Kawalan Jangkitan dan Keselamatan Pesakit: pek ulang kaji kilat

Lembaran formula, langkah kaedah utama untuk setiap topik dan 6 soalan latihan, dengan penyelesaian penuh di bahagian belakang.

Soalan baharuKembali ke kursus

Dalam tetingkap cetak, pilih “Simpan sebagai PDF” untuk menyimpan salinan pada peranti anda.

1Formula dan kaedah

Kawalan jangkitan & keselamatan pesakit

Kaedah

  1. Mulakan dengan langkah berjaga-jaga standard untuk setiap pesakit: kebersihan tangan, PPE untuk pendedahan yang dijangka, benda tajam yang selamat.
  2. Tambah langkah berjaga-jaga mengikut laluan: sentuhan (gaun, sarung tangan), titisan (pelitup muka pembedahan), bawaan udara (N95, bilik tekanan negatif).
  3. Pastikan item steril kekal steril: jika ragu-ragu, ia tidak steril; gantikan, jangan sekali-kali dilap.
  4. Cegah bahaya dalam persekitaran: langkah pencegahan jatuh, sekatan hanya sebagai pilihan terakhir, RACE dan PASS untuk kebakaran.
  5. Semak hak pemberian ubat, dua pengenalpastian dan perlindungan tambahan untuk ubat berisiko tinggi; laporkan kesilapan dan hampir-hampir terlepas.

2Soalan latihan

1.Kawalan jangkitan & keselamatan pesakitSederhana

A nurse gives part of a dose of an opioid from a vial and must discard the rest. What is correct?

  1. ADiscard it in front of a second licensed (registered) nurse, who witnesses and documents it
  2. BDiscard it alone in the sink and document the amount wasted later in the shift
  3. CReturn the rest to the patient’s medication drawer
  4. DKeep the rest for the patient’s next dose
2.Kawalan jangkitan & keselamatan pesakitSukar

A patient on chemotherapy develops shingles over several areas on both sides of the body. Which precautions are needed?

  1. AContact precautions only, with gloves for dressing changes
  2. BStandard precautions only, with the lesions covered
  3. CDroplet precautions until the pain settles
  4. DAirborne and contact precautions until all lesions are crusted
3.Asas kejururawatanSederhana

When should blood cultures be taken in a patient with suspected sepsis?

  1. AOnly if the temperature rises above 40 °C
  2. BOnly after three days of antibiotics, to see if they are working
  3. CBefore antibiotics are given, as long as this does not delay them
  4. DAfter the patient has recovered from the infection
4.Asas kejururawatanSukar

A potassium result is unexpectedly high and the lab reports that the sample was haemolysed. What does this mean?

  1. AThe patient definitely has dangerous hyperkalaemia needing treatment
  2. BThe result is accurate and needs no follow-up
  3. CThe patient definitely has low potassium
  4. DThe result may be falsely high and the test should be repeated
5.MikrobiologiSederhana

Mengapakah liputan vaksinasi yang tinggi juga melindungi bayi yang terlalu muda untuk divaksin?

  1. ABayi secara semula jadi kebal terhadap semua penyakit yang boleh dicegah dengan vaksin
  2. BOrang yang divaksin menyalurkan antibodi kepada semua orang yang ditemuinya
  3. CVaksin membunuh patogen dalam persekitaran
  4. DLebih sedikit orang yang dapat menularkan jangkitan, maka ia kurang merebak
6.MikrobiologiSukar

Beberapa orang muntah dalam beberapa jam selepas makan nasi goreng yang dimasak sehari sebelumnya dan disimpan pada suhu bilik. Organisma manakah punca klasik?

  1. ASalmonella Typhi
  2. BClostridium botulinum
  3. CBacillus cereus
  4. DListeria monocytogenes

3Larutan

1.Kawalan jangkitan & keselamatan pesakit

Jawapan: A · Discard it in front of a second licensed (registered) nurse, who witnesses and documents it

Mengapa ini jawapannya

Wasting controlled substances requires a witness, usually another licensed nurse, and both document the waste. This prevents and detects drug diversion.

Jawapan

A · Discard it in front of a second licensed (registered) nurse, who witnesses and documents it
2.Kawalan jangkitan & keselamatan pesakit

Jawapan: D · Airborne and contact precautions until all lesions are crusted

Mengapa ini jawapannya

Lesions over several areas on both sides mean disseminated zoster, which can spread through the air like chickenpox. Airborne and contact precautions are used until all lesions are dry and crusted. Localized zoster in an immunocompromised patient also needs airborne and contact precautions, but only until dissemination is ruled out.

Jawapan

D · Airborne and contact precautions until all lesions are crusted
3.Asas kejururawatan

Jawapan: C · Before antibiotics are given, as long as this does not delay them

Mengapa ini jawapannya

Taking cultures first gives the best chance of identifying the organism. They are collected with strict asepsis, but antibiotics must not be delayed in sepsis.

Jawapan

C · Before antibiotics are given, as long as this does not delay them
4.Asas kejururawatan

Jawapan: D · The result may be falsely high and the test should be repeated

Mengapa ini jawapannya

Red cells contain a lot of potassium, so haemolysis during collection can falsely raise the result. The sample is repeated, with the patient assessed in the meantime.

Jawapan

D · The result may be falsely high and the test should be repeated
5.Mikrobiologi

Jawapan: D · Lebih sedikit orang yang dapat menularkan jangkitan, maka ia kurang merebak

Mengapa ini jawapannya

Apabila cukup ramai orang kebal, rantaian penularan terputus dan patogen jarang sampai kepada orang yang mudah terdedah, seperti bayi kecil atau pesakit imunosupresi.

Jawapan

D · Lebih sedikit orang yang dapat menularkan jangkitan, maka ia kurang merebak
6.Mikrobiologi

Jawapan: C · Bacillus cereus

Mengapa ini jawapannya

Spora Bacillus cereus bertahan daripada pendidihan. Jika nasi yang dimasak dibiarkan suam, bakteria tumbuh dan menghasilkan toksin emetik yang tahan haba, maka memanaskan semula tidak menjadikan nasi itu selamat.

Jawapan

C · Bacillus cereus

ExamProblems · examproblems.com/courses/infection-control-and-patient-safety