Full Stage of Illness

Presence of specific signs and symptoms of disease (how we can see the disease)

Prodromal Stage

Person is most infectious, vague, and nonspecific signs of disease (how we can see the disease)

Convalescent Period

Recovery from the infection (the pt is getting better)

Incubation Period

Organisms growing and multiplying (it's there but you don't know it yet)

Two types of immunity

• natural (innate) • acquired (adaptive)

Factors affecting an organism's potential to produce disease

• number of organisms • virulence • competence of person immune system • length and intimacy of contact between person and microorganism

Function of the immune system

Fights off harmful germs, viruses, and other foreign antigens

Gram Positive

• purple stain • thick peptidoglycan • no outer membrane • staph, strep

Gram Negative

• pink/red stain • thin peptidoglycan • outer membrane • E. Coli, Klebsiella, Pseudomonas

Anaerobic

Can live without oxygen

Aerobic

Needs oxygen to live

Stages of Infection

• incubation period • prodromal stage • full stage of illness • convalescent period

4 common shapes of bacteria

• cocci (spherical) • bacilli (rod-shaped) • spirilla (spiral) • vibrios (comma-shaped)

Top causes of death in the U.S.

• heart disease • cancer • unintentional injury

Predicted leading cause of illness

• HIV/AIDS • depression • ischemic heart disease

Types of prevention

• Primary • Secondary • Tertiary

Primary Prevention

Intervening before an individual has a health issue 1. Education 2. Immunizations 3. Modifications of risky behaviors

Secondary Prevention

Early identification of the disease 1. Screenings 2. Health fairs 3. Regular BP checks

Tertiary Prevention

Treats the disease and prevents further complications 1. Nutritional education for chronic illness 2. Outpatient therapy 3. Support groups

What is USPSTF?

United States Preventive Services Task Force

Risk for infection is older adults

• reduced immune system • infection could show as confusion or falls instead of a fever

Risk for infection in immunocompromised

• chemo • HIV • organ transplant recipients

Risk for infection in invasive devices

• IV lines • urinary cath • ventilators

Risk for infection in broken skin

• surgical incision • wounds • pressure injury

Risk for infection in chronic conditions

• diabetes • malnutrition • kidney or liver disease

Autoimmune Disorders

Screen for TB and hepatitis B before biologic therapy.

MRSA is resistant to...

methicillin; spread by direct contact and contaminated surfaces

VRE is resistant to...

vancomycin; colonizes the GI tract

C. diff is a...

spore-forming bacterium that causes infectious diarrhea

Prevention for MRSA, VRE, C. diff is...

• hand hygiene • proper PPE • dedicated equipment

Snellen chart

visual acuity

Ishihara test

screening for color blindness

20/20/20 rule

20 second break every 20 minutes to look at something 20 feet away

Poor oral health is known to...

Link to poor overall health

Stomatitis

Inflammation of the oral mucosa

Leukoplakia

White patches that cannot be scraped off

Gate Control Theory

Explains how pain signals are transmitted to the brain and how the pain is perceived

Nociceptive pain

pain caused by tissue damage

Neuropathic pain

pain caused by damage/disease of the nervous system

Analgesics

a pharmaceutical agent that relieves pain

Antagonists

bind to opioid receptors but do not relieve pain

Physical Dependence

the body adapts to repeated opioid use

Tolerance

decreased response to an opioid after regular use

Withdrawal

symptoms that occur when a substance is reduced or stopped

Remission

symptoms are gone but disease is still present

Somatic pain

pain from bones, tendons, ligaments, blood vessels, and nerves

Visceral pain

pain caused by internal organs stretching, swelling, or becoming inflamed

Cutaneous pain

superficial pain in the skin or tissue beneath it

Referred pain

pain felt in a different area from where it originates

Phantom pain

pain in an amputated body part

Fibromyalgia

chronic widespread pain and fatigue with no known cure

Nociceptive pain process

1. Transduction 2. Transmission 3. Perception 4. Modulation of pain

Responses to pain

1. Behavioral (voluntary) 2. Physiological (involuntary) 3. Affective (psychological)

Factors that affect pain

1. culture 2. family, gender, age 3. religious beliefs/spirituality 4. environment/support 5. anxiety 6. past pain experience

Onset

What was the patient doing when the pain started? Did the pain come on gradually or suddenly?

Provocation

What makes the pain worse and what relieves it?

Quality

Describe the pain - sharp, dull, achy, coming and going, constant?

Radiation

Does the pain spread anywhere else in the body?

Severity

How severe is the pain?

Timing

How long has the pain been going on?

Pain Scales

• numeric • faces/wong baker

Analgesics Pharmacologic pain management

• non-opioid agents • opioid/narcotic agents • adjuvant agent

Non-opioid agents

• acetaminophen, NSAIDs • for mild pain and fevers

Opioid/narcotic agents

• morphine • hydromorphone • fentanyl • oxycodone

Adjuvant agents

• local anesthetics • lidocaine • gabapentin • muscle relaxer