感染管理と患者の安全：直前対策パック

公式集、全トピックの解法の要点、6 問の演習問題。完全な解答は巻末にあります。

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1公式と解法

感染管理と患者の安全

解き方

  1. すべての患者に標準予防策から始めます：手指衛生、予想される曝露に応じた個人防護具（PPE）、安全な鋭利器材の扱い。
  2. 経路に応じて予防策を追加します：接触（ガウン、手袋）、飛沫（サージカルマスク）、空気（N95、陰圧室）。
  3. 滅菌物は滅菌のまま保ちます：疑わしければ滅菌ではありません。拭かずに交換します。
  4. 環境内の害を防ぎます：転倒対策、身体拘束は最後の手段、火災には RACE と PASS。
  5. 与薬の権利、2つの識別子、ハイリスク薬の追加の安全対策を確認し、エラーやヒヤリハットを報告します。

2演習問題

1.感染管理と患者の安全ふつう

Before a defibrillator shock is delivered, what must the person operating it do?

  1. AAsk a colleague to hold the paddles in place
  2. BKeep the oxygen mask on the patient’s face, held against the chest
  3. CCall “all clear” and check that nobody is touching the patient or bed
  4. DHold the patient’s hand to keep them still
2.感染管理と患者の安全むずかしい

A 2-year-old living in a house built many decades ago has anemia, irritability and poor appetite. Which cause should the nurse suspect?

  1. AIron overload from eating too much red meat
  2. BA food allergy to cow’s milk proteins
  3. CLead poisoning from old paint dust or chips
  4. DCarbon dioxide from a gas cooker
3.基礎看護学ふつう

What is the main aim of "protected mealtimes" on hospital wards?

  1. ATo give staff a fixed break while the patients are eating their meals
  2. BTo make sure all patients eat the same meal at once
  3. CTo let patients eat without interruptions, with help where needed
  4. DTo stop visitors from bringing any food into hospital
4.基礎看護学むずかしい

A nurse uses SBAR to call a doctor about a breathless patient. Which item belongs under "Background"?

  1. AThe patient has COPD and was admitted two days ago with pneumonia
  2. BHis respiratory rate is 30 and his SpO₂ is 86% on 2 L of oxygen
  3. C"I am calling about Mr Smith in bed 4, who is very breathless."
  4. D"Please come and review him within the next 10 minutes."
5.微生物学ふつう

結核を起こす生物はどれで、グラム染色で染まりにくいのはなぜですか？

  1. AMycobacterium tuberculosis。ミコール酸を含むろう状の細胞壁を持つ
  2. BStreptococcus pneumoniae。莢膜を持つ
  3. CMycoplasma pneumoniae。染色液を取り込む細胞壁を持たない
  4. DLegionella pneumophila。アメーバの中で生きる
6.微生物学むずかしい

サハラ以南のアフリカから帰国した旅行者が発熱しています。マラリアが疑われます。重症マラリアや脳マラリアを起こす可能性が最も高い種はどれですか？

  1. APlasmodium vivax
  2. BPlasmodium malariae
  3. CPlasmodium falciparum
  4. DPlasmodium ovale

3溶液

1.感染管理と患者の安全

答え: C · Call “all clear” and check that nobody is touching the patient or bed

これが答えになる理由

Anyone touching the patient or bed could receive the shock. The operator announces “clear” and looks to confirm that nobody is in contact, and oxygen is moved away from the chest.

答え

C · Call “all clear” and check that nobody is touching the patient or bed
2.感染管理と患者の安全

答え: C · Lead poisoning from old paint dust or chips

これが答えになる理由

Lead-based paint in older housing is the main source of lead exposure in young children, who put dust and chips in their mouths. Lead can cause anemia, behavior changes and developmental problems, and a blood lead level confirms it.

答え

C · Lead poisoning from old paint dust or chips
3.基礎看護学

答え: C · To let patients eat without interruptions, with help where needed

これが答えになる理由

Ward rounds and tests can interrupt meals, and patients then eat less. Protected mealtimes pause non-urgent activity so staff can focus on helping patients eat.

答え

C · To let patients eat without interruptions, with help where needed
4.基礎看護学

答え: A · The patient has COPD and was admitted two days ago with pneumonia

これが答えになる理由

SBAR is Situation (why you are calling), Background (relevant history), Assessment (your findings) and Recommendation (what you need). Clear structure speeds up the response.

答え

A · The patient has COPD and was admitted two days ago with pneumonia
5.微生物学

答え: A · Mycobacterium tuberculosis。ミコール酸を含むろう状の細胞壁を持つ

これが答えになる理由

結核菌の細胞壁はミコール酸に富むためグラム染色に抵抗し、抗酸染色で確認します。

答え

A · Mycobacterium tuberculosis。ミコール酸を含むろう状の細胞壁を持つ
6.微生物学

答え: C · Plasmodium falciparum

これが答えになる理由

P. falciparum は非常に高い原虫血症を起こし、感染赤血球を脳を含む細い血管に付着させます。サハラ以南のアフリカに多く、医学的緊急事態です。

答え

C · Plasmodium falciparum

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