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

A small spill of blood is found on the floor. How should it be cleaned?

  1. AWear gloves, absorb the blood, then clean the area with an approved disinfectant
  2. BWipe it up quickly with a dry cloth using bare hands, then wash the hands well
  3. CLeave it until housekeeping arrives the next morning
  4. DCover it with a clean sheet and keep working
2.Kawalan jangkitan & keselamatan pesakitSukar

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. ACarbon dioxide from a gas cooker
  2. BLead poisoning from old paint dust or chips
  3. CIron overload from eating too much red meat
  4. DA food allergy to cow’s milk proteins
3.Asas kejururawatanSederhana

A patient asks to see their own health records. What is correct in the UK?

  1. AOnly doctors are allowed to see health records
  2. BPatients can only see their records once they have been discharged
  3. CPatients can see their records only with a court order
  4. DPatients have a legal right to request access to their records
4.Asas kejururawatanSukar

Which postoperative finding should be reported most urgently?

  1. AUrine output of 50 mL in the last hour
  2. BPain score of 4/10 at the wound site when moving
  3. CTemperature 37.4 °C on the first day
  4. DRespiratory rate 8/min and difficult to rouse
5.MikrobiologiSederhana

MRSA rintang terhadap metisilin kerana ia mempunyai:

  1. AProtein pengikat penisilin (PBP2a) yang berubah
  2. BKapsul polisakarida yang menyekat kemasukan semua beta-laktam
  3. CTiada dinding sel langsung
  4. DPam efluks untuk setiap antibiotik
6.MikrobiologiSukar

Bagaimanakah jenis HPV berisiko tinggi menyumbang kepada kanser serviks?

  1. AVirus membunuh sel dengan begitu pantas sehingga digantikan oleh sel kanser
  2. BProtein virus E6 dan E7 menyahaktifkan penindas tumor p53 dan Rb
  3. CVirus memusnahkan sel T CD4 dalam serviks
  4. DVirus menghasilkan endotoksin yang merosakkan DNA

3Larutan

1.Kawalan jangkitan & keselamatan pesakit

Jawapan: A · Wear gloves, absorb the blood, then clean the area with an approved disinfectant

Mengapa ini jawapannya

Blood spills are cleaned promptly by staff wearing gloves. The blood is absorbed with disposable material, then the area is cleaned and disinfected with a hospital disinfectant, and waste goes into clinical waste.

Jawapan

A · Wear gloves, absorb the blood, then clean the area with an approved disinfectant
2.Kawalan jangkitan & keselamatan pesakit

Jawapan: B · Lead poisoning from old paint dust or chips

Mengapa ini jawapannya

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.

Jawapan

B · Lead poisoning from old paint dust or chips
3.Asas kejururawatan

Jawapan: D · Patients have a legal right to request access to their records

Mengapa ini jawapannya

Under data protection law, patients can request access to their health records. The nurse explains the local process for making a request.

Jawapan

D · Patients have a legal right to request access to their records
4.Asas kejururawatan

Jawapan: D · Respiratory rate 8/min and difficult to rouse

Mengapa ini jawapannya

A low respiratory rate with reduced consciousness may mean opioid toxicity or deterioration and threatens the airway. The other findings are common after surgery and can be managed routinely.

Jawapan

D · Respiratory rate 8/min and difficult to rouse
5.Mikrobiologi

Jawapan: A · Protein pengikat penisilin (PBP2a) yang berubah

Mengapa ini jawapannya

Gen mecA mengekod PBP2a, yang mempunyai afiniti rendah terhadap beta-laktam, maka bakteria boleh terus membina dinding selnya walaupun terdapat metisilin.

Jawapan

A · Protein pengikat penisilin (PBP2a) yang berubah
6.Mikrobiologi

Jawapan: B · Protein virus E6 dan E7 menyahaktifkan penindas tumor p53 dan Rb

Mengapa ini jawapannya

E6 menggalakkan pemecahan p53 dan E7 mengikat Rb, menyingkirkan kawalan ke atas pembahagian sel dan pembaikan DNA. Sel yang dijangkiti kemudian boleh mengumpul mutasi dan menjadi kanser selama bertahun-tahun.

Jawapan

B · Protein virus E6 dan E7 menyahaktifkan penindas tumor p53 dan Rb

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