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

When should the transparent dressing over a peripheral IV site be changed?

  1. AOnly when the patient asks for a new dressing
  2. BWhen it is damp, loose or visibly soiled
  3. COnly when the IV catheter is removed, whatever its state
  4. DEvery hour, so the site can be cleaned again
2.感染控制与患者安全困难

A patient on a general ward for two days is found to have smear-positive pulmonary TB. What should the nurse do besides moving the patient to an airborne isolation room?

  1. AClose the ward to all new admissions for a full year
  2. BNothing more, because the patient has now been isolated
  3. CTell all the exposed patients to start TB drugs at once, before any testing
  4. DInform infection prevention so exposed patients and staff can be identified and followed up
3.护理学基础中等

Where in the eye should eye drops be placed?

  1. AOnto the upper eyelid while the eye is shut
  2. BInto the inner corner of the eye only
  3. CInto the pocket of the lower eyelid
  4. DDirectly onto the centre of the cornea
4.护理学基础困难

A competent adult who is a Jehovah's Witness refuses a blood transfusion that the team believes is needed. Which two ethical principles are in conflict?

  1. AAutonomy and beneficence
  2. BVeracity and non-maleficence
  3. CFidelity and justice
  4. DJustice and veracity
5.微生物学中等

什么是潜伏期？

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

为什么人可以多次得流感，而麻疹通常只得一次？

  1. A麻疹病毒没有表面抗原
  2. B流感病毒攻击并破坏感染后形成的记忆细胞
  3. C麻疹由细菌引起
  4. D流感病毒经常改变其表面抗原

3溶液

1.感染控制与患者安全

答案: B · When it is damp, loose or visibly soiled

为什么是这个答案

A dressing that is wet, loose or dirty no longer protects the insertion site and is changed using aseptic technique. Otherwise, it is changed according to policy.

答案

B · When it is damp, loose or visibly soiled
2.感染控制与患者安全

答案: D · Inform infection prevention so exposed patients and staff can be identified and followed up

为什么是这个答案

Infection prevention and public health carry out a contact investigation to identify and screen people exposed while the patient was not isolated. Treatment of contacts depends on their test results.

答案

D · Inform infection prevention so exposed patients and staff can be identified and followed up
3.护理学基础

答案: C · Into the pocket of the lower eyelid

为什么是这个答案

Drops go into the lower conjunctival sac, which is less sensitive than the cornea. Pressing gently on the inner corner afterwards reduces drainage into the nose.

答案

C · Into the pocket of the lower eyelid
4.护理学基础

答案: A · Autonomy and beneficence

为什么是这个答案

The patient's right to decide (autonomy) conflicts with the team's wish to do good (beneficence). A valid refusal by a competent adult is respected, and alternatives to blood are explored.

答案

A · Autonomy and beneficence
5.微生物学

答案: A · 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

A · 从感染到出现最初症状的时间
6.微生物学

答案: D · 流感病毒经常改变其表面抗原

为什么是这个答案

流感病毒的血凝素和神经氨酸酶会通过漂移（小突变）和转变（基因重配）而改变，旧抗体可能识别不了新毒株。麻疹病毒抗原稳定。

答案

D · 流感病毒经常改变其表面抗原

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