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.

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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

How does a nurse add a sterile gauze pack to a sterile field that is already set up?

  1. AOpen the wrapper away from the field and drop the item on it without reaching over
  2. BTip the item onto the field and push it into place with the wrapper
  3. CReach across the field with clean gloves to place the item
  4. DPlace the whole wrapped pack on the field and open it there with sterile gloves
2.Kawalan jangkitan & keselamatan pesakitSukar

A patient’s WBC is 4,000/mm3, with 30% neutrophils and 5% bands. What is the absolute neutrophil count (ANC)?

  1. A3,500/mm3
  2. B1,200/mm3
  3. C140/mm3
  4. D1,400/mm3
3.Asas kejururawatanSederhana

If hair needs to be removed before surgery, what is recommended?

  1. AElectric clippers on the day of surgery
  2. BPlucking the hairs with tweezers
  3. CHair removal cream applied in theatre
  4. DShaving with a razor the night before
4.Asas kejururawatanSukar

A colleague asks the nurse to countersign the controlled drug register for a dose the nurse did not see being prepared or given. What should the nurse do?

  1. ASign it later, at the end of the shift, once the colleague explains
  2. BSign, but only if the colleague is senior
  3. CSign, as the colleague is trustworthy
  4. DRefuse, as they can only sign for what they have witnessed
5.MikrobiologiSederhana

Bagaimanakah DNA dipindahkan antara bakteria semasa konjugasi?

  1. AMelalui bakteriofaj yang membawa DNA bakteria
  2. BMelalui sentuhan langsung menggunakan pilus seks
  3. CMelalui pengambilan DNA bebas daripada persekitaran
  4. DMelalui pelakuran dua sel bakteria menjadi satu
6.MikrobiologiSukar

Kultur darah positif menunjukkan kokus Gram-positif berkelompok. Organisma manakah yang paling berkemungkinan?

  1. AStaphylococcus
  2. BEnterococcus dalam rantai pendek
  3. CNeisseria
  4. DStreptococcus

3Larutan

1.Kawalan jangkitan & keselamatan pesakit

Jawapan: A · Open the wrapper away from the field and drop the item on it without reaching over

Mengapa ini jawapannya

The nurse opens the package so the sterile item can be dropped onto the field from a short height, without the wrapper or arms crossing over the sterile area. The item must land well inside the non-sterile border.

Jawapan

A · Open the wrapper away from the field and drop the item on it without reaching over
2.Kawalan jangkitan & keselamatan pesakit

Jawapan: D · 1,400/mm3

Mengapa ini jawapannya

ANC = 4,000 × (0.30 + 0.05) = 1,400/mm3. This is below normal (neutropenia), so the patient has a raised risk of infection.

Jawapan

D · 1,400/mm3
3.Asas kejururawatan

Jawapan: A · Electric clippers on the day of surgery

Mengapa ini jawapannya

Razors cause small skin cuts that increase surgical site infection. If needed, hair is removed with electric clippers close to the time of surgery.

Jawapan

A · Electric clippers on the day of surgery
4.Asas kejururawatan

Jawapan: D · Refuse, as they can only sign for what they have witnessed

Mengapa ini jawapannya

Countersigning means confirming that you witnessed the check and administration. Signing for something you did not see is dishonest and removes an important safety check.

Jawapan

D · Refuse, as they can only sign for what they have witnessed
5.Mikrobiologi

Jawapan: B · Melalui sentuhan langsung menggunakan pilus seks

Mengapa ini jawapannya

Dalam konjugasi sel penderma membentuk pilus kepada penerima dan memindahkan DNA, selalunya plasmid. Ia cara penting untuk gen rintangan antibiotik tersebar.

Jawapan

B · Melalui sentuhan langsung menggunakan pilus seks
6.Mikrobiologi

Jawapan: A · Staphylococcus

Mengapa ini jawapannya

Stafilokokus tumbuh dalam kelompok seperti buah anggur; streptokokus dan enterokokus dalam rantai atau berpasangan. Neisseria ialah diplokokus Gram-negatif.

Jawapan

A · Staphylococcus

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