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。
护理采取空气传播预防的患者后,N95 呼吸器应在何时摘下?
A patient restrained because of violent behavior is now calm, oriented and following instructions. What should the nurse do?
How should adhesive tape be removed from an older patient's fragile skin?
A patient taking furosemide has a serum potassium of 3.0 mmol/L (3.0 mEq/L). Why is this important?
为什么革兰氏阴性菌往往更难用抗生素治疗?
为什么沙眼衣原体(Chlamydia trachomatis)通常用核酸扩增试验而不是常规琼脂培养来诊断?
答案: B · 离开房间并关上门之后
因为传染性颗粒仍留在房间的空气中,所以应在房门关闭后到房间外摘下呼吸器,随后进行手卫生。手套、护目装备和隔离衣应先脱下。
答案: C · Remove the restraints, because the reason for them has ended
Restraints are used only as long as needed to keep people safe. Once the patient no longer presents a danger, the restraints are removed, even if the order has not yet expired.
答案: B · Slowly, low and close to the skin, while supporting the skin
Peeling the tape back low and slow while holding the skin reduces the pulling force on fragile skin. Adhesive removers can also help.
答案: B · Loop diuretics cause potassium loss, and low levels can cause arrhythmias
Furosemide increases potassium loss in the urine. Hypokalaemia causes muscle weakness and cardiac arrhythmias, so the result is reported and replacement considered.
答案: B · 它们的外膜阻挡了许多药物
革兰氏阴性菌的外膜含脂多糖和孔蛋白,能把许多抗生素挡在外面,并与外排泵和酶的防御共同作用。
答案: C · 它是专性细胞内寄生菌,不能在普通培养基上生长
衣原体只在宿主细胞内复制,因此不能在琼脂上培养。对尿液或拭子进行的 PCR 等核酸扩增试验(NAAT)灵敏度高,是标准的诊断方法。
ExamProblems · examproblems.com/courses/infection-control-and-patient-safety