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 patient with diabetes will use lancets and insulin needles at home. Which teaching about disposal is correct?

  1. ARecap each needle with two hands before putting it in the kitchen trash
  2. BPut them loose in the household trash bag, as long as the bag is tied shut
  3. CFlush the used lancets and needles down the toilet
  4. DPut them in a puncture-resistant container with a lid and follow local disposal rules
2.感染控制与患者安全困难

Which patient with a suspected infection meets the qSOFA criteria that signal a higher risk of a poor outcome?

  1. ARespiratory rate 16/min, alert, systolic BP 105 mmHg, WBC 13,000/mm3
  2. BRespiratory rate 20/min, alert, systolic BP 110 mmHg, heart rate 110/min
  3. CRespiratory rate 24/min, new confusion, systolic BP 95 mmHg
  4. DRespiratory rate 18/min, alert, systolic BP 130 mmHg, temperature 38.5 °C
3.护理学基础中等

Why is a slide sheet used to move a patient up the bed?

  1. AIt keeps the bed clean during the move
  2. BIt reduces friction and shear on the skin
  3. CIt lets one nurse lift the patient alone
  4. DIt warms the patient during the move
4.护理学基础困难

A patient with a new colostomy has been taught stoma care. Which statement shows a need for further teaching?

  1. A"I'll dry the skin well before putting on a new bag."
  2. B"I'll check the skin around my stoma when I change the bag."
  3. C"I'll measure the stoma again as it shrinks over the next weeks."
  4. D"I'll cut the opening much bigger than my stoma so it doesn't rub."
5.微生物学中等

高压蒸汽灭菌器如何对器械进行灭菌？

  1. A在室温下用酒精蒸气
  2. B用约121 °C 的加压蒸汽
  3. C用约60 °C 的干热
  4. D只用紫外线
6.微生物学困难

一根导尿管已被生物膜中的细菌定植。为什么通常要更换导尿管，而不只是给予抗生素？

  1. A生物膜中的细菌受到保护，抗生素难以杀灭得多
  2. B生物膜中只含病毒，所以抗生素无效
  3. C抗生素会损坏导尿管材料
  4. D生物膜细菌不能致病

3溶液

1.感染控制与患者安全

答案: D · Put them in a puncture-resistant container with a lid and follow local disposal rules

为什么是这个答案

Home sharps go into a puncture-resistant container, such as an approved sharps container or a rigid plastic bottle if local rules allow, which is closed and disposed of according to local guidance.

答案

D · Put them in a puncture-resistant container with a lid and follow local disposal rules
2.感染控制与患者安全

答案: C · Respiratory rate 24/min, new confusion, systolic BP 95 mmHg

为什么是这个答案

qSOFA scores one point each for a respiratory rate of 22/min or more, altered mental status and a systolic BP of 100 mmHg or less. Two or more points mean higher risk, so the first patient needs urgent escalation.

答案

C · Respiratory rate 24/min, new confusion, systolic BP 95 mmHg
3.护理学基础

答案: B · It reduces friction and shear on the skin

为什么是这个答案

Slide sheets let the patient glide rather than be dragged, protecting the skin from friction and shear and reducing strain on staff.

答案

B · It reduces friction and shear on the skin
4.护理学基础

答案: D · "I'll cut the opening much bigger than my stoma so it doesn't rub."

为什么是这个答案

An opening that is too large leaves skin exposed to output, causing soreness and leaks. Checking the skin, re-measuring and drying the skin are correct.

答案

D · "I'll cut the opening much bigger than my stoma so it doesn't rub."
5.微生物学

答案: B · 用约121 °C 的加压蒸汽

为什么是这个答案

加压蒸汽可达约121 °C，能杀死包括芽孢在内的所有微生物，通常需要约15分钟或更长时间，取决于装载量。

答案

B · 用约121 °C 的加压蒸汽
6.微生物学

答案: A · 生物膜中的细菌受到保护，抗生素难以杀灭得多

为什么是这个答案

在生物膜中，细菌生活在保护性基质里，生长缓慢，能耐受高浓度抗生素。拔除器械就去除了感染源。

答案

A · 生物膜中的细菌受到保护，抗生素难以杀灭得多

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