& Hygiene |2026 Latest Update with Complete Solution-Herzing
Unit 4 : Hygiene practices, infection s asepsis
🦠 Chapter 28: Infection Prevention and Control
🔑 Must-Know Definitions
Term Meaning
Infection Invasion of the body by pathogens, resulting in disease.
Colonization Microorganisms are present without causing infection.
Asepsis Absence of disease-producing microorganisms.
Medical Asepsis Clean technique (e.g., hand hygiene, gloves).
Surgical Asepsis Sterile technique (e.g., OR, catheter insertion).
🔁 Chain of Infection (CRUCIAL FOR HESI)
Know how nurses break this chain!
1. Infectious Agent – Bacteria, virus, fungi, protozoa
2. Reservoir – Human body, animals, water, food, environment
3. Portal of Exit – Skin, mucous membranes, respiratory/GI/GU tracts
4. Mode of Transmission – Contact, droplet, airborne, vector
5. Portal of Entry – Same as exit
6. Susceptible Host – Immunocompromised, elderly, infants
´O• Break the chain = hand hygiene, PPE, clean equipment, vaccines
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Stages of Infection
Stage Characteristics
Incubation Pathogen enters → first symptoms (no signs yet)
Prodromal Early, vague symptoms (most contagious)
Illness Full symptoms specific to infection
Convalescence Recovery, tissue repair, return to baseline
Types of Infections
Type Notes
Localized Redness, swelling, warmth, pain, drainage
Systemic Fever, chills, ↑HR, ↑RR, ↓BP, malaise
HAIs Health care-associated infections (CAUTI, CLABSI, SSI, VAP)
, Iatrogenic From procedure
Exogenous From outside the body
Endogenous From the patient’s own flora
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´·,˙ Common HAI organisms: MRSA, VRE, C. diff
🚧 Standard Precautions (for All Patients)
Use when contact with:
• Blood
• Body fluids
• Nonintact skin
• Mucous membranes
Includes:
Hand hygiene
Gloves
Respiratory hygiene
Safe injection practices
Proper equipment cleaning
🧤 Transmission-Based Precautions (HESI High-Yield)
Type PPE Examples
Contact Gloves + gown MRSA, VRE, C. diff (soap & water)
Droplet Surgical mask Influenza, meningitis, rubella
N95 + neg. pressure room, gown,
Airborne TB, measles, varicella, shingles
gloves, goggles (if indicated)
Protective (reverse) isolation: For immunocompromised clients (e.g., cancer, transplant)
🖐️ Hand Hygiene Guidelines
Method When to Use
Soap & Water Hands visibly soiled, after C. diff exposure
Alcohol-based rub All other routine care
’·● Duration:
• Alcohol rub: 20–30 sec
• Hand wash: 15–20 sec
,D Lab Indicators of Infection
Test Normal Range Infection Indicator
5,000–
WBC 10,000/mm³ ↑ = infection, ↓ = immunosuppression
ESR (seditation rate) <20 mm/hr ↑ = inflammation
Culture & Sensitivity — Identifies pathogen & best antibiotic
CRP <1 mg/dL ↑ = acute inflammation
🩺 Signs of Infection
Localized Systemic
Redness, warmth, swelling, pain, Fever, chills, ↑HR, ↑RR, fatigue, confusion (esp. in
drainage elderly)
🧠 HESI Critical Thinking Tips
• Always start with hand hygiene in priority questions.
• For isolation questions, choose the correct PPE sequence:
o Donning: Gown → Mask → Goggles → Gloves
o Doffing: Gloves → Goggles → Gown → Mask
• Immunocompromised patients = protective precautions!
• For C. diff → use soap & water, not alcohol rub.
• If exposed to blood/body fluids, wash → report → fill incident report → seek eval.
• Elderly may not show classic signs of infection—look for confusion or falls.
🧾 Documentation & Communication
• Report HAI risks or exposures promptly.
• Document:
o Site of infection
o Signs/Symptoms
o Interventions (PPE, isolation)
o Patient teaching
📌 Quick HESI Review Checklist
⬛ Know all 6 links in the chain of infection
⬛ Understand types of precautions and when to use them
⬛ Master PPE order for donning and doffing
⬛ Recognize signs of localized vs. systemic infection
, ⬛ Memorize WBC values and culture relevance
⬛ Choose soap and water for C. diff
⬛ Apply standard precautions to all patients
⬛ Understand how to protect immunocompromised clients
🧼 Chapter 40: Hygiene
🧠 Why Hygiene Matters (HESI Connection)
• Hygiene promotes comfort, safety, and well-being.
• Poor hygiene leads to infections, skin breakdown, and decreased dignity.
• Nurses assess hygiene needs and assist based on client condition, preferences, and
safety.
📋 Activities of Daily Living (ADLs)
Know these for client assessments and care planning:
• Bathing
• Brushing teeth
• Shaving
• Hair care
• Nail care
• Perineal care
• Dressing
˛ HESI Tip: Impaired mobility, confusion, or fatigue → partial or complete assistance
C*
required with hygiene.
🧍♀️ Factors Influencing Hygiene
Factor Impact
Culture Bathing frequency, products used
Socioeconomic status Access to water, hygiene supplies
Developmental stage Elderly = fragile skin, ↓ mobility
Physical condition Weakness, cognitive deficits, pain limit independence
Personal preferences Routine, products, timing, privacy needs
🛁 Types of Hygiene Care
Type Description