SAFETY AND INFECTION CONTROL

1. A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal

meningitis. Which of the following nursing measures should the nurse do FIRST?
a. Institute seizure precautions
b. Assess neurologic status
c. lace in respirator! isolation
d. Assess "ital signs
Answer C. The initial therapeutic management of acute bacterial meningitis includes
isolation precautions# initiation of antimicrobial therap! and maintenance of optimum
h!dration. $urses should ta%e necessar! precautions to protect themsel"es and others
from possible infection.
Seorang ana% dirawat di unit pediatri% dengan diagnosis meningitis meningo%o%us.
&ana%ah tinda%an %eperawatan 'TA&A !ang harus perawat la%u%an?
a. &ela%u%an tinda%an pencegahan %e(ang
b. )a(i status neurologis
c. osisi%an sesuai dengan isolasi pernapasan
d. )a(i tanda*tanda "ital
+awaban ,. &ana(emen terapi awal meningitis dari bakteri akut meliputi
tindakan pencegahan isolasi, inisiasi terapi antimikroba dan
pemeliharaan hidrasi yang optimal. Perawat harus mengambil
tindakan pencegahan yang diperlukan untuk melindungi diri mereka
sendiri dan orang lain dari kemungkinan infeksi.
-. +a!son# 1 !ear old child has a staph s%in infection. .er brother has also de"eloped the
same infection. Which beha"ior b! the children is most li%el! to ha"e caused the
transmission of the organism?
a. /athing together.
b. ,oughing on each other.
c. Sharing pacifiers.
d. 0ating off the same plate.
Answer A. 1irect contact is the mode of transmission for staph!lococcus. Staph is
not spread b! coughing. Staph is not spread through oral secretions. 1irect contact is
re2uired. Staph is not spread through oral secretions.
+a!son# ana% berusia 1 tahun %ulitn!a terinfe%si staph!lococcus. )a%a%n!a (uga
mengalami infe%si !ang sama. &ana%ah perila%u ana%*ana% !ang paling mung%in
men!ebab%an transmisi organisme 3penularan4?
a. &andi bersama*sama.
b. &enular%an melalui batu% satu sama lain.
c. /erbagi dot.
d. &a%an dari piring !ang sama
+awaban A. )onta% langsung adalah cara penularan untu% staph!lococcus. Staph tida%
men!ebar melalui batu%. Staph tida% men!ebar melalui se%resi oral. )onta% langsung
diperlu%an.
5. +essie# a !oung man with newl! diagnosed ac2uired immune deficienc! s!ndrome
3AI1S4 is being discharged from the hospital. The nurse %nows that teaching
regarding pre"ention of AI1S transmission has been effecti"e when the client6
a. "erbalizes the role of se7ual acti"it! in spread of the disorder.
b. states he will ma%e arrangements to drop his college classes.
c. ac%nowledges the need to a"oid all contact sports.
d. sa!s he will a"oid close contact with his three*!ear*old niece.
Answer A. The AI1S "irus is spread through direct contact with bod! fluids such as
blood and through se7ual intercourse. ,asual contact with other people does not pose
a ris% of transmission of AI1S. 'nless the client is feeling "er! ill# there is no need
for him to drop his college classes. ,ontact sports are not contraindicated unless there
is a significant chance of bleeding and direct contact with others. ,asual contact with
other people does not pose a ris% of transmission of AI1S. There is no need to limit
casual contact with children.
+essie# seorang pemuda !ang baru didiagnosis Ac2uired Immune 1eficienc!
S!ndrome 3AI1S4 baru %eluar dari rumah sa%it. erawat tahu bahwa penga(aran
tentang pencegahan penularan AI1S telah efe%tif %eti%a %lien6
a. &engung%ap%an peran a%ti"itas se%sual dalam pen!ebaran gangguan tersebut.
b. &en!ata%an ia a%an mengatur untu% berhenti %uliah.
c. &enga%ui %ebutuhan untu% menghindari semua %onta% olahraga.
d. &engata%an ia a%an menghindari %onta% langsung dengan %epona%ann!a selama
tiga tahun laman!a.
+awaban A. 8irus AI1S menular melalui %onta% langsung dengan cairan tubuh seperti
darah dan melalui hubungan se%sual. )onta% biasa dengan orang*orang lain tida%
menimbul%an risi%o penularan AI1S. )ecuali %lien merasa sangat sa%it# tida% perlu
bagin!a untu% berhenti %uliah. 9lahraga tida% memili%i %ontraindi%asi %ecuali ada
%esempatan !ang signifi%an perdarahan dan %onta% langsung dengan orang lain.
)onta% biasa dengan orang*orang lain tida% menimbul%an risi%o penularan AI1S.
Tida% perlu untu% membatasi %onta% biasa dengan ana%*ana%.
:. Which 2uestion is least useful in the assessment of a client with AI1S?
a. Are !ou a drug user?
b. 1o !ou ha"e man! se7 partners?
c. What is !our method of birth control?
d. .ow old were !ou when !ou became se7uall! acti"e?
Answer D. 1rug use is a ris% factor for AI1S. &ultiple se7 partners is a ris% factor
for AI1S. /irth control methods are important to pre"ent a bab! from being born with
the AI1S "irus. The age at which se7ual acti"it! began it not rele"ant as it does not
usuall! pro"ide information that identifies the presence of ris% factors for AI1S.
ertan!aan mana%ah !ang paling sedi%it diguna%an dalam penilaian %lien dengan
AI1S?
a. Apa%ah Anda seorang pengguna nar%oba?
b. Apa%ah Anda memili%i ban!a% pasangan se%s?
c. Apa metode !ang anda guna%an untu% mengontrol %elahiran?
d. /erapa umur Anda saat Anda a%tif berhubungan se%sual?
+awaban 1. enggunaan nar%oba adalah fa%tor risi%o untu% AI1S. /erganti*ganti
pasangan merupa%an fa%tor risi%o untu% AI1S. &etode pengendalian %elahiran
penting untu% mencegah ba!i lahir dengan "irus AI1S. 'sia di mana a%ti"itas se%sual
mulai tida% rele"an %arena tida% selalu memberi%an informasi !ang mengidentifi%asi
adan!a fa%tor risi%o untu% AI1S.
;. &rs. ar%er# a <=*!ear*old woman with se"ere macular degeneration# is admitted to
the hospital the da! before scheduled surger!. The nurse>s preoperati"e goals for &rs.
&. would include6
a. independentl! ambulating around the unit.
b. reading the routine preoperati"e education materials.
c. maneu"ering safel! after orientation to the room.
d. using a bedpan for elimination needs.
Answer C. Independentl! ambulating around the unit is not appropriate because the
unit en"ironment can change and in(ur! could result. Assistance is necessar! because
of the client>s "isual deficit. It is unli%el! the client can see well enough to read the
materials. &aneu"ering safel! after orientation to the room is a realistic goal for a
person with impaired "ision. 9rienting the client to the room should help the client to
mo"e safel!. 'sing the bedpan is an unnecessar! restriction on the client as she can be
oriented to the bathroom or to call for assistance.
$!on!a ar%er# seorang wanita <= tahun dengan degenerasi ma%ula a%ut# dirawat di
rumah sa%it pada hari sebelum (adwal operasi. Tu(uan pra operasi perawat untu% &rs
&. a%an menca%up6
a. Independen ambulating unit se%itar.
b. membaca materi pendidi%an pra operasi rutin.
c. manu"er dengan aman setelah orientasi %amar.
d. mengguna%an pispot untu% %ebutuhan eliminasi.
+awaban ,. Independen ambulating unit se%itar tida% tepat %arena ling%ungan satuan
dapat mengubah dan cedera dapat ter(adi. /antuan diperlu%an %arena defisit "isual
%lien. .al ini tida% memung%in%an %lien untu% bisa melihat cu%up bai% dalam
membaca materi. &anu"er aman setelah orientasi %amar adalah tu(uan !ang realistis
untu% orang dengan gangguan penglihatan. /erorientasi %amar %lien harus membantu
%lien untu% bergera% dengan aman. &engguna%an pispot merupa%an pembatasan !ang
tida% perlu pada %lien saat ia dapat berorientasi %e %amar mandi atau untu% meminta
bantuan.
?. A client is diagnosed with methicillin resistant staph!lococcus aureus pneumonia.
What t!pe of isolation is &9ST appropriate for this client?
a. Re"erse isolation
b. Respirator! isolation
c. Standard precautions
d. ,ontact isolation
Answer D. ,ontact or /od! Substance Isolation 3/SI4 in"ol"es the use of barrier
protection 3e.g. glo"es# mas%# gown# or protecti"e e!ewear as appropriate4 whene"er
direct contact with an! bod! fluid is e7pected. When determining the t!pe of isolation
to use# one must consider the mode of transmission. The hands of personnel continues
to be the principal mode of transmission for methicillin resistant staph!lococcus
aureus 3&RSA4. /ecause the organism is limited to the sputum in this e7ample#
precautions are ta%en if contact with the patient@s sputum is e7pected. A pri"ate room
and /SI# along with good hand washing techni2ues# are the best defense against the
spread of &RSA pneumonia.
Seorang %lien didiagnosis dengan methicillin resistant staph!lococcus aureus
pneumonia. Apa (enis isolasi AAI$B sesuai untu% %lien ini?
a. re"erse isolasi
b. isolasi pernapasan
c. %ewaspadaan standar
d. .ubungi isolasi
+awaban 1. ,ontact atau /adan Cat Isolasi 3/SI4 melibat%an penggunaan
perlindungan penghalang 3misaln!a sarung tangan# mas%er# gaun# atau %acamata
pelindung !ang sesuai4 setiap %ali %onta% langsung dengan cairan tubuh !ang
diharap%an. )eti%a menentu%an (enis isolasi untu% mengguna%an# %ita harus
mempertimbang%an modus penularan. Tangan personil terus men(adi modus utama
penularan untu% methicillin Staph!lococcus resisten aureus 3&RSA4. )arena
organisme ini terbatas pada daha% dalam contoh ini# tinda%an pencegahan !ang
diambil (i%a %onta% dengan pasien Ds sputum diharap%an. Sebuah %amar pribadi dan
/SI# serta tehni% mencuci tangan !ang bai%# adalah pertahanan terbai% terhadap
pen!ebaran &RSA pneumonia.
<. Which of the following is the FIRST priorit! in pre"enting infections when pro"iding
care for a client?
a. .andwashing
b. Wearing glo"es
c. 'sing a barrier between client>s furniture and nurse>s bag
d. Wearing gowns and goggles
Answer A. .andwashing remains the most effecti"e wa! to a"oid spreading
infection. .owe"er# too often nurses do not practice good handwashing techni2ues
and do not teach families to do so. $urses need to wash their hands before and after
touching the client and before entering the nursing bag.
&ana%ah prioritas 0RTA&A dalam mencegah infe%si saat memberi%an pela!anan
%epada %lien?
a. ,uci Tangan a%ai Sabun
b. mengena%an sarung tangan
c. &engguna%an penghalang antara furnitur %lien dan tas perawat
d. &engena%an gaun dan %acamata
+awaban A. &encuci tangan tetap merupa%an cara !ang paling efe%tif untu%
menghindari pen!ebaran infe%si. $amun# terlalu sering perawat tida% berlatih te%ni%
mencuci tangan !ang bai% dan tida% menga(ar%an %eluarga untu% mela%u%ann!a.
erawat perlu mencuci tangan sebelum dan setelah men!entuh %lien dan sebelum
memasu%i %antong %eperawatan.
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