Deck 71: Management of Patients With Infectious Diseases

Question 1

Several patients on your unit have recently been diagnosed with C.difficile.Identify how this organism causes pathology.What nursing interventions should beused to reduce the risk of new infections? What strategies are used to control C.difficile in healthcare facilities?

Answer 1

Clostridium difficile or C. difficile is a virulent bacterium that has affected hospital establishments in North America in the past. C. difficile is resilient to antibiotics. An antibiotic treatment interrupts normal intestinal organisms, which allows C. difficile to proliferate within the intestine. The proliferation facilitates release of toxins into intestines, which may cause severe sepsis if left untreated.
Health care providers should use gowns and gloves during patient interaction. C. difficile is resilient to alcohol-based products. Therefore, washing hands with soap water are better. In addition, bleach-type cleaning agents are a superior option to alcohol-based cleaning products.
Various strategies are employed to control C. difficile including patient edification and disrupting the chain of infection. A chain of infection involves various elements including causative organism, reservoir of organisms and mode of exit, transmission, and entry. Disruption of the chain can be achieved by handwashing, disinfection, identifying and treating infection and environmental sanitation.

Question 2

You are the nurse on a cruise ship where an outbreak of Norovirus occurs.What is the evidence base to assist in intervening and containing this outbreak?Identify the criteria used to evaluate the strength of the evidence for the practices.

Answer 2

Norovirus or Calcivirus is the most prevalent cause of gastroenteritis ensuing from food-borne contaminants. Outbreaks often occur between November and April. Contagion is by direct contact and fecal to oral route.
The infected individual generally recovers within 2 days. However, children under six months may be infected for a further two weeks according to studies.
During an outbreak, Kaplan Criteria is used:
• Fecal specimens examined
• 50% or more with vomiting
• Duration of illness between 12 to 60 hours
• Incubation 1 to 2 days

Question 3

Identify the priorities, approach, and techniques you would use to perform acomprehensive assessment on a 25-year-old woman who presents to the local publichealth clinic with an STI. How would your priorities, approach, and techniques differif the patient is a 25-year-old man? If the patient has AIDS? If the patient is from aculture with very different values from your own?

Answer 3

Priorities during an assessment include taking a description symptom and its progression, presence of wound, drainage. It is important to explain the reason for gathering information and using layman's terms during the assessment. Gloves should be worn during mouth, vaginal or rectal examinations.
A technique recommended for obtaining sexual history is the 5 P's. Questions comprise or details regarding partners, pregnancy prevention, protection from STIs (sexually transmitted infections), practices, history of STIs.
Women younger than 25 years are mostly asymptomatic for Chlamydia. Annual screening tests are recommended. Men can sometimes be asymptomatic for N. gonorrheae but should be educated on safer sex or using a condom.
Human Immunodeficiency Virus or HIV infections lead to immunosuppression, which allows many other opportunistic diseases to invade. Assessment should include to identifying the presence of secondary infections.
Obtaining a medical history from STI patients of a different cultural background should be sensitive to individual's culture and preference.