N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide Chapter Six: Biological Concerns Biological issues for patients revolve around infection and the prevention of the infection. These infections can be disease processes (e.g., measles and mumps), environmental (e.g., wound infections caused by organisms in the environment), or man-made (e.g., anthrax and other organisms used for bioterrorism). Regardless of how the patient acquires the infection, the nurse must be aware of the chain of infection and how it can be broken. 6.1 Chain of Infection The chain of infection includes the infectious agent, the source, the exit portal, the mode of transmission, the entry portal and the host. Each of these elements must be present in order for an infection to occur. The first goal of the healthcare team is to prevent infection; once infection occurs, the goal of the team is to help the patient get rid of the infection. The Infectious Agent Any bacteria, fungus, parasite, or virus may act as an infectious agent. Whether or not an agent is infectious depends on its ability to attach itself to a host, its ability to overcome the immune defenses of the host, and its ability to produce toxins. There are several terms used to describe a potentially infectious agent: • Pathogenesis: This refers to the ability of the agent to cause disease. • Virulence: This refers to the agent’s ability to grow and multiply. • Invasiveness: This refers to the ease with which an agent can enter the host’s system. • Specificity: This refers to the agent’s attraction to a specific host. The Source The source of an agent is the particular element in the environment, which carries the potential pathogen. These can include: • Other people, especially healthcare workers, people who might be infected but in the incubation period for the disease, or people who are “carriers” of an agent but never show symptoms of a disease • Insects or animals; rats and mosquitoes are responsible for transmission of many diseases, such as plague and malaria • Inanimate objects including medications, food, and water; all of these objects provide an environment in which certain pathogens can survive and thrive • The patient’s own normal body flora that normally would not cause infection The Exit Portal The exit portal is the way the agent leaves the source. When a person is the source, the exit portal might be through a sneeze, cough, blood, any bodily drainage, or emesis. An insect or animal may produce a bite or sting that transfers pathogens from the animal into the person through blood or saliva.

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