感染控制与患者安全
方法
- 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。
- 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)。
- 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。
- 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。
- 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。
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。
A nurse’s hands are dry and cracked from frequent hand hygiene. What is the best approach?
当明确需要留置导尿管时,哪种方法最能预防导管相关尿路感染?
What is medicines reconciliation on admission?
A patient says they have no pain, but grimaces and holds their side whenever they move. What should the nurse do?
新感染时哪类抗体最先升高?
一位老年人在胸部一侧出现带状分布的疼痛性水疱疹。如何解释这种分布?
答案: B · Use the hand lotion approved by the facility to keep the skin intact
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: B · 无菌插管、封闭系统和每日评估是否需要
预防 CAUTI 包括无菌插管、集尿袋低于膀胱且引流通畅的封闭系统,以及每日评估,以便在不再需要时尽快拔除导尿管。频繁更换和破坏封闭系统会增加感染风险。
答案: A · Getting an accurate list of the medicines taken before admission
Medicines reconciliation compares the patient's own medicines with what is prescribed in hospital, using several sources, so that changes are intended and errors are avoided.
答案: C · Explore the difference gently and assess the pain further
When cues conflict, the nurse looks further. Patients may play pain down for many reasons, such as not wanting to bother staff or fearing side effects.
答案: C · IgM
在初次免疫应答中 IgM 最先出现;随后出现 IgG,提供长期保护。因此 IgM 阳性提示近期感染。
答案: B · 水痘-带状疱疹病毒从一个感觉神经节重新激活,并沿其神经移行
患水痘后,VZV 潜伏在脊神经后根或脑神经节中。当免疫力下降时,它可能重新激活,沿该神经下行,在其支配的皮节引起带状疱疹。
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