Definition: At increased opportunity for beingness invaded past times pathogenic organisms
Risk Factors:
Invasive procedures; insufficient noesis regarding avoidance of exposure to pathogens; trauma; tissue devastation as well as increased environmental exposure; rupture of amniotic membranes; pharmaceutical agents (e.g., immunosuppressants); malnutrition; increased environmental exposure to pathogens; immunosuppression; inadequate acquired immunity; inadequate secondary defenses (e.g., decreased hemoglobin, leukopenia, suppressed inflammatory response); inadequate principal defenses (e.g., broken skin, traumatized tissue, decrease inwards ciliary action, stasis of torso fluids, alter inwards pH secretions, altered peristalsis); chronic disease.
Nursing Interventions for Risk for Infection
1. Monitor the next for signs of infection:
- Redness, swelling, increased pain, or purulent drainage at incisions, injured sites, transcend away sites of tubes, drains, or catheters Any suspicious drainage should live cultured; antibiotic therapy is determined past times pathogens identified at culture.
- Elevated temperature Fever of upwardly to 38° C (100.4° F) for 48 hours later surgical operation is related to surgical stress; later 48 hours, fever to a higher house 37.7° C (99.8° F) suggests infection; fever spikes that tumble out as well as subside are indicative of wound infection; really high fever accompanied past times sweating as well as chills may betoken septicemia.
- Color of respiratory secretions Yellow or yellow-green sputum is indicative of respiratory infection.
- Appearance of urine Cloudy, foul-smelling urine amongst visible sediment is indicative of urinary tract or bladder infection.
2. Monitor white blood count (WBC). Rising WBC indicates body’s efforts to fighting pathogens; normal values: 4000 to 11,000 mm3. Very depression WBC (neutropenia <1000 mm3) indicates severe opportunity for infection because patient does non convey sufficient WBCs to struggle infection.
NOTE: In elderly patients, infection may live acquaint without an increased WBC.
3. Assess for presence, existence of, as well as history of opportunity factors such equally opened upwardly wounds as well as abrasions; in-dwelling catheters (Foley, peritoneal); wound drainage tubes (T-tubes, Penrose, Jackson-Pratt); endotracheal or tracheostomy tubes; venous or arterial access devices; as well as orthopedic fixator pins. Each of these examples correspond a intermission inwards the body’s normal commencement lines of defense.
4. In important patients, assess intactness of amniotic membranes. Prolonged rupture of amniotic membranes earlier delivery places the woman parent as well as babe at increased opportunity for infection.
5. Assess for history of drug purpose or handling modalities that may drive immunosuppression. Antineoplastic agents as well as corticosteroids trim down immunocompetence.
6. Assess immunization status. Elderly patients as well as those non raised inwards the United States of America of America may non convey completed immunizations, as well as so non convey sufficient acquired immunocompetence.
7. Assess nutritional status, including weight, history of weight loss, as well as serum albumin. Patients amongst pitiable nutritional condition may live anergic, or unable to muster a cellular immune reply to pathogens as well as are so to a greater extent than susceptible to infection.
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