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 nurse’s hands are dry and cracked from frequent hand hygiene. What is the best approach?

  1. AUse any lotion from home, whatever its contents
  2. BWear gloves all day instead of cleaning the hands between patients
  3. CUse the hand lotion approved by the facility to keep the skin intact
  4. DStop hand hygiene until the skin heals
2.感染控制与患者安全困难

While preparing a chemotherapy infusion, the drug splashes onto a nurse’s forearm. What should the nurse do first?

  1. AFinish hanging the infusion and then wash the skin
  2. BRemove contaminated PPE and wash the skin with soap and water at once
  3. CWipe the skin with an alcohol swab and continue preparing the infusion
  4. DCover the area with a dressing and report later
3.护理学基础中等

When using a metered-dose inhaler without a spacer, what should the patient do straight after inhaling the dose?

  1. ATake another dose at once without pausing
  2. BHold their breath for about 10 seconds
  3. CRinse the mouth before breathing in
  4. DBreathe out hard through the mouthpiece
4.护理学基础困难

Which postoperative finding should be reported most urgently?

  1. ARespiratory rate 8/min and difficult to rouse
  2. BUrine output of 50 mL in the last hour
  3. CPain score of 4/10 at the wound site when moving
  4. DTemperature 37.4 °C on the first day
5.微生物学中等

哪种生物是烧伤和囊性纤维化患者感染的常见病原，并能产生绿色色素？

  1. AStreptococcus pyogenes
  2. BHelicobacter pylori
  3. CClostridium tetani
  4. DPseudomonas aeruginosa
6.微生物学困难

一名年轻成人有咽痛、发热和淋巴结肿大，服用阿莫西林后出现广泛皮疹。最可能是哪种感染？

  1. A水痘
  2. B链球菌性扁桃体炎
  3. C麻疹
  4. D由 Epstein–Barr 病毒引起的传染性单核细胞增多症

3溶液

1.感染控制与患者安全

答案: C · Use the hand lotion approved by the facility to keep the skin intact

为什么是这个答案

Cracked skin is harder to clean and harbors more organisms. Facility-approved lotions help keep the skin healthy without reducing the effect of hand antiseptics such as chlorhexidine.

答案

C · Use the hand lotion approved by the facility to keep the skin intact
2.感染控制与患者安全

答案: B · Remove contaminated PPE and wash the skin with soap and water at once

为什么是这个答案

Skin exposure to hazardous drugs is washed immediately with soap and water after removing contaminated gloves or gown. The exposure is then reported and treated according to policy.

答案

B · Remove contaminated PPE and wash the skin with soap and water at once
3.护理学基础

答案: B · Hold their breath for about 10 seconds

为什么是这个答案

The patient breathes out, seals the lips round the mouthpiece, presses as they start a slow deep breath in, then holds the breath for about 10 seconds or as long as is comfortable.

答案

B · Hold their breath for about 10 seconds
4.护理学基础

答案: A · Respiratory rate 8/min and difficult to rouse

为什么是这个答案

A low respiratory rate with reduced consciousness may mean opioid toxicity or deterioration and threatens the airway. The other findings are common after surgery and can be managed routinely.

答案

A · Respiratory rate 8/min and difficult to rouse
5.微生物学

答案: D · Pseudomonas aeruginosa

为什么是这个答案

铜绿假单胞菌（Pseudomonas aeruginosa）是烧伤、机械通气患者和囊性纤维化患者肺部的机会性病原体。它对许多抗生素天然耐药。

答案

D · Pseudomonas aeruginosa
6.微生物学

答案: D · 由 Epstein–Barr 病毒引起的传染性单核细胞增多症

为什么是这个答案

传染性单核细胞增多症（腺热）由 EBV 引起。许多患者在患病期间服用阿莫西林后会出现皮疹。由于病因是病毒，抗生素没有帮助。

答案

D · 由 Epstein–Barr 病毒引起的传染性单核细胞增多症

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