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

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?

  1. A定期断开集尿袋以便更方便地排空
  2. B无菌插管、封闭系统和每日评估是否需要
  3. C把集尿袋放在床上,与膀胱同高
  4. D每天更换导尿管以保持清洁、无结痂
3.护理学基础中等

What is medicines reconciliation on admission?

  1. AGetting an accurate list of the medicines taken before admission
  2. BChanging all the patient's medicines to hospital brands
  3. CCounting the tablets in the ward drug trolley at the start of each shift
  4. DOrdering new stock from the pharmacy
4.护理学基础困难

A patient says they have no pain, but grimaces and holds their side whenever they move. What should the nurse do?

  1. ARecord "no pain" and take no further action
  2. BGive the strongest analgesic available straight away
  3. CExplore the difference gently and assess the pain further
  4. DTell the patient they are not being honest
5.微生物学中等

新感染时哪类抗体最先升高?

  1. AIgA
  2. BIgG
  3. CIgM
  4. DIgE
6.微生物学困难

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?

  1. A新的水痘感染经血液扩散到身体一侧
  2. 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
  3. C细菌沿胸部淋巴管扩散
  4. D对衣物的过敏反应影响了一个皮节

3溶液

1.感染控制与患者安全

答案: B · 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

B · 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 · 无菌插管、封闭系统和每日评估是否需要

为什么是这个答案

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

B · 无菌插管、封闭系统和每日评估是否需要
3.护理学基础

答案: A · Getting an accurate list of the medicines taken before admission

为什么是这个答案

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

A · Getting an accurate list of the medicines taken before admission
4.护理学基础

答案: C · Explore the difference gently and assess the pain further

为什么是这个答案

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 · Explore the difference gently and assess the pain further
5.微生物学

答案: C · IgM

为什么是这个答案

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

C · IgM
6.微生物学

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

为什么是这个答案

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。

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

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