hello uh I am Miss green and you are in the concept of infection so this is a video um that I won't play due to it being a recording but about infection really keep funny video and so the student learning outcomes you can read over this this is basically saying by the end of this class you will be able to do all of the following based on this lecture and the material that you have to cover in um your readings so terms of infection you have infection which is the growth of a microorganism in a body tissue where they are usually not found so that is a growth of a microorganism in a body tissue where they are usually not found typically called an infectious agent disease is a detectable alteration and normal tissue function and virulence this is a microorganism's ability to cause disease so if you think of virulence as an HIV viral right that's a viral load that's the ability to cause disease so deter dep depending on the viral load of an HIV patient that depends on if the person is able to pass on the HIV infection to someone else and then pathogenicity this is the ability to produce disease so the pathogen is a microorganism that causes causes diseases true pathogens can affect healthy individuals whereas opportunistic pathogens cause disease only in a susceptible individual so susceptible individual will be somebody whose immune system is compromised who maybe have cancer someone who maybe had a transplant um or anyone or infants or older adults but anybody who immune system is compromised so the types of infection that we have you have um colonization um and this is strains of microorganism that become resident flora I.E staff right this lives on our body there's a colonization they occupy a particular body site and then they can outnumber the person's own cells so staff again if it outnumbers the cells on your body uh and they begin to multiply then they um can cause the disease if there is a break in your defense mechanism I.E breaking the skin you have a cut you have staff on your skin and there's an over over colonization of Staff then you get what they call as merca or staff infection then your local infection is limited to a specific part of the body local infection this is limited to your hand the staff infection that's on your hand your foot your leg your arm whatever it is but it's only in that one area of the body if the infection spread it is now considered a systemic infection so that local infection that has now spray because it was left untreated now becomes a systemic infection and it can be bacteria this is when there's blood a bacteria found in the blood or septicemia so this is a multiplication of the bacteria that's in the blood so bacteria this is General blood bacteria in the blood and then again left untreated can multiply and cause septicemia as sepsis is what you may know it by acute infections appear suddenly um this going be something like your typical cold or upper respiratory infection strep throat it has a rapid but short course so acute infections rapid but short course chronic infections typically occur slower over a longer period of time so this may last months to years so something like chronic obstructive pulmonary disease COPD um and then Unos soomal infections or Health Care Associated infections this means means it originated in the hospital so Healthcare Associated infections it originated in the hospital while the patient was in the hospital so you have endogenous this originates from the patient I.E resident Flor staff or exogenous Hospital environment and the hospital Personnel so endogenous the patient has staff on their skin um and the patient does not wash their hands properly and so the patient notices that there's a cut on the Scan they don't wash their hand properly the patient gets staff that is originated from the patient but developed in the hospital whereas exogenous that means the hospital Personnel UI or any other Hospital Personnel um or the envirment so again with the staff so let's just say a nurse goes into patient's room she didn't wash her hands and she touches the remote for the patient she didn't wash her hands she has staff on her hands the patient has a cut on their hand um and they touch that same remote that occurred from the environment so that will be a hospital acquired infection exogenous from the environment so the CDC reports that two-thirds of healthcare Associated infections are Central IV Associated bloodstream infections IE Central lines catheter Associated UTI and then ventilator Associated pneumonia so again those Healthcare Associated infections can be ventilated Associated pneumonia SE is a big one uh CI which is catheter uh catheter Associated urinary tract infections surgical s infections and central line Associated bloodstream infections healthc care Associated infections are the leading complication of hospital care and one of the 10 leading causes of death this accounts for any infections that are associated with health care no matter the setting that it takes place so 1 and 25 Ty Ally develops a healthcare Associated infection C death is the most common and it can cause the hospital about 28 to $33 billion per year so again um recognize conditions that promote the transmission of healthcare Associated infection so urinary tract surgical sight bloodstream and pneumonia and with that you have your urinary tract this is improper catheter ation technique so again Hospital Healthcare Associated infections urinary tract infections can come from improper catheterization technique contamination of the cloth drainage system inadequate hand hygiene all not limited to but all reasons why someone would develop a urinary tract Associated infection surgical type inadequate hand hygiene and proper dressing change technique bloodstream inadequate hand hygiene and proper IV tubing fluid rather tubing and sight care technique and then pneumonia inadequate hand hygiene and proper suction and technique so again this is not limited to just these reasons why the patients get these infections in the hospital but these are some of the most common ways that they can get it and if you don't see it the common denominator is inadequate hand hygiene which the number one way to prevent or prevent the spread of infection is through hand hygiene so systemic ver versus local right looking at this picture you think all right the person on your left or the person the lady that's in the bed she looks like she's intubated looks like the nurse has on um some contact U PPE so a gown and gloves she has a lot of IV uh pumps going a lot of IV tubing um this person ideally looks like they have a systemic infection versus the person on the right um who has a localized infection right if you're looking at her leg one foot looks perfectly fine and then the other one is red swollen and she has a bandage on her big toe so that leads you to believe that this is a local infection however that local infection that's left untreated can spray to a systemic infection again so how does your body respond to infection you have five cardinal signs for localized infection five signs hyper heat imp AED or loss of function and duration have pain edema and redness so heat the temperature of the site loss of function to that site pain to that site swelling to that site and redness to that site and sometimes it may also have exudate exudate is basically drainage so that is the five local signs hyper and then systemic signs you have five signs which are fever increased pulse and respiratory rate Mala which is generalized weakness and fatigue um anorexia nausea vomiting and ly atopy right swollen lift node so you can have all of those these are your five cardinal signs for a systemic infection so um just like we have hyper for localized infection um this is how I it helps me to remember for systemic infection van looked for inspiration musically so V right what would that be vomiting nausea lympha opathy fever increased pulse and respiratory rate malays so five signs van look for inspiration musically all whatever helps you to remember the five systemic signs however you will need to know the difference between localized um symptoms and systemic symptoms so examine the post exposure or stages of the infection process you're going to go through four stages everybody goes through these four stages to become infected you have your incubation period this is where it's incubating it's growing and multiplying you have no signs of an infection but it is there and it's growing and multiplying so no signs of infection but you are capable of infecting other people but you don't even know you had it and then your prodromal this is a person is most infection infectious and you may have very vague and nonspecific symptoms your illness stage this is when the person has very specific signs and symptoms of the disease that they have or the microorganism that they came into contact with they have very specific signs and symptoms and then you're convalescent this is your recovery period where you're starting to feel better so incubation period this is where it grows and multiply um you went to the parade and then you came into contact with someone that had covid you didn't know it so you came to clinical on your clinical day um you had no signs of an infection but you're very you're infectious um um and you're grow the microorganism is growing in multiplying so you came to clinical um not really understanding and knowing what was going on you didn't really feel sick the day before but then you came to clinical and then now at this stage you have very vague nonspecific signs and symptoms your eyes may be running you may have a slight cough you may feel slightly bad but you may think it's allergies because well the poin is high as well so you have very vague non-specific symptoms however your most infectious during this period and then you go through your illness stage you're like oh my God I went to clinical but I feel worse the next day and then I go get tested for covid and then I have very specific signs and symptoms um loss of taste and smell you have a high fever 102 um and you have fatigue right so now you're thinking oh my God I have covid this is your illness period and then you go through the illness period and then you recover in your convalescent stage so how do you get infected right those the previous one was telling you the stages that you go through infection and this is the Chain of Infection which means you have to go through all six of these to pass the infection on so when you went to the parade the person that you were talking to in the MST of you guys went through these six steps for you to become infected so your infectious agent this is your microorganism or whatever the offended agent is such as covid-19 and then you have your Reservoir the place where the microorganism typically resides so infectious ages is co covid-19 all right and Corona virus and where it lives it typically lives in uh the lungs or your respiratory tract our reservoirs can be carriers where they do not show any signs of disease we can't pass it to someone else so again infectious agent Corona virus covid-19 the reservoir is where it typically lives I.E the respiratory tract your portal of exit um this is how it leaves the person who initially has the microorganism so again you went to the parade you're with your friend friend didn't know that they had covid you're talking talking talking it is in the person's lungs their respiratory tract they sneeze you say bless you however she didn't cover her mouth so now you inhale and then you get it so right infectious agent Reservoir where it lives and the respiratory tract portal exit through the sneeze right respiratory track mode of transmission how it gets to the next person this is the means of microorganisms to exit the reservoir and enter a susceptible host through a portal of entry so infectious agent is the Corona virus covid-19 the reservoir is the respiratory tract of where it lives portal of exit is when your friend sneeze didn't cover her mouth and then it transmitted to you mode of transmission through the air right so droplet precautions within three feet so you're talking laughing like girl you did not um cover your mouth but continue to laugh and smile and so you then getting that so you're Port of Entry yall are talking laughing and smiling about the fact that that she did not cover her mouth however she did also didn't know that she had covid and then you inhale covid right so portal of exit is typically the same as the portal of entry which is respiratory tract and then you are a susceptable host so a susceptible host is anyone at risk for infection no everyone will not get covid-19 if they come into contact with somebody who has covid-19 you have to be a susceptable host which is anyone who is at risk so maybe you were you know on the verge of being sick or maybe your immune system is weak or maybe you're taking steroids for whatever reason whatever the case is at that moment you are a susceptable host and then you contracted covid-19 from your friend and then you go through the previous stages of the incubation period your Poma your illness and your convalescent stages so your infectious agent again this is your microorganism like bacteria viruses fungi and parasites your Reservoir the carrier can be human animal or insect or the environment and then it can be human through the skin the nasal passages your mouth the intestine anterior urethra and the vagina and animals through saliva or feces and your portal of exit respiratory tract GI tract urinary tract reproductive tract blood or tissue so infectious agent microorganism the bacteria or whatever it is Reservoir where it lives portal of exit how it exits the thing that it where it's living and then your method and mode of transmission direct through touching biting kissing sexual intercourse any direct physical contact that is direct mode of transmission you have to physically touch the person or the thing to actually get the infection indirect is vehicle bone which is inanimate materials are objects something that is not living this is your forks this is your spoons this is the cell phone anything inanimate material or objects and then it can be through water food blood serum or plasma as well and your vector born this is through animals flying or crawling insects so indirect has two types vehicle born and Vector born so vehicle born again is inanimate materials are objects uh and then your vector born is through animals flying or crawling insects and then you have the Airborne which is in the air such as tuberculosis that it has to be in the air there's no particular feet that will save you from being infected it's in the air if you breathe the air you're going to get it and then droplets within three feet if you are within three feet of the person who has a whatever microorganism um and they sneeze cough sneeze or cough or whatever the case is you will get it if you are in within three feet your portal of entry this is your respiratory tract GI tract urinary tract reproductive tract Blood and Tissue again the portal of exit is typically the same as the portal of entry and then your successible host is someone's age INF fense older adults uh and compromised individuals somebody whose immune system is compromised so again someone who may have cancer someone who may have had a transplant or someone who has um a weaken immune system for whatever reason they're taking steroids or any other reason that they are susceptible um maybe nourishment right somebody who is not well nourished is also a compromised individual and a susceptable host so patients most at risk infants newborns and older adults have reduced defense against infection young children and compromised individuals newborns are only passively protected for two to three months after being born so that is when an infant newborn baby is born they are protected with antibodies from their mother up to three months and as adults they get older their immune system response weaken so factors that increase susceptibility to infection age again we talked about newborn protect talking about older adults hereditary your stress level yes stress can cause disease nutritional status yes if a person who is not well-nourished or have a poor diet eating fast food every day all day not eating healthier options current medical therapy again if they're on steroids if they're taking any type of amuno supression drugs or pre-existing conditions like diabetes or if they have um uncontrolled high blood pressure or any other preexisting condition so this um just shows you all the various ways that um it goes through your ideologic agent or your um microorganism your Reservoir where it lives your portal of exit the mode of transmission how it gets to the next person portal of entry and then susceptible hes so just common places where the reservoir lives right where it can live Port of exit right you see this little cute baby and your baby comes from daycare after putting all these nasty toys in their mouth and then you kiss your baby and you get sick yes and then direct transmission who doesn't want to kiss their child or touch their loved one right indirect the toys at the daycare right if you're going to another country and you're eating food from a food truck or even here for that matter eating food from a food food truck or going to restaurants and eating off the utensils that you clearly can see that it's not the cleanest and then vectorborne and then Airborne transmission right so again airborne and um droplet the difference is is that Airborne it is in the air if you inhale the air you will get it there's no dropping off at 3 feet with droplet it will drop off after um within 3 feet so after 3 feet drops off and then your portal of entry all the various ways that you can get um inhale or touch or get the microorganism from the person the host and then a susceptible host right pregnant women yes their immune system is compromised because they're pregnant and they're having to make antibodies for her and the child um but their immune system is compromised because they're developing more uh they have to eat more they have a lot more blood circulation they having to do a lot more physically to ensure that their baby is protected newborns older adults and then a person who has a break in the skin also compromised individual so which patient is most at risk for infection and again most at RIS is a key word and it is a 80-year-old with the history of diabetes and is on dialysis right we just talked about ages of factor pre-existing condition diabetes and the kidneys are B so they're on dialysis right so all of these puts this patient at risk for infection so how do you break the Chain of Infection now we talked about how to get the infection right the Chain of Infection all six things have to happen but then we want to tell you how to break the chain of infection so ensure items are clean disinfected or sterilized educate the patient and family so the ideologic agent your microorganism whatever the offending offending agent is you want to ensure items are clean disinfected or sterilized and educating the patient and family about the microorganisms are ways to prevent um the infection from transmitting the reservoir where the microorganism lives you want to assist with skin and Oral Care disposing of soiled items empty containers as appropriate and cover container containers as appropriate and then the portal of exit again you your Reservoir where the uh offending microorganism live I.E respiratory tract and your portal of exit right avoid talking coughing or sneezing during patient care uh cover your mouth and nose when coughing or sneezing so if the respiratory tract is a route that um is a exit then those are things that you want to do if it's a different route then you have to ensure that that particular route you are um not going to um you're going to break the Chain of Infection there as well so if let's say the urinary trct um is a portal of exit then that's one one way that you want to make sure that you're using gloves um and that the person is wiping properly uh after they urinate and washing their hands so m mode of transmission to Break the Chain of Infection you want to have proper hand hygiene again this is how it gets to the next person so again if the person has let's say ecoli and the nurse is touching a catheter and doesn't wash their hands and then they go to the next person so the mode of transmission is from the patient to the nurse's hands and then the nurse came to your room and then wear an appropriate PPE gves gwn mask gole Shields as appropriate Port portal of entry to the susceptable use proper medical aseptic technique use appropriate surgical aseptic technique dispose of used equipment or items properly use single items per patient so again the portal of entry how it gets to the next person so if the person the nurse is in the room and she touches the catheter uh there's eoli on the catheter she doesn't wash her hands she comes in the other the next patient's room and then she um touches a stethoscope with the stethoscope on the patient um and does not clean the stethoscope or wash your hand this is how it enters the next version and susceptable Host this is anybody again who's compromised so maintain intact skin and mucous membrane so again the susceptible host infants older adults pregnant women uh immune compromise ensure a balanced diet educate and encourage immunizations Stress Management and ensuring that they're getting activities of daily living or that they're exercising so we talked about previously medical asepsis and surgical asepsis so what is this asepsis is the freedom from disease causing microorganisms or germs aseptic technique is used to decrease the possibility of transferring microorganisms from one place to another medical asepsis is used to limit the growth and transmission of microorganisms objects can be clean ensuring that there are little germs as possible in that area or dirty soiled or contaminated surgical asepsis can also be thought of as a sterile technique this is used to keep the environment free from all microorganisms and then stero technique um so sterile technique this is sterile gloves and sterile supplies um modify sterile technique non-sterile gloves with sterile supplies and then clean technique clean hands are non-sterile gloves and clean supplies so just ensuring that you have a mod modified sterile technique again what we teach and we tell you is that steroid to steroid only but if you are not the person that's doing the procedure and you're helping the provider then you can have on clean gloves ensuring not to touch anything that's therough that's going to enter the patient's body so specific and non-specific defenses how does your body fight against infection well you have specific defenses and you have non-specific defenses non-specific is primary prevention um from an organism or microorganism entering the body I.E anatomic and physiological barriers and your inflammatory response your specific defense is your cell mediated or antibody mediated defenses means this is specifically for the microorganism that your body has encountered so nonspecific defenses anatomic and physiological barrier intact skin this is how your body protects you intact skin there's no breaks in the skin and then your mucous membrane eyes nose mouth right um urinary tract mucous membran not and then inflammatory response vascular and cellular responses exudate production and reparative phase so intact skin no breaks right this is your primary anatomic and physiological barrier intact skin no breaks this is the number one way that your body protects you the best way and then mucus membranes through your eyes nose mouth GI tract right vomiting saliva and gut track and urinating this all these are all ways to help protect you and then secondary defenses phagocytosis fosy destroys a pathogen you have your compliment Cascade with the pathogen cell membranes begin to rupture histamine begins to release inflammate inflam as you date production which is your histamine continues to release blood vessels dilate and then you may have drainage and then you possibly have fever so this is your secondary inflammatory response and then your tertiary are specific defenses you have your antibody mediated and your cell mediated antibody mediate active immunity passive immunity and then your cell mediated this is your te- cell system your helper t- cell your cytotoxic te- cell and your suppressor te- cells so with your antibody mediat defenses you have extracellular phases of bacterial and viral infections it's extracellular or outside the cell which means the bacteria or virus does not invade the cell so you have your extracellular phase of bacterial and viral infections and then you have your active immunity the host the personal who as the microorganism produces antibodies so you you come into contact with covid-19 you produce antibodies in response to the Natural antigen or the covid-19 Infectious microorganism or artificial antigens vaccines so you produce antibodies due to a known identifi and identifiable microorganism and then you have passive immunity the host receive natural antibodies from a nursing mother or artificial immune serum such as IVIG um to prevent the patient from becoming sick and to offer antibodies to the patient so your cell mediate defenses you have your te- cell you have your helper te- cells which function functions in the immune system you have your cytotoxic te- cells they attack and kill microorganisms sometimes attacking and killing the body's own cells and then you have your suppressor te- cells so this is basically your your you come into contact with a microorganism and then your tea cells come all right y let's just all line up and let's just go to the fight right this is what we're doing so the tel says we're all going to go to the fight well your helper te- cells are like I'm up first let me go and get them I got this um and then so sometimes the te- cells can be overtaken or they're not doing enough and so your cytotoxic your crazy cousin comes up and says okay no you they doing too much right so let me come and help you and they start to kill the microorganism well sometimes you know they just get too excited and start to attack their own people right so they start attacking you cytotoxic tea cells and then your suppressor te cells these are your ones that's like oh no that's enough that's too much we didn't did enough killing let's calm down and allow stop the immune response right so your body says let's come down let's go back and high because well we don't need to be doing all of this we've done enough so what happens if cell mediated immunity is lost people become defenses against most viral bacterial and fungal infections so a normal lab level um and what's more specific to you here is white blood cells five to 10 all you sometimes you'll hear 5,000 to 10,000 or 5 to 10 so for you specifically here for infection is white blood cells so Vera is a 28-year old female she is unmarried and is employed as a server in her grandparents restaurant she is attending a local community college and enrolled in the nursing program in the first semester ver lives with her partner Joan ver underw surgery 48 hours ago on physical assessment you notice that the wound looks red and swollen and tender to touch a white blood cell comes 12,000 what do you want to do if you want to start antibiotics do you want to notify the physician do you want to document the finies and reassess the two hours or do you want to place the patient on isolation proportion and the correct answer is B notify the physician well you can't start antibiotics without a doctor's order um we don't document if the finders and reassess well we will document the findings and reassess in two hours however the most important thing here is to notify the physician first because if you document the findings first and reassess in two hours and never call the doctor it have it could have gotten much worser um and then place the patient on isolation precautions well we don't even know if it warrants that and we also need a doctor's order order for that so we will not place the patient on isolation precautions based on um that so the CDC right this is who governs um I don't want to say governs but this is who we follow according to their guidelines and standards so they focus on infectious diseases full born pathogens environmental health occupational safety and health health promotion and injury prevention they also focus on things like obesity and diabetes they are national public Institute House in Atlanta Georgia and they are under the federal Agency for the Department of Health and Human Services so you have different tiers for the CDC said says that there's two tiers for um you to protect yourself you have tier one which is also known as your standard precaution or universal precautions this is used with all patient doesn't matter the race the sex if they're big they're small whatever the case is you assume that everybody's infectious and then you use standard universal precautions right so this means you are going to protect yourself at any point when you come into um contact with blood or bodily fluids we have tier two and these precautions are known as transmission based precautions they are specific to the type of infection and how it is transmitted I.E Airborne droplet or contact so again you have your standard precaution you're going to use it with every patient no matter what um standard precautions if you are going to come into contact with blood bodily fluid um or any open wounds you should use standard precaution which is the bare minimum gloves or any other protection that you need uh if you're going to irrigate you probably should use standard precautions as well and then um transmission based precautions so in addition to standard precautions then you advance it to transmission based precautions which this means that the person has now had an identifiable infection and can be Tre transmitted either Airborne droplet or contact and so then you would Implement one of the three and then you're going to use the correct PPE of personal protective equipment so your standard precaution this is universal precautions applies to all patients uh it applies to blood and Bly fluids and secretions and non intact skin it does not apply to sweat however if you choose to wear sweat when you are dealing with I mean gloves when when a patient is sweating then you are absolutely okay to do that and your um sent precautions that reduce the risk of transmission of micro M organisms from recognized and unrecognized sources so how does this happen you have your hand hygiene standard precautions hand hygiene washing your hands using hand alcohol-based sanitizer clean gloves mask and our goggles and our face shield clean nonsterile gown disposing of soiled items properly handling soiled linen as little as possible and then following the agency's protocol regarding your shops right we're not going to push the shars down and the shars bin we're not going to try to make room we are going to ensure that um if there's not enough room we go and get another shars container so use hand hygiene before and after all patient contact whereing the PPE for the appropriate um microorganism and the way that it's transmitted disposing of all shops in a puncture resistant container know your shops cannot go in the trash if you put it in the trash it is an unsafe behavior and you are at risk for getting a unsat do not recap break Bend needles after use dispose of in in Ed waste as per agency policy and buer hasard R bag disposal of other waste unsoiled Linens equipment per agency policy using protective equipment U for mouthpiece for CPR transporting specimens of blood and body fluids in appropriate container with lids and work restriction if the nurse has communicable illness so transmission based precautions this is your Airborne um contact and drop so again standard applies to everyone and then if you need to expand it to your Airborne contact and drop it so your standard precautions you have Airborne things like your misus vacera tuberculosis again this means that it is in the air you if you get it it is because you are in an environment where it is there and you are breathing in it doesn't matter whether you're 3 feet 6 feet 12 feet it is in the air with your droplet this is things like your diptheria pusis Ms pneumonia and the flu and then your contact is your MRSA C diff of VRE so your contact you have to physically touch something or someone that has um one of these not limitting not limited to diseases so this is the sign that you will see on every patient's door who is on contact clean their hands including before entering and when leaving the room make sure that at the bare minimum that you are wearing clean gloves and a gown for every patient that is on contact precautions you must wear clean gloves and a gown that is a requirement and then this is your airbone precautions everyone must again clean your hand before entering the room and when leaving the room put on a fit tested n95 this means that you have gone to your employee health they have um put a hood on your head and sprayed some sweet stuff inside of the hood and had given you a mask that specifically fit to your size if you can taste or smell the uh solution that they spread into the hood then that mess is not the right size for you if you cannot then you are good so a tested n95 and then remove the respirator After exiting the room and closing the door so you can not take off the mask before exiting the room you have to remove it in the anti uh room where you're going from the hallway door and then there's a little anti- room which is where you will put on your PPE there's a sink typically and then you're going to ensure that the hallway door is closed before walk walking into the patient room and the door to the patient room must remain closed at all times and then your droplet precautions again hand hygiene before and after entering the patient's room make sure that your eyes nose mouth are fully covered and then remove your face protection before you exit the room again be further than 3 feet away and then when you're at the trash you can throw away uh your protect equipment so PPE is used to PPE is used to protect the healthcare workers and patients from Transmissions of potentially infective materials so Dawning PPE wash your hands apply gown apply face mask apply eye protection apply glove so this is how you do it wash your hands first and then app apply your gown apply your face mask apply your eye protection apply your gloves and then offing PPE taking it off there's two types um that the CDC has we're going to go with this one where you remove your gown and gloves first and then you remove your goggles or eyewear and then your mask and then you wash your hands so your exemplars are ciff and influenza ciff this is a gram positive vacilla it's a most common cause of antibiotic Associated diarrhea in the US 96 96% of patients infected with C diff receive antibiotics within the last three months um and then the rest of reoccurrence occurs if you have been previously infected and it increases the hospital state by two to five days it may be resistant to many types of disinfectants Heats and dryness it can live for months on surfaces in skin folds and on the hands lack of handwashing is the primary spray of cedi and then signs and symptoms is mild to moderate diarrhea complications would be hypo Valia or decreased blood volume toxic megacolon to enlarge colon potentially subsis potential kidney insufficiency and skin breakdown then the influenza this is your incubation period you have 18 to 72 hours it is highly contagious viral respiratory uh infection it's uncomplicated has it's through naso farang inflammation viral upper respiratory infection followed by bacterial infection if left untreated or if it progresses or viral pneumonia signs of symptoms headache fever cough muscle pain or fatigue and it can be obtained um through a chest x-ray Labs a nasal or throat swab which the nasal swab is the most most common test and then treatment is symptomatic relief inh or tlu and most common one is tlu s is a 28- year old female she is unmarried and is employed as a server in her grandparents restaurant she's attending a local community college and enrolled in the nursing program in the first semester Vera lives with her partner Joan Vera was discharged from the hospital and one week later began having signs of an infection marked by sudden onset of detectable symptoms such as headache sore throat cough and sneeze within four days Vera noticed her symptoms started to clear and by day five her symptoms were gone what type of infection did Vera have an acute infection and then John was admitted to the EO with redness and inflammation to her left leg she was diagnosed with cellulitis what labs do you expect the provider to order and what level would you expect this lab to be above CBC white blood cells specifically and above 10,000 the nurs is preparing to irrigate Jones infected wound that is noted to have V what PPE would the nurse wear so what do you want this nurse to wear do you want her to wear gloves gone in particular respirator do you want her to wear just gloves and surg surgical mask do you want her to wear gloves to eye protection and shoe cover do you want her to do D which is gloves gone eye protection and surgical mask and the answer is d right because she has v which we know is a contact precaution so gloves and gown are the minimum the bare minimum that you have to wear for contact precaution but then since you're irrigating are washing the wound out you need to protect your mucous membranes because if it splashes in your eyes nose mouth then you could potentially have that V area as well and your eyes mve them out so you're going to use the eye protection and surgical Mas to protect your mucous membranes due to the chances of its flattering and then this is just a pole how many people clean their cell phones prior to the pandemic or how many people became more aware of cleaning their phones washing their hands pandemic and then this is just a video um that you can watch if it's going to play it won't let me play it because I'm recording in the zoom however um it is a video and for you all right so this is the end of the infection lecture if you have any questions please feel free to go to uh the discussion board and put your questions there as well as Ure to um review this leure and let me know if you liked it