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BAKERSFIELD COLLEGE LICENSED VOCATIONAL NURSING PROGRAM 1ST SEMESTER FUNDAMENTALS SCIENTIFIC BASIS FOR NURSING PRACTICE CHAPTER 34 - INFECTION PREVENTION AND CONTROL: MEDICAL ASEPSIS INTRODUCTION Both the nurse and the client are often in contact with many types of pathogens. Unless the nurse practices techniques to control or eliminate the transmission of these pathogens the client, the nurse, or other individuals can become the host of disease-producing organisms. OBJECTIVES Upon completion of this unit, the student will be able to: A. Theory 1. Define these terms- antiseptic, asepsis, exudates, iatrogenic infections, inflammation, nosocomial infection, pathogen, purulent. 2. Identify the body’s normal defenses against infection. 3. Describe characteristics of each link of the infection chain. 4. Identify the sites and causes for nosocomial infection. 5. Identify clients most at risk for acquiring an infection. 6. State the events in the inflammatory response. 7. Describe the signs/symptoms of a localized infection and those of a systemic infection. 8. Explain universal blood and body fluid precautions. 9. Describe the nursing interventions designed to break each link in the chain of infection. 10. Recognize the different types of isolation categories and give an example of a disease that would be isolated from each category. 11. Describe the situations in which the nurse should wear gloves, gown, and/or mask according to the “Guidelines for Universal Precautions” issued by the Centers for Disease Control (CDC). B. Laboratory 1. Review handwashing technique for medical asepsis. 2. Correctly apply and remove an isolation gown, mask, and gloves. ASSIGNMENT A. Read Chapter 34- Potter & Perry- Study Guide for Chapter 34 Chapter 34 Infection Prevention and Control Scientific Knowledge Base Nature of infection o Entry and multiplication of organism results in disease o Colonization occurs when a microorganism invades the host but does not cause infection o Communicable disease is the infectious process transmitted from one person to another o Chain of Infection Infectious agent or pathogen Reservoir or source for pathogen growth Portal of exit Mode of transmission Portal of entry Susceptible host Infectious Process Incubation period Prodromal stage Illness stage Defenses Against Infection Normal flora Body defense mechanisms Inflammation Vascular and cellular responses Inflammatory exudate Tissue repair Health Care–Associated Infection (Nosocomial) Hospital-acquired infections Community-acquired infections Exogenous infection Endogenous infection Nursing Process Assessment includes a through investigation. o Review of past diseases, travel history o Immunizations and vaccinations o Status of defense mechanisms o Client susceptibility o Clinical appearance o Laboratory results Diagnosis and Planning These are the second and third steps of the nursing process. Use NANDA-approved diagnoses. Identify goals and outcomes. Set priorities. Implementation When implementing care, consider: o Medical and surgical asepsis o Control or elimination of infectious agents o Control or elimination of reservoirs o Control of portals of entry o Control of transmission o Hand hygiene o Isolation and isolation precautions o Evaluation Measure the success of the infection control techniques. Compare the client’s actual response with expected outcomes. If goals are not achieved, determine what steps must be taken. CASE STUDY FOR INFECTION CONTROL You are the nurse caring for an 80-year-old woman with a history of Type 2 diabetes and a SBO (small bowel obstruction). She has been in the hospital for 3 days, prior to that she had been at home and became dehydrated due to her nausea and vomiting that she had for 1 week (her daughter finally convinced her she needed to see a doctor. She just had surgery yesterday (a hemicolectomy), to relieve her small bowel obstruction. She has a central line (IV) in her right upper chest, a foley catheter to drain her bladder, and a dressing over her midline abdominal incision. At this time she is still NPO and all of her meds are given via her IV line. She is in pretty good spirits, although she is having some pain in her abdomen. She is looking forward to her daughter coming to see her this evening because she is bringing her grandson and her new great-granddaughter. You are making a care plan for your client and you are now focusing on keeping her free of infection. 1. Is your client at risk for infection, if yes, why? 2. What might you do as the nurse to break each link of the chain of infection: A. Control or elimination of infectious agent: B. Control or elimination of reservoirs: C. Control of portals of exit: D. Control of transmission: E. Control of portals of entry: F. Protection of susceptible host: