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

Which measure reduces errors caused by interruptions during medication preparation?

  1. AA quiet “no interruption” zone or signal while preparing medications
  2. BPreparing medications at the busiest place on the ward
  3. CAnswering phone calls and pages while counting tablets, to save time
  4. DPreparing medications for all patients at once
2.感染控制与患者安全困难

A patient with suspected sepsis has orders for blood cultures and an IV antibiotic. What is the correct order of actions?

  1. AWait for the culture results before starting the antibiotic
  2. BGive the antibiotic and take the cultures an hour later
  3. CDraw the blood cultures first, then give the antibiotic without delay
  4. DGive the antibiotic first so that treatment starts, and take the cultures the next day
3.护理学基础中等

How should the ear be positioned when taking a tympanic temperature in an adult?

  1. AGently pull the outer ear down and back
  2. BGently pull the outer ear up and back
  3. CLeave the ear alone and insert the probe deeply
  4. DPush the outer ear forward against the cheek
4.护理学基础困难

Which of these patients should the nurse attend to first?

  1. AA patient asking for their regular evening medicines
  2. BA patient with diabetes who is sweaty and shaky with a glucose of 2.9 mmol/L (52 mg/dL)
  3. CA patient with a pain score of 4/10 who had analgesia 30 minutes ago
  4. DA patient who wants to talk about the results of a scan
5.微生物学中等

刚地弓形虫（Toxoplasma gondii）在妊娠期具有风险。哪项建议可以减少接触？

  1. A避免清理猫砂，避免食用未煮熟的肉
  2. B避免接触狗
  3. C避免去游泳池和所有其他公共浴场
  4. D避免食用所有水果和蔬菜
6.微生物学困难

一名疑似传染性肺结核的患者入院。需要采取哪些防护措施？

  1. A用外科口罩进行飞沫防护，且只在一米范围内
  2. B无须特殊防护，因为结核病只经血液传播
  3. C只需接触防护，戴手套和穿围裙
  4. D空气传播防护，最好使用负压病房，工作人员佩戴呼吸防护口罩

3溶液

1.感染控制与患者安全

答案: A · A quiet “no interruption” zone or signal while preparing medications

为什么是这个答案

Interruptions during medication preparation are linked to more errors. Many units use quiet zones, vests or signs to show that the nurse should not be interrupted.

答案

A · A quiet “no interruption” zone or signal while preparing medications
2.感染控制与患者安全

答案: C · Draw the blood cultures first, then give the antibiotic without delay

为什么是这个答案

Cultures are drawn before the first antibiotic dose so the organism can still be grown and identified. The antibiotic is then given promptly, because delay increases the risk of death in sepsis.

答案

C · Draw the blood cultures first, then give the antibiotic without delay
3.护理学基础

答案: B · Gently pull the outer ear up and back

为什么是这个答案

Pulling the pinna up and back straightens the adult ear canal so the probe points at the eardrum. In young children the pinna is pulled down and back instead.

答案

B · Gently pull the outer ear up and back
4.护理学基础

答案: B · A patient with diabetes who is sweaty and shaky with a glucose of 2.9 mmol/L (52 mg/dL)

为什么是这个答案

Hypoglycaemia can quickly lead to unconsciousness and seizures and needs immediate treatment. The other patients' needs are important but can wait a few minutes.

答案

B · A patient with diabetes who is sweaty and shaky with a glucose of 2.9 mmol/L (52 mg/dL)
5.微生物学

答案: A · 避免清理猫砂，避免食用未煮熟的肉

为什么是这个答案

弓形虫卵囊随猫粪便排出，包囊存在于未煮熟的肉中。妊娠期感染可损害胎儿的大脑和眼睛。

答案

A · 避免清理猫砂，避免食用未煮熟的肉
6.微生物学

答案: D · 空气传播防护，最好使用负压病房，工作人员佩戴呼吸防护口罩

为什么是这个答案

结核分枝杆菌（M. tuberculosis）通过能长时间悬浮的空气飞沫核传播。患者应尽可能住在负压单间，工作人员佩戴 FFP2/FFP3 或 N95 呼吸防护口罩。

答案

D · 空气传播防护，最好使用负压病房，工作人员佩戴呼吸防护口罩

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