Nursing Concepts Study Guide
Asepsis:
1. Explain the concepts of medical and surgical asepsis.
• Medical Asepsis- All practices intended to confine specific microorganisms to a specific
area, limiting the number, growth, and transmission of microorganisms, clean technique.
Not free from all microorganisms. Washing hands is an example.
• Surgical Asepsis- Sterile technique. All practices to keep an area or object free of
all microorganisms. Includes practices that destroy all microorganisms and spores.
2. Identify risks for nosocomial infections and health-care associated infections.
• Nosocomial Infections- Infections associated with the delivery of health care services in a
hospital. A subgroup of health care-associated infections (HAIs) that originate in any
health care setting.
➢ Origin is endogenous (originate within the body of the patient..i.e. resident flora
in an area where it doesn’t belong such as e. coli from the intestines in the
urinary tract) or exogenous (originate outside the patient’s body. A nurse bringing
germs
from one patient and transferring them to another).
➢ Longer hospital stays and exposure to more health care providers increases risk of
nosocomial infections as well as being a compromised host.
• Iatrogenic Infections are the direct result of diagnostic or therapeutic procedures. One
example is bacteremia that results from an intravascular infusion line or poor procedure
when inserting a catheter.
3. Identify signs of localized and systemic infections and inflammation.
, • Local infection- limited to the specific part of the body where the microorganisms
remain.
o Redness, swelling, heat, pain, loss of function
• Systemic infection- microorganisms spread and damage different parts of the body.
o Fever, headache, malaise, enlarged lymph nodes
4. Identify the difference between acute and chronic infections.
• Acute infection- Short term. (Flu for a week)
• Chronic Infection- Long term. Remission and exacerbation. (Hepatitis)
5. Identify factors influencing a microorganism’s capability to produce an infectious process.
• Virulence- the power and degree of pathogenicity possessed by a microorganism
• Pathogenicity- The ability to produce disease
6. Identify the differences in nonspecific and specific body defenses.
• Nonspecific- Anatomic and physiologic barriers that protect against all microorganisms
regardless of prior exposure.
o Inflammatory response
o Skin
• Specific- Antibody-mediated defenses
o Cell-mediated defenses
o Specific to certain microorganisms
7. Identify anatomic and physiologic barriers that defend the body against microorganisms.
• Intact skin and mucous membranes of orifices are the body’s first line of defense against
microorganisms. Unless the skin and mucosa become broken, they are an effective barrier
against bacteria.
• Dryness of skin is also a deterrent to bacteria.
• High acidity of secretions are also a deterrent
• Inflammation is a local and nonspecific defensive response of the tissues to an injurious
or infectious agent.
,8. Differentiate active from passive immunity.
• Active- antibodies are produced by the body in response to an antigen
o Natural- Antibodies are formed in the presence of active infection
o Artificial- Antigens (vaccines or toxoids) are administered to stimulate antibody
production.
• Passive- antibodies are produced by another source, animal or human
o Natural- antibodies are transferred naturally from an immune mother to her baby
through the placenta or in colostrum
o Artificial- Immune serum (antibody) from an animal or another human
in injected. Rabies, snake bite anti-venom.
9. Identify the links of the chain of infection.
• Etiologic agent- The microorganism that causes disease.
• Reservoir- source of a microorganism. Common sources are other humans, the client’s
own microorganisms, plants, animals, or the general environment. A carrier is a person
or animal reservoir of a specific infectious agent that usually does not manifest any
clinical
signs of disease.
• Portal of exit from reservoir- Before an infection can establish itself in a host, the
microorganisms must leave the reservoir. Common portals of exit from human reservoirs
include, nose or mouth through sneezing/coughing, anus, urethra, or an open wound
• Method of transmission- A microorganism requires a means of transmission to reach
another person or host through a receptive portal of entry. There are 3 mechanisms.
o Direct transmission- immediate and direct transfer of microorganisms from
person to person through touching, biting, kissing, or sexual intercourse. Droplet
spread is also a form of direct transmission but can occur only if the source and
the host
are within 3 feet of each other.
o Indirect transmission- vehicle born or vector born
▪ Vehicle born transmission- A vehicle is any substance that serves as an
intermediate means to transport and introduce an infectious agent into a
, susceptible host. Fomites such as handkerchiefs, toys, soiled clothes,
cooking or eating utensils, and surgical instruments or dressings, can act as
vehicles. Water, blood, food, serum and plasma are other vehicles.
▪ Vector born transmission- An animal or flying or crawling insect that
serves as an intermediate means of transporting the infectious agent.
o Airborne transmission- May involve droplets or dust. Droplet nuclei, the residue
of evaporated droplets emitted by an infected host such as someone with
tuberculosis, can remain in the air for long periods. Dust particles containing the
infectious agents can also become airborne. Usually enters by the respiratory tract
of another person.
10. Identify relevant nursing diagnoses and contributing factors for clients at risk for infection
and who have an infection.
• Risk factors include
o Inadequate primary defenses such as broken skin, traumatized tissue, decreased
ciliary action, stasis of body fluids, change in pH of secretions, or altered
peristalsis.
o Inadequate secondary defenses such as leukopenia, immunosuppression,
decreased hemoglobin, or suppressed inflammatory response.
• Example of nursing diagnoses or collaborative problems that may arise from the actual
presence of an infection include the following:
o Potential complication of infection: fever
o Imbalanced nutrition: less than body requirements if the client is too ill to eat
adequately
o Acute pain: if the client is experiencing tissue damage and discomfort
o Impaired social interaction or social isolation: if the client is required to be
separated from others during a contagious episode.
Asepsis:
1. Explain the concepts of medical and surgical asepsis.
• Medical Asepsis- All practices intended to confine specific microorganisms to a specific
area, limiting the number, growth, and transmission of microorganisms, clean technique.
Not free from all microorganisms. Washing hands is an example.
• Surgical Asepsis- Sterile technique. All practices to keep an area or object free of
all microorganisms. Includes practices that destroy all microorganisms and spores.
2. Identify risks for nosocomial infections and health-care associated infections.
• Nosocomial Infections- Infections associated with the delivery of health care services in a
hospital. A subgroup of health care-associated infections (HAIs) that originate in any
health care setting.
➢ Origin is endogenous (originate within the body of the patient..i.e. resident flora
in an area where it doesn’t belong such as e. coli from the intestines in the
urinary tract) or exogenous (originate outside the patient’s body. A nurse bringing
germs
from one patient and transferring them to another).
➢ Longer hospital stays and exposure to more health care providers increases risk of
nosocomial infections as well as being a compromised host.
• Iatrogenic Infections are the direct result of diagnostic or therapeutic procedures. One
example is bacteremia that results from an intravascular infusion line or poor procedure
when inserting a catheter.
3. Identify signs of localized and systemic infections and inflammation.
, • Local infection- limited to the specific part of the body where the microorganisms
remain.
o Redness, swelling, heat, pain, loss of function
• Systemic infection- microorganisms spread and damage different parts of the body.
o Fever, headache, malaise, enlarged lymph nodes
4. Identify the difference between acute and chronic infections.
• Acute infection- Short term. (Flu for a week)
• Chronic Infection- Long term. Remission and exacerbation. (Hepatitis)
5. Identify factors influencing a microorganism’s capability to produce an infectious process.
• Virulence- the power and degree of pathogenicity possessed by a microorganism
• Pathogenicity- The ability to produce disease
6. Identify the differences in nonspecific and specific body defenses.
• Nonspecific- Anatomic and physiologic barriers that protect against all microorganisms
regardless of prior exposure.
o Inflammatory response
o Skin
• Specific- Antibody-mediated defenses
o Cell-mediated defenses
o Specific to certain microorganisms
7. Identify anatomic and physiologic barriers that defend the body against microorganisms.
• Intact skin and mucous membranes of orifices are the body’s first line of defense against
microorganisms. Unless the skin and mucosa become broken, they are an effective barrier
against bacteria.
• Dryness of skin is also a deterrent to bacteria.
• High acidity of secretions are also a deterrent
• Inflammation is a local and nonspecific defensive response of the tissues to an injurious
or infectious agent.
,8. Differentiate active from passive immunity.
• Active- antibodies are produced by the body in response to an antigen
o Natural- Antibodies are formed in the presence of active infection
o Artificial- Antigens (vaccines or toxoids) are administered to stimulate antibody
production.
• Passive- antibodies are produced by another source, animal or human
o Natural- antibodies are transferred naturally from an immune mother to her baby
through the placenta or in colostrum
o Artificial- Immune serum (antibody) from an animal or another human
in injected. Rabies, snake bite anti-venom.
9. Identify the links of the chain of infection.
• Etiologic agent- The microorganism that causes disease.
• Reservoir- source of a microorganism. Common sources are other humans, the client’s
own microorganisms, plants, animals, or the general environment. A carrier is a person
or animal reservoir of a specific infectious agent that usually does not manifest any
clinical
signs of disease.
• Portal of exit from reservoir- Before an infection can establish itself in a host, the
microorganisms must leave the reservoir. Common portals of exit from human reservoirs
include, nose or mouth through sneezing/coughing, anus, urethra, or an open wound
• Method of transmission- A microorganism requires a means of transmission to reach
another person or host through a receptive portal of entry. There are 3 mechanisms.
o Direct transmission- immediate and direct transfer of microorganisms from
person to person through touching, biting, kissing, or sexual intercourse. Droplet
spread is also a form of direct transmission but can occur only if the source and
the host
are within 3 feet of each other.
o Indirect transmission- vehicle born or vector born
▪ Vehicle born transmission- A vehicle is any substance that serves as an
intermediate means to transport and introduce an infectious agent into a
, susceptible host. Fomites such as handkerchiefs, toys, soiled clothes,
cooking or eating utensils, and surgical instruments or dressings, can act as
vehicles. Water, blood, food, serum and plasma are other vehicles.
▪ Vector born transmission- An animal or flying or crawling insect that
serves as an intermediate means of transporting the infectious agent.
o Airborne transmission- May involve droplets or dust. Droplet nuclei, the residue
of evaporated droplets emitted by an infected host such as someone with
tuberculosis, can remain in the air for long periods. Dust particles containing the
infectious agents can also become airborne. Usually enters by the respiratory tract
of another person.
10. Identify relevant nursing diagnoses and contributing factors for clients at risk for infection
and who have an infection.
• Risk factors include
o Inadequate primary defenses such as broken skin, traumatized tissue, decreased
ciliary action, stasis of body fluids, change in pH of secretions, or altered
peristalsis.
o Inadequate secondary defenses such as leukopenia, immunosuppression,
decreased hemoglobin, or suppressed inflammatory response.
• Example of nursing diagnoses or collaborative problems that may arise from the actual
presence of an infection include the following:
o Potential complication of infection: fever
o Imbalanced nutrition: less than body requirements if the client is too ill to eat
adequately
o Acute pain: if the client is experiencing tissue damage and discomfort
o Impaired social interaction or social isolation: if the client is required to be
separated from others during a contagious episode.
