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

A patient receiving continuous nasogastric feeding has pulled the tube partly out. What should the nurse do first?

  1. AStop the feeding until the tube position is checked
  2. BIncrease the feed rate to make up for the lost time
  3. CPush the tube back in and restart the feed
  4. DTape the tube in its new position and continue
2.感染控制与患者安全困难

A patient after heart surgery has temporary epicardial pacing wires. Why do staff take special care with electrical safety?

  1. ASmall currents can travel along the wires straight to the heart and cause arrhythmias
  2. BThe wires make the patient immune to electric shock
  3. CElectrical safety only matters for patients who have permanent implanted pacemakers
  4. DPacing wires can only carry current coming from the pacemaker box itself
3.护理学基础中等

Before discharge, what is most important to confirm about the patient's new medicines?

  1. AThat they know the chemical name of each drug
  2. BThat they know the price of each medicine and where to buy it
  3. CThat they know which company makes each drug
  4. DThat they know how and when to take them and what to report
4.护理学基础困难

An older patient's leg wound has become more painful and has a new unpleasant smell, but there is no fever. What does this suggest?

  1. ANormal healing, because there is no fever and the wound is still closed
  2. BA possible wound infection that needs assessment and reporting
  3. CThe wound has dried out and needs to be left open
  4. DAn allergy to the dressing that needs no action
5.微生物学中等

什么是内毒素？

  1. A只在人体细胞内产生的毒素
  2. B潮湿建筑中真菌产生的毒素
  3. C革兰氏阴性菌外膜中的脂多糖
  4. D革兰氏阳性菌分泌到周围组织中的蛋白质毒素
6.微生物学困难

一处又深又脏的伤口变得肿胀且剧烈疼痛，皮下能触到气体。最可能的病原体是什么？

  1. ANeisseria gonorrhoeae
  2. BBordetella pertussis
  3. CClostridium perfringens
  4. DStreptococcus pneumoniae

3溶液

1.感染控制与患者安全

答案: A · Stop the feeding until the tube position is checked

为什么是这个答案

A displaced tube may now sit in the esophagus or airway. The feeding is stopped and the tube is not pushed back blindly. Its position is checked according to policy, or it is replaced.

答案

A · Stop the feeding until the tube position is checked
2.感染控制与患者安全

答案: A · Small currents can travel along the wires straight to the heart and cause arrhythmias

为什么是这个答案

Wires that lead directly to the heart allow tiny currents (microshock) to reach the myocardium and cause ventricular fibrillation. Staff wear gloves when handling them, cover exposed ends and use properly grounded equipment.

答案

A · Small currents can travel along the wires straight to the heart and cause arrhythmias
3.护理学基础

答案: D · That they know how and when to take them and what to report

为什么是这个答案

Safe discharge needs the patient or carer to understand dose, timing, purpose and important side effects. Teach-back and written information help confirm this.

答案

D · That they know how and when to take them and what to report
4.护理学基础

答案: B · A possible wound infection that needs assessment and reporting

为什么是这个答案

Increasing pain, odour, new exudate or delayed healing can signal infection even without fever, especially in older adults. The wound is assessed, the change reported and a swab taken if policy advises.

答案

B · A possible wound infection that needs assessment and reporting
5.微生物学

答案: C · 革兰氏阴性菌外膜中的脂多糖

为什么是这个答案

内毒素是脂多糖中的类脂 A。它引发伴有发热的强烈免疫反应，大量时可导致感染性休克。

答案

C · 革兰氏阴性菌外膜中的脂多糖
6.微生物学

答案: C · Clostridium perfringens

为什么是这个答案

产气荚膜梭菌（Clostridium perfringens）在缺氧伤口中引起气性坏疽。它的毒素破坏肌肉，代谢产生的气体可触及捻发感。需要紧急手术和抗生素治疗。

答案

C · Clostridium perfringens

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