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。
A patient cannot bear weight and cannot help with transfers. Which method is safest to move the patient from bed to chair?
A nurse has a needlestick from a patient known to have hepatitis C. Which statement about management is correct?
During a manual blood pressure measurement in an adult, which point is usually recorded as the diastolic pressure?
测量了卧位和立位血压。哪项结果符合直立性低血压的通常定义?
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?
哪些肝炎病毒主要通过受污染的食物和水传播?
答案: C · A mechanical lift used by enough trained staff
For a patient who cannot bear weight or help, a mechanical lift prevents injury to both patient and staff. Lifting under the arms can injure the shoulders, and pivot transfers need weight bearing.
答案: D · There is no preventive drug, so baseline and follow-up testing are done to detect infection early
There is no vaccine or post-exposure prophylaxis for hepatitis C. The exposure is reported, baseline tests are taken and follow-up testing identifies infection early, because effective treatment is available.
答案: B · When the sounds disappear completely
The first clear sound marks the systolic pressure; in adults the point at which the sounds disappear (phase 5) is recorded as diastolic.
答案: C · 站立后 3 分钟内收缩压下降 20 mmHg 或以上
直立性低血压通常定义为站立后 3 分钟内收缩压下降至少 20 mmHg 或舒张压下降至少 10 mmHg。它是跌倒评估中的重要发现。
答案: B · 能传播感染的人减少了,因此感染传播得更少
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 · 甲型和戊型肝炎
甲型(A)和戊型(E)肝炎经粪-口途径传播。乙型、丙型和丁型通过血液和体液传播,并可引起慢性感染。
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