AF Safety & Infection Control 2 — Questions and Answers
Question 1: A patient with AF undergoes transesophageal echocardiography (TEE). Which infection control measure is MOST critical for the TEE probe between patients?
- Wipe with alcohol wipe and reuse immediately
- High-level disinfection with glutaraldehyde or equivalent agent (Correct answer)
- Autoclave sterilization after every use
- Rinse with sterile water only
Correct answer: High-level disinfection with glutaraldehyde or equivalent agent
TEE probes are semi-critical devices requiring high-level disinfection (e.g., glutaraldehyde, ortho-phthalaldehyde) between patients to eliminate pathogens.
Question 2: During catheter ablation for AF, the nurse notes the patient's groin access site has purulent drainage 48 hours post-procedure. The FIRST action is to:
- Apply a compression bandage and reassess in 24 hours
- Notify the physician and obtain a wound culture (Correct answer)
- Irrigate the site with hydrogen peroxide
- Administer prophylactic antibiotics without culture
Correct answer: Notify the physician and obtain a wound culture
Purulent drainage at a vascular access site is a sign of infection requiring immediate physician notification and culture before initiating antibiotic therapy.
Question 3: Which PPE is required when a clinician is defibrillating an AF patient in contact precautions for MRSA?
- N95 respirator and face shield only
- Gloves and gown as per contact precautions (Correct answer)
- No additional PPE is required for emergencies
- Full surgical attire including sterile drapes
Correct answer: Gloves and gown as per contact precautions
Contact precautions require gloves and gown regardless of the urgency of the procedure, including defibrillation.
Question 4: A patient on anticoagulation for AF develops a fever of 38.8°C after pacemaker implantation 10 days ago. Which assessment finding most strongly suggests device pocket infection?
- Sinus tachycardia on ECG
- Erythema, warmth, and fluctuance over the device pocket (Correct answer)
- Elevated BNP level
- New-onset left bundle branch block
Correct answer: Erythema, warmth, and fluctuance over the device pocket
Local signs of erythema, warmth, and fluctuance over the device pocket are hallmark indicators of cardiac implantable electronic device (CIED) pocket infection.
Question 5: An AF patient is on warfarin and requires urinary catheterization. To prevent CAUTI, the nurse should:
- Use the largest available catheter to reduce reinsertion frequency
- Maintain a closed drainage system and remove the catheter as soon as clinically possible (Correct answer)
- Irrigate the catheter daily with antiseptic solution
- Change the catheter every 48 hours regardless of clinical need
Correct answer: Maintain a closed drainage system and remove the catheter as soon as clinically possible
Maintaining a closed drainage system and removing the catheter at the earliest opportunity are the most effective CAUTI prevention strategies.
Question 6: When preparing the groin for femoral arterial access in an AF ablation procedure, the recommended skin antiseptic agent is:
- Povidone-iodine paint applied without drying
- Chlorhexidine gluconate with isopropyl alcohol, allowed to dry completely (Correct answer)
- Isopropyl alcohol 70% applied once
- Soap and water scrub only
Correct answer: Chlorhexidine gluconate with isopropyl alcohol, allowed to dry completely
Chlorhexidine-alcohol combination is the preferred pre-procedural skin antiseptic and must be allowed to dry fully before draping to achieve maximum efficacy.
Question 7: A nurse preparing to administer IV heparin to an AF patient notices the IV bag port looks cracked. The safest action is to:
- Reinforce the port with tape and administer carefully
- Discard the bag and obtain a new one (Correct answer)
- Filter the medication through an inline filter
- Administer the drug faster to minimize exposure time
Correct answer: Discard the bag and obtain a new one
A cracked IV bag port compromises sterility; the bag must be discarded and replaced to prevent contamination and patient harm.
AF Safety & Infection Control 2
A patient with AF undergoes transesophageal echocardiography (TEE).
Which infection control measure is MOST critical for the TEE probe between patients?