Term
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Definition
When microorganisms reach the blood stream (bacteremia or septicemia), it may lead to a systemic inflammatory response syndrome resulting from infection; impacts every system.
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Term
| What is the difference between aerobic and anaerobic? |
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Definition
| Aerobic- with oxygen (microorganisms that require oxygen-enriched environments to strive) Anaerobic-without oxygen (microorganisms that require oxygen-free environments to thrive) |
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Term
| What is an immunosuppressant? |
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Definition
| Agent that interferes with the ability of the immune system to respond to infection; stops body from fighting. |
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Term
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Definition
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Term
| What does virulence mean? |
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Definition
| Ability/degree of a microorganism to cause infection. |
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Term
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Definition
| Leukopenia- decrease WBC count Leukocytosis- increased WBC count |
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Term
| What is the difference between localized infection and systemic infection? |
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Definition
| Localized is a specific area on the body. Systemic is all the body systems are affected. |
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Term
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Definition
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Term
| What is the difference between virus and bacteria? |
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Definition
| *Bacteria is a single celled microorganism classified by shape, how they grow, how they stain and if they use oxygen or not. *A virus is only seen with an electron microscope. They use metabolic materials of living human cells to grow and multiply. Can survive short periods outside living organisms but cannot grow or reproduce. |
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Term
| What are the 3 types of fungal infections and examples? |
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Definition
| Superficial- affect skin, hair, nails ex: ringworm, athlete's foot Intermediate- affect subcutaneous tissue ex: candidiasis-affects mucus membranes, yeast infections Deep- affects deep tissues and organs ex: pneumocystis pneumonia |
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Term
| What are examples of Rickettsia? |
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Definition
| (Resemble bacteria but act like viruses, cannot survive without host) Lyme disease, Malaria, & West Nile Virus |
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Term
| What do protozoans affect? |
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Definition
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Term
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Definition
| *Single-celled, lack cell wall,can be many different shapes *Primarily affect GI/GU |
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Term
| What are the 3 types of helminths? |
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Definition
| Roundworm, Tapeworm, and Flatworms |
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Term
| What are prions and an example? |
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Definition
| *Infectious particle composed primarily of protein *Mad cow disease |
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Term
| What are the links of infection transmission? |
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Definition
| Susceptible Host Infectious agent Reservoirs Portal on entry Means of transmission Portal of exit |
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Term
| How do we prevent infection? |
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Definition
| Remove one link in the links of infection transmission |
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Term
| What is the first line of defense against infection? |
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Definition
| Integumentary system: skin |
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Term
| What are examples of mechanical defenses? |
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Definition
| Coughing, Sneezing, & Vomiting |
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Term
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Definition
| Large phagocytes present in tissues such as lungs, liver, lymph nodes, spleen and peritoneum. Perform phagocytosis: ingestion of dead cells and foreign material |
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Term
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Definition
| attack foreign invaders and weaken them for WBC's |
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Term
| What are the 3 responses of inflammatory process? |
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Definition
| Cellular, Vascular & Chemical |
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Term
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Definition
| Body's first attempt to destroy pathogens with heat |
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Term
| How does bacteremia/septicemia occur? |
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Definition
| The lymphatic system drains into the venous system and can allow infection entry into the blood stream. |
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Term
| What are the signs and symptoms of sepsis? |
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Definition
| *Two or more of the following.... Temperature >38 C (100.4 F) Heart Rate > 90 Respiratory Rate > 20 WBC count > 12,000 |
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Term
| What are the characteristics of severe sepsis? |
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Definition
| Organ dysfunction/failure, hypotention, hypo-perfusion, altered mental status, lactic acidosis |
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Term
| What are the diagnostic test for sepsis/infection? |
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Definition
| Culture & Sensitivity CBC w/diff Immunologic tests: C-reactive protein, ESR |
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Term
| What does the "diff" show with infection? |
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Definition
Percentage of WBC subtypes- tells us stage of infection *Elevated Neutorphils: early stages
*Elevated Bands:later part of early stages
*Elevated Monocytes: second stage infection |
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Term
| What are the different treatments for infection? |
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Definition
| Antibiotics, antifungals, antivirals, and other antimicrobial's, remove infected wounds, increase WBC's production and bone marrow transplant |
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Term
| What is MRSA and what causes it? |
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Definition
| *Lack of susceptibility to all penicillin's *Over prescribing unnecessary antibiotics |
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Term
| What are the drugs of choice for gram positive cocci? |
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Definition
| Penicillins: amoxicillin, nafcillin, piperacillin |
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Term
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Definition
| Wash hands, keep wounds covered, prpper use of PPE's, sanitary environments, good hygiene |
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Term
| What do generations of antibodies mean? |
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Definition
| 1st gen: more effective towards gram-positive bacteria 2nd gen & 3rd gen: 1/2 gram-pos, 1/2 gram-negative 4th gen: more effective against gram-negative bacteria |
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Term
| How do carbapenems destroy bacteria? |
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Definition
| By destroying the cell wall |
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Term
| What are the contraindications for tetracycline? |
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Definition
| pregnant women and children under 8 |
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Term
| What is the drug of choice for aerobic gram negative bacilli? |
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Definition
| Aminoglycosides: gentamycin, tobramycin |
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Term
| How do sulfonamides work? |
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Definition
| Inhibit bacterial growth by preventing folic acid syntheses; which is essential for DNA, RNA production |
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Term
| What is the drug of choice for anthrax? |
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Definition
| Fluoroquinolones: ciprofloxacin, levofloxacin |
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Term
| Isoniazid is used in conjunction with what meds for active TB? |
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Definition
| rifampin & pyridoxine (6 month regimen) |
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Term
| What is the common treatment for c.diff? |
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Definition
| Antiprotozoals; metronidazole(Flagyl) |
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Term
| What is the treatment for fungal infections? |
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Definition
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Term
| What is a potentially toxic unclassified anti-infective? |
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Definition
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Term
| What is the nursing management of infection? |
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Definition
| Maintain patient skin integrity, monitor vital signs, promote adequate nutrition/hydration, maintain controlled blood glucose(sugar inhibits microorganism growth), review CBC and report abnormal results, obtain cultures & send to lab, provide aseptic wound care, administer antimicrobial drugs |
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Term
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Definition
| Life-threatening: insufficient arterial blood flow; insufficient cell and tissue oxygenation |
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Term
| What are causes of shock? |
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Definition
| decreased blood volume, heart failure, massive dilation of peripheral blood vessels |
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Term
| How does hypovolemic shock occur? |
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Definition
| significantly diminished extracellular (intravascular) fluid; decrease blood volume |
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Term
| What is the rarest type of shock and how does it occur? |
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Definition
| Neurogenic Shock- results from damage to the brain or peripheral nerves that innervate the sympathetic nervous system; leads to decreased vasoconstriction, hypotension, and decreased cardiac output |
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Term
| What shock has the highest mortality rate? |
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Definition
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Term
| How is septic shock caused? |
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Definition
| Overwhelming bacterial infections that cause a severe systemic inflammatory/immune response leading to vasodilation, hypotention, increased capillary permeability, and fluid shifting into the inter-cellular spaces leading to decreased tissue perfusion/oxygenation |
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Term
| What happens during anaphylactic shock? |
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Definition
| massive release of histamine and vasoactive chemicals that cause vasodilation, increased capillary permeability, airway inflammation, hypotension, and hives/rash |
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Term
| What is obstructive shock caused by? |
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Definition
| *Caused by conditions that fill the thoracic cavity w/ fluid, air *ex: pneumothrorax, cardiac tamponade (blood/fluid buildup in the pericardial space) |
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Term
| What is the outcome of cardiogenic shock? |
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Definition
| MI w/subsequent heart failure |
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Term
| What is the first stage of compensation attempt? |
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Definition
| Catecholamine release neurotransmitters that stimulate the sympathetic nervous system; Epinephrine & Norepinephrine |
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Term
| What is the RAAS compensation? Explain the steps |
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Definition
| *Renin-Angiotensin-Aldosterone System- increases BP 1. Low kidney profusion tells nephrons in kidneys to release Renin 2. Renin activates Angiotensinogen, converting it to Angiotension I 3. The lungs have an Angiotensin-converting-enzyme(ACE) that converts Angiotensin I into Angiotensin II 4. Angiotensin II stimulates the adrenal cortex to release aldosterone 5. Aldosterone promotes re-absorption of sodium and water by kidneys which helps increase blood volume |
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Term
| What do ACTH and ADH do during shock? |
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Definition
| Pituitary gland releases; *ACTH; stimulates adrenal gland to secrete a cortiosteroid hormones (aldosterone) to conserve sodium excretion and promote potassium excretion by the kidneys *ADH; promotes kidneys to reabsorb and retain water |
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Term
| What happens during decompensation? |
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Definition
| Compensatory mechanisms fail: cellular hypoxia, coagulation defects, anaerobic metabolism, lactic acidosis, cardiovascular changes |
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Term
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Definition
| Disseminated intravascular coagulation:Clots prevent blood flow, cell organ death |
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Term
| What is the last stage of shock? |
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Definition
| Irreversible Stage: Imminent death |
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Term
| What happens to the vital signs during shock? |
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Definition
| *Blood Pressure- falls, compensation stage may increase BP, then decomensation brings another fall *Pulse Rate- Tachycardia; decompensation stage bradycardia Respiration's- Tachypnea Temperature- Drops (hypothermia); septic shock may by hyperthermia due to infection |
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Term
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Definition
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Term
| What are the normal ABG findings? |
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Definition
Ph: 7.35-7.45
PaO2(partial pressure of oxygen): 80-100mmHG
PaCO2(partial pressure of CO2): 35-45mmHg |
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Term
| What happens to ABG findings during shock? |
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Definition
PaO2: falls below 60mmHg
PaCO2: can be normal, decreased or increased
Ph: higher PaCO2 leads to higher acidity |
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Term
What is CVP?
a. Normal values
b. hypovolemic shock
c. cardiogenic shock |
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Definition
Central Venous Pressure- BP in the Vena Cava at right atrium; provides information about right ventricular function
a. 2-10 mm Hg
b. Lower due to low circulating volume
c. higher due to venous congestion from low CO |
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Term
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Definition
| Pulmonary artery pressure |
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Term
| Where does the catheter sit when placed during PAP test? |
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Definition
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Term
| Treatments of shock include what? |
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Definition
| IV fluids, mechanical devices, drug therapy, blood transfusion |
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Term
| What is the ratio of IV fluid given to fluid loss? |
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Definition
*3L given to every 1L fluid lost (3:1)
* ratio not applied to cardiogenic shock |
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Term
| What are the mechanical devices used for shock? |
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Definition
*Intra-aortic ballon pump (IABP)
*Ventricular Assist device (VAD) |
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Term
| What are the life threatening complications of shock? |
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Definition
*kidney failure: Neurologic deficits
*bleeding disorders: disseminated intravascular coagulation (DIC)
*acute respiratory distress syndrome(ARDS)
*Sepsis |
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