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

Why should a child’s weight be recorded only in kilograms?

  1. AScales that show kilograms are always more accurate than those that show pounds
  2. BKilograms are easier for parents to remember
  3. CMixing up pounds and kilograms can lead to large dosing errors
  4. DChildren weigh less, so smaller units are needed
2.感染控制与患者安全困难

A patient with pulmonary tuberculosis has been on treatment. Which findings usually allow airborne isolation to end?

  1. AThe patient has been in hospital for one week and has taken every dose of medicine
  2. BThree negative sputum smears, clinical improvement and continued therapy
  3. COne negative chest x-ray after starting treatment
  4. DThe cough has stopped, even with no sputum tests
3.护理学基础中等

A small blood spill is found on the ward floor. What is the correct approach?

  1. AWear gloves and an apron and clean it with an approved disinfectant per policy
  2. BLeave it for the domestic staff to clean at the end of the day
  3. CWipe it up with a paper towel without gloves, then wash your hands well afterwards
  4. DCover it with a sheet so no one steps in it
4.护理学基础困难

一名糖尿病患者被发现无反应，血糖极低且不能吞咽。正确的做法是什么？

  1. A呼救，并按规程经其他途径给予葡萄糖，如静脉葡萄糖或肌注胰高血糖素
  2. B把含糖果汁倒进患者嘴里
  3. C给予患者平常剂量的胰岛素
  4. D等患者醒来后再给食物
5.微生物学中等

什么是潜伏期？

  1. A患者对他人保持传染性的时间
  2. B从感染到出现最初症状的时间
  3. C实验室培养所需的时间
  4. D抗生素起效所需的时间
6.微生物学困难

哪种细菌毒素引起破伤风的肌肉痉挛？

  1. A外膜的内毒素
  2. B破伤风痉挛毒素，阻断抑制性神经递质的释放
  3. C肉毒毒素，阻断神经肌肉接头处乙酰胆碱的释放
  4. D霍乱毒素，激活腺苷酸环化酶

3溶液

1.感染控制与患者安全

答案: C · Mixing up pounds and kilograms can lead to large dosing errors

为什么是这个答案

Pediatric doses are often calculated per kilogram. A weight recorded in pounds but read as kilograms gives a dose more than twice as high, so weight is recorded and used only in kilograms.

答案

C · Mixing up pounds and kilograms can lead to large dosing errors
2.感染控制与患者安全

答案: B · Three negative sputum smears, clinical improvement and continued therapy

为什么是这个答案

Airborne precautions usually continue until the patient is on effective therapy, is improving clinically and has three negative sputum smears for acid-fast bacilli, according to policy.

答案

B · Three negative sputum smears, clinical improvement and continued therapy
3.护理学基础

答案: A · Wear gloves and an apron and clean it with an approved disinfectant per policy

为什么是这个答案

Under standard precautions all blood is handled as potentially infectious. Spills are cleaned promptly using PPE and the spill kit or disinfectant set out in local policy.

答案

A · Wear gloves and an apron and clean it with an approved disinfectant per policy
4.护理学基础

答案: A · 呼救，并按规程经其他途径给予葡萄糖，如静脉葡萄糖或肌注胰高血糖素

为什么是这个答案

患者不能吞咽时口服葡萄糖有误吸风险。护士应按照本单位规程呼救、保护气道，给予静脉葡萄糖或肌注胰高血糖素，然后复测血糖。

答案

A · 呼救，并按规程经其他途径给予葡萄糖，如静脉葡萄糖或肌注胰高血糖素
5.微生物学

答案: B · 从感染到出现最初症状的时间

为什么是这个答案

潜伏期是从接触病原体到症状出现的时间。有时在潜伏期内就已经可以传播感染。

答案

B · 从感染到出现最初症状的时间
6.微生物学

答案: B · 破伤风痉挛毒素，阻断抑制性神经递质的释放

为什么是这个答案

破伤风梭菌的破伤风痉挛毒素阻断抑制性中间神经元释放 GABA 和甘氨酸，导致痉挛性瘫痪。肉毒毒素则引起弛缓性瘫痪。

答案

B · 破伤风痉挛毒素，阻断抑制性神经递质的释放

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