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。
Which instruction about using a standard walker is correct?
一名干细胞移植后严重免疫抑制的患者住在保护性环境中。下列哪件物品不应带入房间?
How should a liquid medicine be measured in a medicine cup?
A patient with a valid DNACPR (DNR) decision, whose death was expected, stops breathing. What should the nurse do?
Streptococcus pneumoniae 的主要毒力因子、也是其疫苗的靶点是什么?
1854年,约翰·斯诺把伦敦的一次霍乱暴发追溯到宽街(Broad Street)的水泵。这项研究为什么重要?
答案: A · Move the walker forward, then step into it
The patient moves the walker forward, sets it down with all legs on the floor and then steps into it. To stand, they push up from the chair arms, because a walker can tip if used to pull up.
答案: C · 鲜花或盆栽植物
鲜花和植物可携带曲霉菌(Aspergillus)等霉菌以及水源性细菌,可在严重免疫功能低下的患者中引起严重感染。干净、可擦拭的个人物品通常是允许的。
答案: A · At eye level, reading the lowest point of the curved surface
The cup is placed on a flat surface and read at eye level at the bottom of the meniscus. An oral syringe is more accurate for small volumes.
答案: A · Not start CPR, note the time, inform the team and support the family
CPR is not attempted when a valid DNACPR decision applies. The nurse notes the time, follows local policy for verifying death, informs the medical team and supports the family.
答案: D · 它的多糖荚膜
荚膜保护 S. pneumoniae 免受吞噬。荚膜型有很多种,肺炎球菌疫苗含有最常见型别的荚膜多糖。
答案: C · 它表明霍乱通过被污染的水传播,奠定了现代流行病学的基础
斯诺绘制了水泵周围的病例分布图,并将病例与该泵的水联系起来。拆除水泵把手是利用流行病学查明并切断传染源的经典例子,而当时病原菌尚未被发现。
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