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1Rumus dan metode
Pengendalian infeksi & keselamatan pasien
Metode
Mulailah dengan kewaspadaan standar untuk setiap pasien: kebersihan tangan, APD sesuai pajanan yang diperkirakan, benda tajam yang aman.
Tambahkan kewaspadaan menurut jalur: kontak (gaun, sarung tangan), droplet (masker bedah), udara (N95, ruang bertekanan negatif).
Jaga barang steril tetap steril: bila ragu, anggap tidak steril; ganti, jangan pernah dilap.
Cegah bahaya di lingkungan: tindakan pencegahan jatuh, restrain hanya sebagai pilihan terakhir, RACE dan PASS untuk kebakaran.
Periksa prinsip benar dalam pemberian obat, dua identitas, dan pengaman tambahan untuk obat berisiko tinggi; laporkan kesalahan dan nyaris cedera.
2Soal latihan
1.Pengendalian infeksi & keselamatan pasienSedang
How should the urethral meatus be cared for in a patient with an indwelling urinary catheter?
ABy sliding the catheter in and out a little to clean it
BWith antiseptic cream applied to the meatus every shift
CWith daily bladder irrigation using an antibiotic solution through the catheter
DWith routine hygiene, using soap and water during daily washing
2.Pengendalian infeksi & keselamatan pasienSulit
During flu season, a nurse wakes up with fever, cough and muscle aches. What is the best action?
AGo to work but avoid caring for patients who have weak immune systems
BStay home and inform the employer according to the illness policy
CGo to work but wear a surgical mask for the whole shift
DTake an antipyretic so the fever does not show at work
3.Dasar-dasar keperawatanSedang
Why does long-term immobility increase the risk of kidney stones?
ALying flat makes the kidneys produce extra uric acid
BPatients on bed rest drink too much fluid
CCalcium released from bone raises the calcium in the urine
DThe kidneys stop producing urine during bed rest
4.Dasar-dasar keperawatanSulit
A patient has a generalised tonic-clonic seizure in bed. What should the nurse do?
AGive a drink of water as soon as the jerking starts
BHold the arms and legs firmly so that the jerking movements stop more quickly
CPut a spoon between the teeth to stop tongue biting
DProtect the head, move objects away, time it and do not restrain
5.MikrobiologiSedang
MRSA resisten terhadap metisilin karena memiliki:
AKapsul polisakarida yang menghalangi masuknya semua beta-laktam
BProtein pengikat penisilin yang berubah (PBP2a)
CPompa efluks untuk setiap antibiotik
DSama sekali tidak memiliki dinding sel
6.MikrobiologiSulit
Tes darah seorang tenaga kesehatan positif untuk anti-HBs (antibodi permukaan hepatitis B) dan negatif untuk HBsAg dan anti-HBc. Apa arti paling mungkin dari hasil ini?
AInfeksi hepatitis B kronis
BInfeksi alami di masa lalu yang telah sembuh
CInfeksi hepatitis B akut saat ini
DKekebalan dari vaksinasi hepatitis B
3Larutan
1.Pengendalian infeksi & keselamatan pasien
Jawaban: D · With routine hygiene, using soap and water during daily washing
Mengapa ini jawabannya
Routine perineal hygiene with soap and water is recommended. Antiseptic creams and routine irrigation do not reduce infection, and moving the catheter in and out carries organisms into the bladder.
Jawaban
D · With routine hygiene, using soap and water during daily washing
2.Pengendalian infeksi & keselamatan pasien
Jawaban: B · Stay home and inform the employer according to the illness policy
Mengapa ini jawabannya
Health care workers with signs of influenza should not work, because they can infect patients and colleagues. They follow the employer’s policy on when they may return.
Jawaban
B · Stay home and inform the employer according to the illness policy
3.Dasar-dasar keperawatan
Jawaban: C · Calcium released from bone raises the calcium in the urine
Mengapa ini jawabannya
Without weight-bearing, bone releases calcium, and urine also drains less well when lying flat. Mobilisation and adequate fluids reduce the risk.
Jawaban
C · Calcium released from bone raises the calcium in the urine
4.Dasar-dasar keperawatan
Jawaban: D · Protect the head, move objects away, time it and do not restrain
Mengapa ini jawabannya
During a seizure the nurse keeps the patient safe, notes the time and the features, and never puts anything in the mouth. Afterwards the patient is placed in the recovery position and the airway checked.
Jawaban
D · Protect the head, move objects away, time it and do not restrain
5.Mikrobiologi
Jawaban: B · Protein pengikat penisilin yang berubah (PBP2a)
Mengapa ini jawabannya
Gen mecA mengode PBP2a, yang afinitasnya terhadap beta-laktam rendah, sehingga bakteri tetap bisa membangun dinding selnya meskipun ada metisilin.
Jawaban
B · Protein pengikat penisilin yang berubah (PBP2a)
6.Mikrobiologi
Jawaban: D · Kekebalan dari vaksinasi hepatitis B
Mengapa ini jawabannya
Vaksin mengandung HBsAg, sehingga orang yang divaksinasi membentuk anti-HBs tetapi tidak anti-HBc. Infeksi alami di masa lalu menghasilkan anti-HBs dan anti-HBc, dan infeksi yang sedang berlangsung menunjukkan HBsAg.