Infection Control Flashcards

What is the most important measure to prevent ventilator-associated pneumonia (VAP)?

Answer: Maintain head of bed at 30–45 degrees, perform oral care with chlorhexidine, and assess readiness to extubate daily

The VAP bundle includes: head of bed elevation 30–45° (reduces aspiration), oral decontamination with chlorhexidine (reduces oropharyngeal bacteria), daily sedation vacation and spontaneous breathing trials (to minimize ventilator days), and cuff pressure maintenance. Routine ventilator circuit changes are not recommended.

What does 'isolation' precautions for immunocompromised patients include?

Answer: Protective (reverse) isolation: restricting pathogens from entering the patient's environment

Immunocompromised patients (post-BMT, severe neutropenia) require protective (reverse) isolation: HEPA-filtered rooms, restricted visitors, no fresh flowers or plants, careful food safety, and cohorting staff to reduce exposure from external pathogens that could be fatal in a patient with no immune defenses.

A nurse observes another nurse reusing a single-use medical device. What is the appropriate action?

Answer: Immediately intervene to stop the practice and report to the charge nurse and infection control

Reusing single-use devices risks transmission of bloodborne pathogens and other infections, and compromises device integrity. This is a patient safety issue requiring immediate intervention to stop the practice, followed by mandatory reporting to the charge nurse and infection control for investigation and corrective action.

What is the purpose of biofilm in healthcare-associated infections?

Answer: Bacteria within biofilm are protected from antibiotics and immune cells, making infections very difficult to treat

Biofilms are structured communities of bacteria encased in a self-produced polysaccharide matrix, forming on urinary catheters, central lines, prosthetic joints, and chronic wounds. Bacteria within biofilm are up to 1000 times more resistant to antibiotics and evade immune defenses.

What is the recommended frequency for changing peripheral IV catheter sites?

Answer: Only when clinically indicated (signs of infection, infiltration, or thrombophlebitis) — not routine 72–96 hour changes

Current CDC guidelines recommend against routine scheduled replacement of peripheral IV catheters. Sites should be changed when there are clinical indications (phlebitis, infiltration, infection signs) or when the catheter is malfunctioning. Routine 72–96 hour changes are no longer recommended.

What personal protective equipment is required when preparing cytotoxic chemotherapy drugs?

Answer: Double gloves, chemotherapy-rated gown, eye/face protection, and a biological safety cabinet

Cytotoxic drugs are hazardous materials. Preparation requires: double chemotherapy-tested gloves, a closed-front chemo-rated gown (not a regular isolation gown), eye/face protection, and preparation in a biological safety cabinet (Class II, Type B2) to protect the preparer from aerosolized drug.