Nursing 2312: Week 3 Write-Up. Questions & Answers.

Week 3 Write - Up Infection Prevention and Control Jane Martin, a 75-year-old widow, is admitted to the hospital for treatment of a postoperative infection of her left knee. She had total knee replacement surgery 3 weeks ago and went to her orthopedic surgeon with a complaint of pain, redness, and swelling in the operative joint. The incision is draining a purulent drainage. Her vital signs are blood pressure, 130/80 mm Hg; temperature, 101° F orally; pulse, 108 beats/min; and respirations, 18 breaths/min. She rates the pain in her left knee as a 6 on a scale from 1 to 10. Mrs. Martin has type 2 diabetes and has controlled her disease with oral antihyperglycemic agents. She has not had much of an appetite since her surgery and has lost 4 lb. Mary, a senior student nurse, is assigned to begin admitting Mrs. Martin. Include your Answers and Rationales 1. Mary knows that the most important way to prevent infection is how? By keeping the site of the surgery clean and also by taking any antibiotics the doctor may have prescribed to avoid infection. But most importantly good wound care is essential. 2. The surgeon has ordered that Mrs. Martin be placed in isolation. Which type of isolation is most appropriate, and what precautions are included in this type of isolation? Contact precautions (direct patient or environmental contact) were probably ordered by the physician because Mrs. Martin infection seems to be serious and she is not doing so well. Therefore the physician wants to protect Mrs. Martin from any further infections. 3. Mrs. Martin asks Mary why some of the staff members wash their hands at the sink and others just wipe their hands with the stuff in the container. How should Mary respond so that Mrs. Martin knows when it is appropriate to not wash hands with soap and water? Mary should tell her that it depends on what they were doing, for example if they get their gloved or ungloved hands soiled they wash their hands, but if they do not get their hands soiled hand sanitizer suffices. 4. Mrs. Martin’s physician has decided to put in a peripherally inserted central catheter (PICC) line so she can receive intravenous antibiotics for 3 weeks. What type of preparation should Mary anticipate for this invasive procedure? Mary can speak with Mrs. Martin and explain to her what procedure she will be getting done and for what. Also explain to her the antibiotic she will be on for three weeks and/or about any other medication such as blood thinners she may have to take for the procedure to avoid any blood clots.