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

When walking with axillary crutches, where should the patient’s weight be taken?

  1. AOn the shoulders, with the crutches pressed upward
  2. BOn the hands, with the crutch tops a few finger widths below the armpits
  3. COn the armpits, resting on the crutch tops
  4. DOn the elbows, kept bent at a right angle with the crutch tops tucked under the arms
2.感染控制与患者安全困难

A patient restrained because of violent behavior is now calm, oriented and following instructions. What should the nurse do?

  1. AKeep the restraints until the next provider visit
  2. BRemove one restraint each day to test the patient’s behavior
  3. CKeep the restraints until the order expires
  4. DRemove the restraints, because the reason for them has ended
3.护理学基础中等

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

  1. AHair removal cream applied in theatre
  2. BPlucking the hairs with tweezers
  3. CShaving with a razor the night before
  4. DElectric clippers on the day of surgery
4.护理学基础困难

At the start of a shift, which task should the nurse do first?

  1. AUpdate the ward whiteboard with the names of all the new patients
  2. BOrder supplies for the ward store room
  3. CChange the bed linen of a patient who is going home
  4. DGive the first IV antibiotic dose to a patient with suspected sepsis
5.微生物学中等

为什么建议孕妇避免食用未经巴氏消毒的软奶酪？

  1. A其中常常含有能通过胎盘的丙型肝炎病毒
  2. B其中可能含有李斯特菌，会危害胎儿
  3. C其中可能含有绦虫卵
  4. D其中所含乳糖对胎儿来说太多
6.微生物学困难

一根导尿管已被生物膜中的细菌定植。为什么通常要更换导尿管，而不只是给予抗生素？

  1. A抗生素会损坏导尿管材料
  2. B生物膜细菌不能致病
  3. C生物膜中的细菌受到保护，抗生素难以杀灭得多
  4. D生物膜中只含病毒，所以抗生素无效

3溶液

1.感染控制与患者安全

答案: B · On the hands, with the crutch tops a few finger widths below the armpits

为什么是这个答案

Weight is taken on the hands and arms. Leaning on the crutch tops can compress the brachial plexus and cause crutch palsy, so a gap is kept between the crutch top and the axilla.

答案

B · On the hands, with the crutch tops a few finger widths below the armpits
2.感染控制与患者安全

答案: D · Remove the restraints, because the reason for them has ended

为什么是这个答案

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

D · Remove the restraints, because the reason for them has ended
3.护理学基础

答案: D · Electric clippers on the day of surgery

为什么是这个答案

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

答案

D · Electric clippers on the day of surgery
4.护理学基础

答案: D · Give the first IV antibiotic dose to a patient with suspected sepsis

为什么是这个答案

In sepsis antibiotics are time-critical, and every hour of delay increases the risk of death. Routine tasks are done afterwards.

答案

D · Give the first IV antibiotic dose to a patient with suspected sepsis
5.微生物学

答案: B · 其中可能含有李斯特菌，会危害胎儿

为什么是这个答案

单核细胞增生李斯特菌（Listeria monocytogenes）能在冷藏食品中生长并穿过胎盘，可导致流产、死产或严重的新生儿感染。

答案

B · 其中可能含有李斯特菌，会危害胎儿
6.微生物学

答案: C · 生物膜中的细菌受到保护，抗生素难以杀灭得多

为什么是这个答案

在生物膜中，细菌生活在保护性基质里，生长缓慢，能耐受高浓度抗生素。拔除器械就去除了感染源。

答案

C · 生物膜中的细菌受到保护，抗生素难以杀灭得多

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