Transcript Infection/Inflammation

Infection/Inflammation
,
What is the primary task a nurse can
perform to prevent the spread of
infections?
1. Wash hands for 30
seconds
2. Wear a mask
3. Wear gloves
4. Sneeze into his
hand.
INFECTION
• A disease state caused by the invasion and
multiplication of a pathogen, a diseaseproducing microorganism, in body tissues.
• Pathogens – bacteria, viruses, fungi or parasites
• The body responds to the invasion by forming
antibodies and a series of physiological changes
common organisms with antimicrobial
resistance
• Methicillen Resistant Staphylococcus aureus
(MRSA),
• Methicillen Resistant Staphylococcus
epidermis (MRSE),
• Vancomycin Resistant Enterococcus faecium
(VRE)
COURSE OF INFECTION
• Clinical course of infection – period when it
can be transmitted to others.
• Clinical course of an infection varies:
– Causative organism
– Dose and virulence of the causative organism
– Mode of entry of the organism
– Site of infection
– Overall host resistance (health status) of the
infected person
4-PHASES OF AN INFECTION
• INCUB ATION PERIOD – exposure to first
symptom
– Depending on the disease it can be transmitted
– Incubation period varies
– Knowing the incubation period may be helpful. .
.why?
4-PHASES CONT.
• PRODROMAL PHASE – is a period of vague,
nonspecific symptoms that may precede the
full manifestation of some infections.
– Symptoms may include: malaise, low-grade fever,
nausea, weakness, general aches
4 – PHASES CONT.
• CLINICAL ILLNESS PHASE – symptoms are fully
manifested and clearly recognized as
representing a specific infection.
– Diagnosis – signs and symptoms and confirmed
after obtaining cultures to identify the specific
organism.
4-PHASES CONT.
• CONVALESCENCE PHASE – is the time
following the acute symptoms to the time of
normal health
– Decreased energy and feeling tired
Phagocytosis – WBCs detect an
intruder then go to eliminate
them. The WBC track and
pursue the invader. Phagocytic
WBCs coat the intruder with
sticky substances and extend
pseudopods (footlike
extensions) to engulf them.
Enzymes within the phagocytic
WBC help digest and neutralize
them. Some debris may leak
from the WBC into the
extracellular fluid. This WBC
migration, phagocytosis, and
leakage all contribute to
inflammation
Physiology of the inflammatory
Process
• Injury>releases substances from damaged cells>
• capillary dilatation>
• increased capillary permeability>
• fluid with infection-fighting proteins escape from wall of
the capillaries>
• proteins release factors that attract phagocytic cells that
engulf or destroy invading microorganisms>
• white and red blood cells are also in the fluid, white blood
cells of various types (leukocytes, macrophages,
granulocytes, and null cells) fight infections
INFLAMMATION
• INFLAMMATION - A basic way in which the
body reacts to infection, irritation or other
injury, the key feature being redness, warmth,
swelling and pain. Inflammation is now
recognized as a type of nonspecific immune
response
INFLAMMATION
• INFLAMMATORY RESPONSE
– Second line of defense against infection
– Localized reaction to injury
– Activated when tissue damage occurs
– Responds to invasion by microorganisms
– Very complex – enormous flexibility and
effectiveness
ACUTE INFLAMMATION
• Acute Inflammation is the short-term immune
response our bodies mount in cases of
trauma, infection, and allergy.
CHRONIC INFLAMMATION
• Chronic inflammation arises when this
response is not completely turned off or
extinguished. It acts like a slow-burning fire,
continuing to stimulate pro-inflammatory
immune cells when they may not be needed.
– Six months generally used to characterize
“chronic.”
NOSOCOMIAL vs.
IATROGENIC INFECTIONS
• Nosocomial Infection
– Hospital-acquired -3 days
– Was not present or
incubating at the time of
admission
– 5-10% of patients
– Multiple resistant
organisms infect 25%
• Iatrogenic Infection
– The direct result of
treatments such as invasive
procedures
DEFENSES AGAINST INFECTION
• Primary
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Skin
Mucous membranes
Respiratory tract
GI tract
GU tract
• Secondary
– The immune and
inflammatory responses
constitute the second
line of defense against
infection
CHAIN OF INFECTION
• Each link represents a component
• Each link must be present and in sequential order for an
infection to occur.
• The links are:
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infectious agent
reservoir
portal of exit from the reservoir
mode of transmission
portal of entry into a susceptible host.
DIAGNOSTIC TEST
• WBC – The total WBC count reflects the body’s
response to infection.
• Neutrophils
50-70%
– Segs
50-70%
– Bands
0-8%
Eosinophils
1-4%
Basophils
0.4-1%
Monocytes
2-6%
Lymphocytes
20-40%
Diagnostic Tests
• Culture – Determines actual organism causing
infection
• Gram Stain – Is a specific microscopic test used to
obtain rapid results on a sample
• ESR – Erythrocyte Sedimentation Rate (ESR) is also
called Sed Rate or Sedimentation Rate. It is a simple
test used to determine how much inflammation is in
the body, but it cannot diagnose the specific
condition causing the inflammation.
DIAGNOSTIC TESTS
• Antigen – is a substance capable of inducing a
specific immune response. The term is derived
from the (gen) (eration) of (anti) (bodies) to
such substances. Specific immune responses
require recognition molecules like the T cell
receptor or antibodies which recognize the
antigen, or parts of it, and stimulate a response
by the specific arm of the immune response (T
or B cells).
DIAGNOSTIC TESTS
• C-reactive Protein
– Nonspecific test used to diagnose bacterial
infections, inflammation, and necrosis
– CRP is more sensitive and responds more rapidly
than the ESR
– Increase CRP may predict coronary events
ASSESSMENT OF PATIENT FOR
INFECTION
• Health History
– Questions r/t immunization
– Exposure to communicable disease
– Current and past illness
– Travel history
– General health status
• Physical Examination – Localized & Systemic
NURSING DIAGNOSIS
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Risk for Infection
Ineffective Protection
Anxiety/Fear
Impaired Social Interaction
NURSING INTERVENTIONS
• Standard Precautions – CDC Tier 1
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Gloves (preferably non-latex).
Water-impermeable gowns
Masks or respirators
Eye protection
• Transmission-Based Precautions –CDC Tier 2
– Airborne
– Droplet
– Contact
NURSING INTERVENTIONS
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Medical Asepsis – Prevention
Hand Hygiene
Environmental Controls
Disposing of Bodily Wastes
INTERVENTIONS
• Select nursing interventions related to:
– Drug Therapy
• Antipyretics(acetaminophen, aspirin)
• Antiinflammatory (salicylates, corticosteriods)
– Diet Therapy
• Fluids
• General Nutrition
• Vitamins
INTERVENTIONS
• Patient Teaching
• Risk for infection and altered protection
• Protection of the immune compromised patient
• Infection Prevention