感染控制与患者安全：速成包

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。

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1公式与方法

感染控制与患者安全

方法

  1. 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。
  2. 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）。
  3. 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。
  4. 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。
  5. 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。

2练习题

1.感染控制与患者安全中等

Why does a nurse wear chemotherapy-tested gloves and a gown when emptying the urinal of a patient who recently had chemotherapy?

  1. AThe body fluids can contain active drug for a time after treatment
  2. BThe urine always contains infectious bacteria after chemotherapy
  3. CChemotherapy makes the urine strongly acidic and corrosive
  4. DThe patient is on airborne precautions after treatment
2.感染控制与患者安全困难

A toddler has bruises of different ages and a burn, and the parent’s explanation does not fit the injuries. What should the nurse do?

  1. AReport the concern following child-protection (safeguarding) procedures
  2. BDocument only and say nothing to anyone
  3. CWait until there is clear proof of abuse before reporting anything at all
  4. DConfront the parent and ask them to admit to abuse
3.护理学基础中等

Which of these is recorded as fluid intake on a fluid balance chart?

  1. AUrine output from a catheter
  2. BWound drainage
  3. CVomit
  4. DIntravenous fluids
4.护理学基础困难

Why must a needlestick injury be reported straight away rather than at the end of the shift?

  1. AThe injury must be documented within ten minutes for the report to be valid
  2. BThe source patient will be discharged soon
  3. CReporting late means the nurse has to pay for the tests
  4. DPost-exposure prophylaxis works best when it is started as soon as possible
5.微生物学中等

为什么高疫苗接种覆盖率也能保护尚不能接种疫苗的婴儿？

  1. A能传播感染的人减少了，因此感染传播得更少
  2. B接种过的人把抗体传给他们遇到的每一个人
  3. C疫苗能杀死环境中的病原体
  4. D婴儿对所有疫苗可预防疾病天生免疫
6.微生物学困难

一名移植后服用大剂量免疫抑制药物的患者需要接种疫苗。一般应避免哪类疫苗？

  1. A减毒活疫苗
  2. B类毒素疫苗
  3. C亚单位疫苗
  4. D灭活全病毒疫苗

3溶液

1.感染控制与患者安全

答案: A · The body fluids can contain active drug for a time after treatment

为什么是这个答案

Many hazardous drugs are excreted in urine, stool and vomit for a period after treatment. Staff wear protective gloves and gowns when handling these fluids, according to policy.

答案

A · The body fluids can contain active drug for a time after treatment
2.感染控制与患者安全

答案: A · Report the concern following child-protection (safeguarding) procedures

为什么是这个答案

Injuries that do not match the history must be reported, and proof is not needed. In the US, nurses are legally mandated reporters; in the UK and many other countries, safeguarding procedures require the concern to be referred to the designated lead or children’s social care. The child’s safety is ensured and the findings are documented factually.

答案

A · Report the concern following child-protection (safeguarding) procedures
3.护理学基础

答案: D · Intravenous fluids

为什么是这个答案

Intake includes oral fluids, enteral feeds and IV fluids, including drug infusions. Urine, vomit, drainage and stool are output.

答案

D · Intravenous fluids
4.护理学基础

答案: D · Post-exposure prophylaxis works best when it is started as soon as possible

为什么是这个答案

After a high-risk exposure, for example to HIV or hepatitis B, preventive treatment is most effective when started early. Prompt reporting also allows the source patient to be assessed.

答案

D · Post-exposure prophylaxis works best when it is started as soon as possible
5.微生物学

答案: A · 能传播感染的人减少了，因此感染传播得更少

为什么是这个答案

当足够多的人具有免疫力时，传播链就会断裂，病原体很少能到达易感人群，例如幼小的婴儿或免疫抑制患者。

答案

A · 能传播感染的人减少了，因此感染传播得更少
6.微生物学

答案: A · 减毒活疫苗

为什么是这个答案

活疫苗含有减毒的生物体，在免疫系统受到严重抑制时可能致病。灭活疫苗、类毒素疫苗和亚单位疫苗是安全的，尽管反应可能较弱。

答案

A · 减毒活疫苗

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