4.Sample answers:
a.Direct contact: Transmission of disease through
touching, kissing, or sexual contact
b.Indirect contact: Personal contact with contam-
inated blood, food, water, etc.
c. Vectors: Mosquitoes, ticks, and lice transmit
organisms from one host to another.
d.Airborne: Spread of droplet nuclei through
coughing, sneezing, or talking- a.Inflammatory response: A protective
mechanism that eliminates the invading
pathogen and allows tissue repair to occur
b.Immune response: Involves specific reactions in
the body as it responds to an invading foreign
protein such as bacteria or, in some cases, the
body’s own proteins. The body responds to an
antigen by producing an antibody. - a.Intact skin and mucous membranes protect the
body against microbial invasion.
b.The normal pH levels of gastric secretions and
of the genitourinary tract help to ward off
microbial invasion.
c. The body’s white blood cells influence resistance
to certain pathogens.
d.Age, sex, race, and hereditary factors influence
susceptibility. - a.Assessing: Early detection and surveillance tech-
niques are critical. The nurse should inquire
about immunization status and previous or
recurring infections, observe nonverbal cues,
and obtain the history of the current disease.
b.Diagnosing: The direction or focus of nursing
care depends on a nursing diagnosis that accu-
rately reflects the patient’s condition.
c. Planning: Effective nursing interventions can
control or prevent infection. Nurses should
review assessment data and consider the cycle
of events that results in infection control as
patient goals are formulated.
d.Implementing: The nurse uses principles of asep-
tic technique to halt the spread of microorgan-
isms and minimize the threat of infection.
e.Evaluating: The nurse can intervene in, and
improve, a patient’s outcome by assessing
the person at risk, selecting appropriate nursing
diagnoses, planning and intervening to
maintain a safe environment, and evaluating
the plan of care to determine whether it is
working.
8.Sample answers:
a.Patient’s home: Wash hands before preparing
food and before eating; use individual personal
care items such as washcloths, towels, and
toothbrushes.
b.Public facilities: Wash hands after using any
public bathroom; use individually wrapped
drinking straws.
c. Community: Use sterilized combs and brushes
in beauty and barber shops; examine food han-
dlers for evidence of disease.
d.Healthcare facility: Use standard aseptic
techniques to prevent further spread of a present
organism and prevent nosocomial infections.- a.Instituting constant surveillance by infection-
control committees and nurse epidemiologists
b.Having written infection-prevention practices
for all agency personnel
c. Using practices that help promote the best pos-
sible physical condition in patients - a.Nature of organisms present: Some organisms are
easily destroyed, whereas others can withstand
certain commonly used sterilization and disinfec-
tion methods.
b.Number of organisms present: The more organ-
isms present on an item, the longer it takes to
destroy them.
c. Type of equipment: Equipment with narrow
lumens, crevices, or joints requires special care.
Certain items may be damaged by sterilization
methods.
d.Intended use of equipment: The need for medical
or surgical asepsis influences the methods used in
the preparation and cleaning of equipment.
e.Available means for sterilization and
disinfection: The choice of chemical or physical
means of sterilization and disinfection takes
into consideration the availability and
practicality of the means.
f. Time: Time is a key factor. Failure to observe
recommended time periods for disinfection and
sterilization significantly increases the risk for
infection and is grossly negligent. - a.Hospital: The infection-control nurse is respon-
sible for educating patients and staff about
effective infection-control techniques and for
collecting statistics about infections.
b.Home care setting: The infection-control
nurse’s duties include surveillance for agency-
associated infections, as well as education, con-
sultation, performance of epidemiologic
investigations and quality improvement activi-
ties, and policy and procedure development. - a.Risk for Infection related to altered skin
integrity/burns
b.Effective nursing interventions can control or
prevent infection. The nurse should review
patient data, consider the cycle of events that
result in the development of an infection, and
incorporate infection control as a patient goal.
13.Use standard precautions for the care of all
patients in the ER. The additional concern with TB
necessitates using airborne precautions in addition
to standard precautions.
REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.How might the nurse respond to Ms. Turheis in a
holistic manner that respects her human dignity,
while at the same time, maintaining a safe environ-
ment for her?
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