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

Before a blood transfusion is started, which check is required?

  1. AThe patient signs the blood bag label to confirm their name before it is hung
  2. BOne nurse checks the blood product against the order at the nurses’ station
  3. CThe patient’s identity is checked against the blood product and its paperwork at the bedside
  4. DThe nurse checks only that the bag number matches the order
2.感染控制与患者安全困难

A nurse teaches a patient about care of a surgical incision at home. Which statement shows a need for further teaching?

  1. A“If the wound gets red and drains pus, I will wait for my appointment next month.”
  2. B“I will call the clinic if I get a fever or more pain around the wound.”
  3. C“I will keep the dressing clean and dry as I was shown.”
  4. D“I will wash my hands with soap before I touch or change the dressing.”
3.护理学基础中等

Why should insulin injection sites be rotated?

  1. ABecause each site can only be used once
  2. BTo prevent lumpy fatty swelling that affects absorption
  3. CTo make the insulin work more quickly with each injection
  4. DTo stop the patient getting used to the needle
4.护理学基础困难

A colleague suggests giving a patient who "asks for pain relief too often" a saline injection to check whether the pain is real. What is correct?

  1. AIt is deceptive; the pain should be assessed and treated
  2. BIt is a good way to test whether the patient's pain is real
  3. CIt is acceptable if the doctor agrees
  4. DIt is acceptable, provided the patient is not told about it
5.微生物学中等

在感染链中，"储存宿主"（reservoir）是什么？

  1. A病原体通常生存和繁殖的地方
  2. B病原体离开被感染宿主身体的途径
  3. C病原体进入新宿主的方式
  4. D感染风险最高的人
6.微生物学困难

19世纪40年代，伊格纳兹·塞麦尔维斯降低了维也纳一家产科诊所的产褥热死亡率。他引入了什么措施？

  1. A在分娩前给所有母亲接种疫苗
  2. B让产妇在分娩后留在单独的隔离病房
  3. C在检查产妇之前用漂白粉（氯化石灰）溶液洗手
  4. D用青霉素治疗产妇

3溶液

1.感染控制与患者安全

答案: C · The patient’s identity is checked against the blood product and its paperwork at the bedside

为什么是这个答案

Wrong-patient transfusion can cause a fatal ABO reaction, so the final check is always done at the bedside, with positive patient identification against the product label, compatibility tag and order. Many US hospitals require two qualified people for this check, while UK guidance allows one trained person if positive identification is used. Local policy decides who checks.

答案

C · The patient’s identity is checked against the blood product and its paperwork at the bedside
2.感染控制与患者安全

答案: A · “If the wound gets red and drains pus, I will wait for my appointment next month.”

为什么是这个答案

Increasing redness, purulent drainage, fever and worsening pain are signs of surgical site infection and should be reported promptly. Waiting a month could allow the infection to spread.

答案

A · “If the wound gets red and drains pus, I will wait for my appointment next month.”
3.护理学基础

答案: B · To prevent lumpy fatty swelling that affects absorption

为什么是这个答案

Injecting in the same place causes lipohypertrophy, which makes absorption unpredictable. Patients rotate within an area and check sites for lumps.

答案

B · To prevent lumpy fatty swelling that affects absorption
4.护理学基础

答案: A · It is deceptive; the pain should be assessed and treated

为什么是这个答案

Using a placebo without consent deceives the patient and damages trust. Response to a placebo does not prove the pain is not real. The patient's report should be believed and reassessed.

答案

A · It is deceptive; the pain should be assessed and treated
5.微生物学

答案: A · 病原体通常生存和繁殖的地方

为什么是这个答案

感染链把病原体、储存宿主、排出门户、传播途径、侵入门户和易感宿主连接起来。打断任何一环都能阻止传播。

答案

A · 病原体通常生存和繁殖的地方
6.微生物学

答案: C · 在检查产妇之前用漂白粉（氯化石灰）溶液洗手

为什么是这个答案

塞麦尔维斯注意到，由同时做尸检的医生负责的病房死亡率更高。用漂白粉进行手消毒使死亡人数大幅下降，而那时细菌学说还远未被接受。

答案

C · 在检查产妇之前用漂白粉（氯化石灰）溶液洗手

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