MEDICAL SURGERICAL NURSING

LECTURE / NURS 13
PPTS / BOOK
INFECTIOUS DISEASES

OUTLINE
I Incidence and Causes
II Fetal Circulation
III Cardiac Disorders in Pediatrics
IV Congenital Heart Diseases
INFECTIOUS DISEASES
 Any disease caused by the growth of pathogenic microbes in
the body
 May or may not be communicable (i.e., contagious)
 It is important to understand infectious causes and the
treatment of contagious, serious, common infections as well as
emerging non common infections
 The nurse plays an important role in infection control and
prevention
 Educating patients may decrease their risk of becoming
infected or may decrease the sequel of infection
 Using appropriate barrier precautions, observing prudent hand
hygiene, and ensuring aseptic care of intravenous (IV)
catheters and other invasive equipment also assists in reducing
infections

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I. THE INFECTIOUS PROCESS
CHAIN OF INFECTION
 A complete chain of events is necessary for infection to occur
 Six elements are necessary, including
 Causative organism
 Reservoir of available organisms
 Portal of exit from the reservoir
 Mode of transmission from the reservoir to the host (an
organism that provides living conditions to support a
microorganism)
 Mode of entry into a susceptible host
 Nurses must clearly understand the elements of the chain of
infection in order to identify points at which they can intervene
to interrupt the chain, thus protecting patients, themselves, and
others from infectious diseases
CAUSATIVE ORGANISM
 Types of microorganisms that cause infections are bacteria,
rickettsiae, viruses, protozoa, fungi, and helminths
RESERVOIR
 Term used for any person, plant, animal, substance, or location
that provides nourishment for microorganisms and enables
further dispersal of the organism
 Infections may be prevented by eliminating the causative
organisms from the reservoir
PORTAL OF EXIT
 An organism must have a portal of exit from a reservoir
 An infected host must shed organisms to another or to the
environment for transmission to occur
 Organisms exit through the respiratory tract, the
gastrointestinal tract, the genitourinary tract, or the blood
ROUTE OF TRANSMISSION
 Necessary to connect the infectious source with its new host
 Organisms may be transmitted through food intake, sexual
contact, skin-to-skin contact, percutaneous injection, or
infectious particles carried in the air
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 A person who carries or transmits a pathogen but does not
have apparent signs and symptoms of infection is called a
carrier
 Specific organisms require specific routes of transmission for
infection to occur
 Example: Mycobacterium tuberculosis is almost always
transmitted by the airborne route
 Example: Staphylococcus aureus are easily transmitted
from patient to patient on the hands of health care
providers
 Some organisms cause infection through several routes
 For example, the virus severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) is highly
contagious
SUSCEPTIBLE HOST
 For infection to occur, the host must be susceptible (not
possessing immunity to a pathogen)
 Previous infection or vaccine may render the host immune
(not susceptible) to further infection with an agent
 Although exposure to potentially infectious microorganisms
occurs essentially on a constant basis, people have complex
immune systems that generally prevent infection from occurring
 A person who is immunosuppressed has much greater
susceptibility to infection than a healthy person
PORTAL OF ENTRY
 Needed for the organism to gain access to the host
 Example: airborne M. tuberculosis does not cause
disease when it settles on the skin of an exposed host;
the only entry route for M. tuberculosis is through the
respiratory tract
COLONIZATION, INFECTION, AND INFECTIOUS
DISEASE
 Relatively few anatomic sites are sterile
 Bacteria found throughout the body usually provide beneficial
normal flora (nonpathogenic organisms colonizing a host) to
compete with potential pathogens, to facilitate digestion, or to
work in other ways symbiotically with the host
COLONIZATION
 Used to describe the presence of microorganisms without host
interference or interaction
 Organisms reported in microbiology test results often reflect
colonization rather than infection
 The patient’s health care team must interpret microbiology test
results accurately to ensure appropriate treatment
INFECTION
 Indicates a host interaction with an organism
 Example: S. aureus
 A patient colonized with S. aureus may have
staphylococci on the skin without any skin interruption or
irritation
 If the patient has an incision, S. aureus entering the
wound can induce an immune system reaction of local
inflammation and migration of white cells to the site
 Clinical evidence of redness, heat, and pain and
laboratory evidence of white blood cells in the wound
specimen smear suggest infection
 In this situation, the host identifies the staphylococci as
foreign
 Infection is recognized by the host reaction (manifested by
signs and symptoms) and by laboratory-based evidence of
white blood cell reaction and microbiologic organism
identification
INFECTIOUS DISEASE
 State in which the infected host displays a decline in wellness
due to the infection
 When the host interacts immunologically with an organism but
remains symptom free, the definition of infectious disease has
not been met
 Latency or the time interval after primary infection when a
microorganism lives within the host without producing clinical
evidence of disease
 For example, most people who are infected with M.
tuberculosis have no symptoms
 The severity of an infectious disease ranges from mild to life-
threatening
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 Microbiology report
 Primary source of information about most bacterial
infections
 Viewed as a tool to be used along with clinical indicators
to determine if a patient is colonized or infected
 Usually show three components: the smear and stain, the
culture and organism identification, and the antimicrobial
susceptibility

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