Fundamentals of Nursing

Nursing

Quiz 31 :

Asepsis

Quiz 31 :

Asepsis

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Cortez is a 76-year-old woman who is independent, lives alone, prefers not to rely on others unless absolutely necessary. She was active and healthy until about 6 months ago, at which time she developed a persistent upper respiratory infection. Because she was unable to obtain or prepare foods, she lost weight and became very weak She finally sought medical attention, but she has not yet fully Recovered. Her primary care provider has admitted Mrs. Cortez to the hospital for shortness of breath, productive cough, dehydration, and nutritional deficiency. You see the nursing assistant leaving Mrs. Cortez's room. The assistant stops to wash her hands. She turns on the water handles and soaps and rubs her hands together under running water for about 5 seconds. She then turns off the faucets with her bare hands and proceeds with drying her hands. Should you intervene and, if so, what should you do?
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A 76-year-old patient is suffering from the infections in her upper respiratory tract. She has gradually lost weight due to the inability to prepare food. She also exhibits certain signs and symptoms of pneumonia, such as the presence of decreased water content, cough, and breathlessness. The patient is on constant supervision by the nurse.
The nursing assistant in this case did not follow the proper protocol for the hand hygiene and the environment control. Such mistakes can spread the nosocomial infections like pneumonia. A nurse is required to intervene in such a situation by correcting the assistant. Then, the assistant is required to be reminded of the proper technique for the hand washing.
The general protocol for the hand washing can be made clear to the assistant and the instructions can be given to him or her to avoid such discrepancy in the hand hygiene protocol. The general protocol for the hand washing involves certain steps that can be mentioned as follows:
1. The tap is required to be turned on and the flow of water should be adjusted.
2. The hands are required to be thoroughly washed and the soap should be adequately applied.
3. The hands are required to be rinsed thoroughly for at least 30 seconds.
4. The hands should be properly dried after washing.
5. The tap is required to be turned off.
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Cortez is a 76-year-old woman who is independent, lives alone, prefers not to rely on others unless absolutely necessary. She was active and healthy until about 6 months ago, at which time she developed a persistent upper respiratory infection. Because she was unable to obtain or prepare foods, she lost weight and became very weak She finally sought medical attention, but she has not yet fully Recovered. Her primary care provider has admitted Mrs. Cortez to the hospital for shortness of breath, productive cough, dehydration, and nutritional deficiency. What other information or assessment data would be helpful to you when planning care for Mrs. Cortez?
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A 76-year-old patient is suffering from the infections in her upper respiratory tract. She has gradually lost weight due to the inability to prepare food. She also exhibits certain signs and symptoms of pneumonia, such as the presence of decreased water content, cough, and breathlessness.
The client's history, the laboratory data, and the physical assessment are the essential information for the assessment of the case. The various assessment data can be mentioned as follows:
1. The nursing history of the client : The nurse assesses the extent to which, a client is at a risk of developing the infection, and any client complaint suggesting an infection. The risk is assessed by interviewing the client about the history of the infection. She may correlate the data with medication, recurrence of the infection, and therapeutic uses.
2. The physical assessment : The various signs and the symptoms of the infection are recorded in this assessment. The symptoms can be sneezing, cough, mucoid discharge, urinary frequency, color of the urine, fever, and marks on the skin. Skin and mucosal infections have symptoms like swelling, redness, pain, loss of function of the localized area. Systemic infections have symptoms like fever, hypertension, fatigue, vomiting, and anorexia.
3. Laboratory data : This information usually confirms the prediction of infection. The laboratory data confirms the presence of an infection if the white blood cell (WBC) count is increased, if only the count of a certain type of WBC is different, there is the presence of high erythrocyte sedimentation rate (ESR), and various other laboratory findings.

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Which of the numbered areas is considered sterile on a person in the operating room? You may assume that all articles were sterile when applied. img
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Sterility refers to the asepsis, which is a state of being free from all the biological contaminants. Sterilization is a process, which eliminates or deactivates almost all the life forms such as viruses, prions, bacteria, fungi, and spores. Sterilization is considered as the distinct form of sanitization, pasteurization, and disinfection.
The areas higher than the neck, above the elbow, below the waist, and back are all considered as unsterile in an operating room. Sterile field maintenance is essential in an operating room in order to prevent the various infections.
Hence, the options 2, 3 4 and 5 are incorrect.
Areas present above the waist are considered as the sterile areas in an operating room. Sterile drapes, gown, mask, and gloves are used to create the sterile field in the operating room.
Hence, the correct answer is option
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Cortez is a 76-year-old woman who is independent, lives alone, prefers not to rely on others unless absolutely necessary. She was active and healthy until about 6 months ago, at which time she developed a persistent upper respiratory infection. Because she was unable to obtain or prepare foods, she lost weight and became very weak She finally sought medical attention, but she has not yet fully Recovered. Her primary care provider has admitted Mrs. Cortez to the hospital for shortness of breath, productive cough, dehydration, and nutritional deficiency. What can you do to prevent the spread of Mrs. Cortez's infection to other hospitalized clients and at the same time prevent Mrs. Cortez from getting infections from other clients?
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The nurse evaluates the chart of a 65-year-old client with no apparent risk factors and concludes that which immunizations are current? Select all that apply. 1) Last tetanus booster was at age 50 2) Receives a flu shot every year 3) Has not received the hepatitis B vaccine 4) Has not received the hepatitis A vaccine 5) Has not received the herpes zoster vaccine
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Cortez is a 76-year-old woman who is independent, lives alone, prefers not to rely on others unless absolutely necessary. She was active and healthy until about 6 months ago, at which time she developed a persistent upper respiratory infection. Because she was unable to obtain or prepare foods, she lost weight and became very weak She finally sought medical attention, but she has not yet fully Recovered. Her primary care provider has admitted Mrs. Cortez to the hospital for shortness of breath, productive cough, dehydration, and nutritional deficiency. You recognize that standard precautions are instituted for all hospitalized clients. Explain why the use of such precautions may not prevent the spread of Mrs. Cortez's respiratory infection to other susceptible clients.
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A client with poor nutrition enters the hospital for treatment of a puncture wound. An appropriate nursing diagnosis would be___________.
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The nurse determines that a field remains sterile if which of the following conditions exist? 1) Tips of wet forceps are held upward when held in ungloved hands. 2) The field was set up 1 hour before the procedure. 3) Sterile items are 2 inches from the edge of the field. 4) The nurse reaches over the field rather than around the edges.
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Cortez is a 76-year-old woman who is independent, lives alone, prefers not to rely on others unless absolutely necessary. She was active and healthy until about 6 months ago, at which time she developed a persistent upper respiratory infection. Because she was unable to obtain or prepare foods, she lost weight and became very weak She finally sought medical attention, but she has not yet fully Recovered. Her primary care provider has admitted Mrs. Cortez to the hospital for shortness of breath, productive cough, dehydration, and nutritional deficiency. Mrs. Cortez's primary care provider suspects that Mrs. Cortez has pneumonia. What data support Mrs. Cortez's increased risk for such an infection?
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Which is the most effective nursing action for preventing and controlling the spread of infection? 1) Thorough hand hygiene 2) Wearing gloves and masks when providing direct client care 3) Implementing appropriate isolation precautions 4) Administering broad-spectrum prophylactic antibiotics
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The client is a chronic carrier of infection. To prevent the spread of the infection to other clients or health care providers, the nurse emphasizes interventions that do which of the following? 1) Eliminate the reservoir. 2) Block the portal of exit from the reservoir. 3) Block the portal of entry into the host. 4) Decrease the susceptibility of the host.
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When caring for a single client during one shift, it is appropriate for the nurse to reuse only which of the following personal protective equipment? 1) Goggles 2) Gown 3) Surgical mask 4) Clean gloves
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In caring for a client on contact precautions for a draining in­fected foot ulcer, which action should the nurse perform? 1) Wear a mask during dressing changes. 2) Provide disposable meal trays and silverware. 3) Follow standard precautions in all interactions with the client. 4) Use surgical aseptic technique for all direct contact with the client.
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After teaching a client and family strategies to prevent infection prevention, which statement by the client would indicate effec­tive learning has occurred? 1) "We will use antimicrobial soap and hot water to wash our hands at least three times per day." 2) "We must wash or peel all raw fruits and vegetables before eating." 3) "A wound or sore is not infected unless we see it draining pus." 4) "We should not share toothbrushes but it is OK to share towels and washcloths."
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While applying sterile gloves (open method), the cuff of the first glove rolls under itself about 0.5 cm (1/4 in.). What is the best action for the nurse to take? 1) Remove the glove and start over with a new pair. 2) Wait until the second glove is in place and then unroll the cuff with the other sterile hand. 3) Ask a colleague to assist by unrolling the cuff. 4) Leave the cuff rolled under.
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