Professional Documents
Culture Documents
impregnated nonadherent
(description)
woven or nonwoven cotton or
synthetic materials are impregnated
impregnated nonadherent
(indications)
postoperative dressing over
staples/sutures, superficial burns
impregnated nonadherent
(examples)
adaptic, aquaphor gauze, carrasyn,
xeroform dressings
hydrocolloids (description)
waterproof adhesive wafers, pastes,
or powders; wafers designed to be
worn 7 days, consists of 2 layers,
inner adhesive layer has particles
that absorb exudates and form
hydrated gel over the wound; outer
layer provides an occlusive seal
hydrocolloids (purpose)
absorb exudate; to produce a moist
environment that facilitates healing
but does not cause maceration of
surrounding skin; protect the wound
from bacterial contamination, foreign
debris, and urine or feces; prevent
shearing
hydrocolloids (indications)
pressure ulcers stage II-IV, autolytic
debridement of eschar, partialthickness wounds
hydrocolloids (examples)
comfeel, duoDERM, replicare, restore,
tegasorb
hydrogels (description)
glycerin or water-based, nonadhesive,
jelly-like sheets, granules, or gels;
oxygen permeable unless covered by
a plastic film; requires secondary
occlusive dressing
hydrogels (purpose)
to liquefy necrotic tissue or slough,
rehydrate wound bed and fill in dead
space
hydrogels (indications)
pressure ulcers, skin tears, partialthickness wounds
hydrogels (examples)
alignates/exudate absorbers
(description)
alignates/exudate absorbers
(purpose)
provide moist wound surface by
interacting with exudate to form
gelatinous mass; absorb exudate;
eliminate dead space or packs
wounds; support debridement
alignates/exudate absorbers
(indications)
pressure ulcers, skin tears, venous
stasis ulcers, surgical wounds,
wounds undergoing chemical
debridement agents
alignates/exudate absorbers
(examples)
algiderm, curasorb, debrisan,
kaltostat, sorbsan
collagen (description)
gels, pastes, powders, granules,
sheets, sponges derived from animal
sources (usually cow or pig)
collagen (purpose)
assists with stopping bleeding, helps
recruit cells into the wound and
stimulates their proliferation to
facilitate healing
collagen (indications)
clean, moist wounds
collagen (examples)
biostep, cellerate RX, NU-gel,
promogran
Learnig Objectives:
Theory
-List the Stages of an infectious process
-Identify 5 ways to decrease the occurrence of health careassociated infections (HAIs)
-Explain how Transmission-Based Precautions are used with
Standard Precautions
-Describe how proceedures for Airborne Precautions differ
from those for Droplet Precautions
-Discuss the special requirements for airborne precautions
when the patient has pulmonary tuberculosis
-Compare infections prevention and control proceedures
appropriate for the hospital with those used in the home
-List techniques for handling specimens, disposing dirty
linen, trash, & sharps; & cleaning the equipment in the
isolation setting
-Give 3 examples of nursing measures used for
phychosocial care of a patient in isolation
-State the 4 rules of surgical asepsis
Learning Objectives:
Clinical Practice
Current Standards
-Teir 1: Standard Precautions:
^delineate methods for avoiding direct contact with body
secretions except sweat
-Teir 2: Transmission-Based Precautions:
^interrupting mode of transmission by identifying specific
secretions that might be infective
^used alone or in combination but always in addition to
Standard Precautions
Transmission-Based Precautions
-Standard Precautions = for all patients
-Airborne Precautions = measles, varicella, TB (special
mask) [my chicken hez TB]
-Droplet Precautions = meningitis, pneumonia, diptheria
[SPIDERMAN]
-Contact Precautions = GI, skin, wound infection, RSV,
herpes simplex [MRS WEE & VCHIPS]
Planning
-Expected outcomes would include "No health careassociated infection is evident"
-When using Transmission-Based Precautions that require
putting on personal proctective equipment (PPE), the nurse
must prepare before each entry into the patient's room
Implementation:
-Patient teaching is needed on disease process, modes of
transmission, & precautions to prevent spread of infection
-Standard Precautions used for each contact with patient
-Hand hygiene:
^MOST IMPORTANT in preventing infection transmission
^before & after contact with patient, wound care, or
invasive procedure
^before donning gloves & after removing them
-PPE:
^disposable gloves
^masks
^gown
^gloves
^goggles/face shield
Protective Isolation
-Patient in special room with own ventilation system
-No one with active infection allowed in patient's room
-Remain aware of your facility's policies and procedures
regarding protective isolation, & follow them at all times
Surgical Asepsis
-4 rules for surgical asepsis:
1) Know what is sterile
2) Know what is NOT sterile
3) Separate sterile from unsterile
4) Remedy contamination immediately
-Goal: keep an area free from microorganisms
Surgical Scrub
-More lengthy & vigorous that regular hand hygiene
-Remove as many microorganisms as possible without
damaging the skin
-Timing based on actual time spent scrubing, not including
rinse time
-Usually 2-4 minutes
-Brushless technique with antimicrobial agent may be used
Evaluation
-Patient recovering without additional instances of infection
from other organisms or infection of other body areas
-Assessing whether the patient's infection has been
transmitted to any health care worker or any other patient
on the unit or in the hospital
Question 1:
During which stage of infection would a patient be
irritable, fatigued, experience malaise, have an elevated
temperature, & be considered highly infectious?
a) Incubation period
b) Prodromal period
c) Ilness period
d) Convalescent period
Answer:
b) Prodromal period
(Stage 2)
Question 2:
Mary is taking care of a patient with tuberculosis. What
specific type of precautions should Mary take?
a) Standard Precautions
b) Airborne Precautions
c) Droplet Precautions
d) Contact Precautions
Answer:
b) Airborne Precautions
(remember My Chicken Hez TB)
Question 3:
When taking care of a known tuberculosis patient, the
nurse must wear:
a) Sterile gloves
b) Sterile gown
c) Particulate filter mask
d) Shoes covers
Answer:
c) Particulate filter mask
Question 4:
When opening a sterile package, a nurse should do all of
the following EXCEPT:
a) Select a moist tabletop at eye level.
b) Wash hands and obtain equipment.
c) Open packages away from the body, opening the distal
flap first.
d) Lift the front flap up and toward the body, handling
only the outside of the wrapper.
Answer:
a) Select a moist tabletop at eye level
(Open-Book Quiz)
Question 1:
Name & describe the stages of the infectious process.
(pg 234)
Answer:
-Stage 1: Incubation Period:
^begins when the organism first enters the body, & lasts
until onset of symptoms; period where organism multiplies;
period duration varies depending on type of organism; may
(Open-Book Quiz)
Question 2:
What are the 2 premises underlying the current system of
isolation?
(pg 236)
Answer:
1) Infection may be present before the diagnosis is made
2) The greatest risk of transmitting infection for most
microorganisms comes from direct contact by the
caregiver's hands or equipment & supplies that have been
soiled by blood, body fluids, & other potentially infectious
materials
(Open-Book Quiz)
Question 3:
Why are the elderly at greater risk for infection?
(pg 237)
Answer:
-The elderly are at greater risk for infection because their
immune system is not as active as that of a younger
person
(Open-Book Quiz)
Question 4:
When treating patients, when do you implement Standard
Precautions & Transmission-Based Precautions?
(pg 236)
Answer:
-Use Standard Precautions for the care of ALL patients
-Use Transmission-Based Precautions for the care of
patients with known or suspected serious illnesses that can
be transmitted via airborne, droplet, or contact
(Open-Book Quiz)
Question 5:
According to the CDC guidlines, in what order do you don
personal protective equipment?
(pg 239)
Answer:
1) gown
2) mask/respirator
3) goggles/face shield
4) gloves
(Open-Book Quiz)
Question 6:
Summarize the guidlines for specimen preparation &
transportation.
(pg 239)
Answer:
-Verify the physician's orders and fill out the correct lab
requisition forms; label the side of specimen container with
patients information; put on gloves; explain what is needed
to patient; collect specimen without contaminating the
outside of the container; secure the lid;
disinfect visibly contaminated containers; place specimen
in laboratory biohazard transport bag & seal it; place lab
requistion forms in outside pocket of lab transport bag
before leaving the patient's room; remove gloves; wash
hands; send specimen to lab for processing
(Open-Book Quiz)
Question 7:
When transporting the isolation patient, what precautions
are recommended?
(pg 240)
Answer:
-Avoid transporting unless absolutely necessary
-Give patient standard mask to wear
-Take measures to prevent soiling of the environment
-Notify receiving department that patient is under the
particular type of Transmission-Based Precautions & any
additional precautions required ahead of time
(Open-Book Quiz)
Question 8:
While a patient is in Transmission-Based Isolation, how
can you prevent sensory deprivation?
(pg 243)
Answer:
-Listen to the patient's feelings
-Make positive comments on grooming & activity efforts
-Engage in meaningful conversation
-Make visitors feel welcome, & help them understand that
ther patient benefits greatly from their presence
(Open-Book Quiz)
Question 9:
List the 3 main modes of occupational exposure to
bloodborne pathogens
(pg 243)
Answer:
1) Puncture wounds
2) Skin contact
3) Mucous membrane contact
(Open-Book Quiz)
Question 10:
What must you do when it is apparent that a break in
surgical asepsis has occured?
(pg 252)
Answer:
-Point out and/or correct the error:
^begin scrub again
^discard & replace gloves & equipment
-A= Adenovirus
-N= Neisseria meningitidis