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 colleague has drawn up a medication and asks the nurse to give it to her patient. What should the nurse do?

  1. AGive it, as long as the syringe has a label with the drug name on it
  2. BGive it, because the colleague is experienced
  3. CGive it, and document that the colleague prepared it
  4. DDecline, and give only medications that the nurse prepared or checked personally
2.感染控制与患者安全困难

Before the wound is closed, the sponge count does not match the starting count. What should happen?

  1. AChange the count on the record so that it matches, then close the wound as planned
  2. BTell the surgeon and team, search for the item, and image the patient per policy if it is not found
  3. CClose the wound to avoid a long anesthetic and recount the sponges after surgery
  4. DAssume that the first count was wrong and continue
3.护理学基础中等

Which of these is recorded as fluid intake on a fluid balance chart?

  1. AUrine output from a catheter
  2. BWound drainage
  3. CVomit
  4. DIntravenous fluids
4.护理学基础困难

A colleague suggests giving a patient who "asks for pain relief too often" a saline injection to check whether the pain is real. What is correct?

  1. AIt is acceptable if the doctor agrees
  2. BIt is acceptable, provided the patient is not told about it
  3. CIt is deceptive; the pain should be assessed and treated
  4. DIt is a good way to test whether the patient's pain is real
5.微生物学中等

哪种感染是使用广谱抗生素的典型并发症，会引起严重腹泻？

  1. A艰难梭菌（Clostridioides difficile）感染
  2. B幽门螺杆菌感染
  3. C甲型肝炎
  4. D沙门氏菌感染
6.微生物学困难

一处又深又脏的伤口变得肿胀且剧烈疼痛，皮下能触到气体。最可能的病原体是什么？

  1. ANeisseria gonorrhoeae
  2. BBordetella pertussis
  3. CClostridium perfringens
  4. DStreptococcus pneumoniae

3溶液

1.感染控制与患者安全

答案: D · Decline, and give only medications that the nurse prepared or checked personally

为什么是这个答案

Nurses give only medicines they prepared themselves or verified fully, because they are accountable for what they give. A drug prepared by someone else may be wrong in ways the nurse cannot see.

答案

D · Decline, and give only medications that the nurse prepared or checked personally
2.感染控制与患者安全

答案: B · Tell the surgeon and team, search for the item, and image the patient per policy if it is not found

为什么是这个答案

A count discrepancy is reported to the whole team at once. Closure waits while the field, wound and room are searched, and an x-ray is taken per policy if the item is still missing.

答案

B · Tell the surgeon and team, search for the item, and image the patient per policy if it is not found
3.护理学基础

答案: D · Intravenous fluids

为什么是这个答案

Intake includes oral fluids, enteral feeds and IV fluids, including drug infusions. Urine, vomit, drainage and stool are output.

答案

D · Intravenous fluids
4.护理学基础

答案: C · It is deceptive; the pain should be assessed and treated

为什么是这个答案

Using a placebo without consent deceives the patient and damages trust. Response to a placebo does not prove the pain is not real. The patient's report should be believed and reassessed.

答案

C · It is deceptive; the pain should be assessed and treated
5.微生物学

答案: A · 艰难梭菌（Clostridioides difficile）感染

为什么是这个答案

抗生素杀死正常肠道细菌，使产毒素的艰难梭菌过度生长。其芽孢不能被酒精凝胶杀灭，因此需要用肥皂和水洗手。

答案

A · 艰难梭菌（Clostridioides difficile）感染
6.微生物学

答案: C · Clostridium perfringens

为什么是这个答案

产气荚膜梭菌（Clostridium perfringens）在缺氧伤口中引起气性坏疽。它的毒素破坏肌肉，代谢产生的气体可触及捻发感。需要紧急手术和抗生素治疗。

答案

C · Clostridium perfringens

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