感染控制与患者安全
方法
- 对每位患者都从标准预防开始:手卫生、针对预期暴露的个人防护装备、安全使用锐器。
- 按传播途径追加预防措施:接触传播(隔离衣、手套)、飞沫传播(外科口罩)、空气传播(N95、负压病房)。
- 保持无菌物品的无菌状态:如有疑问就视为不无菌;更换,绝不擦拭。
- 预防环境中的伤害:防跌倒措施,约束仅作为最后手段,火灾时用 RACE 和 PASS。
- 核对给药的正确原则、两个身份识别信息,以及对高警示药物的额外保障;报告差错和险兆事件。
公式表、每个专题的关键方法步骤和 6 道练习题,完整解答附在最后。
Why can side rails be dangerous for a confused, restless patient?
A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?
什么时候应该用肥皂和水洗手,而不是使用含酒精的手消毒剂?
A patient has a generalised tonic-clonic seizure in bed. What should the nurse do?
免疫系统的哪一部分产生抗体?
为什么在感染后的最初几周 HIV 抗体检测可能呈阴性?
答案: C · The patient may climb over them or get trapped in gaps
Confused patients may climb over rails and fall from a greater height or become trapped between the rail and mattress. Alternatives such as low beds and close observation are often safer.
答案: B · “I can clean the cat’s litter box if I wear a face mask.”
Immunocompromised patients should avoid cleaning litter boxes and other animal waste, because of organisms such as Toxoplasma. Another person should do it. The other statements are correct.
答案: D · 手上有肉眼可见的污垢或污染时
手上有可见污垢或被体液污染时,需要用肥皂和水洗手。对于看起来干净的手,含酒精的手消毒剂在大多数"五个时刻"中都快速有效。
答案: B · Protect the head, move objects away, time it and do not restrain
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.
答案: C · 由 B 淋巴细胞分化而来的浆细胞
被激活的 B 细胞分化为分泌抗体的浆细胞。细胞毒性 T 细胞和 NK 细胞则直接杀伤被感染的细胞。
答案: D · 机体尚未产生足以检测到的抗体
抗体需要数周才会出现。同时检测 p24 抗原的联合检测或病毒 RNA 检测可以缩短这一窗口期。
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