Risk Reducation & Infection Control

olanjones's version from 2017-10-03 18:36


Question Answer
Care for artificial eyeremove daily for cleansing (mild detergent & H2O), dry & store in water or contact-lens solution, remove before general surgery
Retinopathy of prematurity (babies)expert eye exam for <36wks or 2000g @birth, ↓O2, cont. monitor PO2 (SaO2 should be 95-100), Vit E, ↓light & stimulation
Detached retinabedrest (no forward bend/excessive movement), area of detachment should be in dependent position, no hair-washing x 1 wk, avoid strenuous activity x 3 months
Cataracts (post-op)avoid heavy lifting, use eye drops in affected eye, night-shield, sleep on unaffected side, protect from bright lights/water
Glaucomaavoid tight clothing, ↓external stimuli, avoid heavy lifting/straining, avoid mydriatics (Atropine), 5 DANGER SIGNS – brow arching, halos around lights, blurry vision, ↓peripheral vision, HA/eye pain


Question Answer
Post-opreinforce dressing, don’t change, avoid noseblowing/sneezing/coughing, watch for facial nerve damage/infection/vertigo or tinnitus, position on unaffected side, do not apply any pressure if surgery is on internal ear-notify HCP immediately
Otitis mediaadminister abx/antihistamines/nasal decongestants, ventilator tubes, myringotomy, tympanoplasty, bedrest if ↑temp, position on affected ear to promote drainage
Meniere’sadmin antihistamine/antiemetic/antivertigo/diuretics, bedrest in acute phase, protection when ambulating, ↓sodium, avoid caffeine/nicotine/ alcohol, may have decompression w/shunt or total labryinthectomy

Metabolic alterations

Question Answer
PKUmilk substitute for infants (Lofenalac), ↓protein diet (no meat, dairy, eggs, nutrasweet)
renal failure↑calorie, ↓protein (as allowed by kidney function)
hepatobiliary↓fat, ↑protein, vitamins
cystic fibrosispancreatic enzymes, ↑protein, ↑calorie
atherosclerosis↓saturated fat, ↓cholesterol, meds given before meals


Question Answer
ChecklistInformed consent, labs/imaging/EKG, skin prep, bowel prep, IV, NPO, pre-meds, removal of jewelry/dentures/nail polish, nutrition (may need PN or tube feeding pre-op)
Supplement affecting coagulationechinacea, garlic, gingko, ginseng, kava, St. John’s wort
Age appropriate teachingtoddler = simple directions; preschool/school-age = play w/equipment; adolescent = expect resistance

Post-op Complications

Question Answer
Shocktreat cause, O2, IV fluids
Embolism(2nd postop day) O2, anticoag, IV fluids
Paralytic ileusNG suction, IV fluids, decompression
dehiscence/eviscerationlow Fowlers, no coughing, NPO, notify provider, cover w/ sterile saline dressing (wax paper if at home)

Therapeutic procedures

Question Answer
Suctioningwall suction set between 80-120 mm Hg
Trach cuffcheck pressure q 8hrs, maintain at <25 cm/H2O
Chest tubesif suction is to be used fill suction control chamber w/ sterile H2O to the 20cm mark
Central venous pressurenormal reading 4-12 mmHg; instruct client to hold breath on insertion & withdrawal to prevent air embolism
NG Levin/Salem pumpcheck residual before intermittent feeding & q 4hrs for cont. feeding; instill 15-30 mL of saline/H2O before & after each dose of meds & feeding, q 46 hrs w/ cont. feeding, & when feeding is discontinued; 30-50 mL saline for irrigation
Enemahold irrigation set @ 12-18 inches for high enema, 3 inches for low; insert tube no more than 3-4 inches for adult, 2-3 for child, 1-1.5 for infant; retain 5-10 mins
Self-cath (client teaching)done every 4-6 hrs, clean technique (not sterile), remove 350-400 mL each time, use catheter for 2-4 wks then discard, store in sandwich sized bag or clean container, never store wet or in antiseptic solution, drink 250 ml at 2 hour intervals or ↑2L at regular intervals

Infection Control

Question Answer
Standard precautionsapply to contact with blood, body fluids, non-intact skin, & mucous membranes from all clients
Airborneprivate room, monitored negative air pressure, keep door closed, must wear N-95 HEPA filter – measles, TB, chicken pox, disseminated zoster
Dropletcontact of conjunctiva or mucous membranes of nose/mouth (sneezing, coughing, talking, suctioning, bronchoscopy), private room or w/ same infection, maintain 3 ft special separation from infected client/visitors (mask if closer than 3 ft), door may remain open – diphtheria, pneumonia, meningitis, influenza, rubella, mumps, pertussis
Contactclients that require skin-to-skin contact or w/ contact with contaminated object in room, private room or w/ same infection, clean, non-sterile gloves, gown if clothing will have contact w/ potential containment, remove PPE prior to leaving room, dedicated equipment to room – MRSA, herpes simplex, localized herpes zoster, C-diff, RSV, pediculosis, scabies, rotavirus, hepatitis A
Private roompoor hygiene habits, contaminates environment, can’t assist in maintaining infection control precautions (peds, AMS)
Shared roomconsider epidemiology and mode of transmission of infecting organism

Name that precaution!

Question Answer
chicken poxairborne
rubella, mumps, pertussisdroplet
herpes simplex, localized herpes zostercontact
N-95 HEPA filterairborne
Door can remain open, mask if within 3 feet of clientdroplet
Toxic shock syndromestandard precautions

Name that precaution!

Question Answer
Private room, monitored negative air pressure, keep door closedairborne
Must wear N-95 HEPA filterairborne
Pneumonia, InfluenzaDroplet, contact of conjuctiva or mucous membranes of nose/mouth
Can put these clients in private room or with clients that have same infectiondroplet
disseminated zosterairborne
scabies or pediculosiscontact
Hepatitis Acontact