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🦠 Infection Control & Infectious Diseases by Nurse Haley
격리유형 · PPE순서 · 주요 전염병 · 항생제 간호 총정리
📖 Table of Contents
🚧 Isolation Precautions (격리유형)
| Type | Diseases | PPE / Room |
|---|---|---|
| Contact | MRSA, VRE, C. diff, RSV, Scabies, Herpes zoster (localized) |
• Gown + Gloves • Private room (or cohort same infection) • Equipment: dedicated or disinfect after use |
| Droplet | Influenza, Mumps, Rubella, Meningitis, Pertussis |
• Mask (within 3 feet) • Private room preferred • Patient wears mask during transport |
| Airborne | TB, Measles (Rubeola), Varicella (Chickenpox), Disseminated Zoster |
• N95 respirator • Negative-pressure room • Door closed at all times |
⚠️ NCLEX 핵심포인트:
- Airborne = TB, Measles, Varicella 기억!
- TB: N95 + Negative room + Patient surgical mask on transport
- C. diff: 알코올 손소독 ❌ — 반드시 soap & water
- Airborne = TB, Measles, Varicella 기억!
- TB: N95 + Negative room + Patient surgical mask on transport
- C. diff: 알코올 손소독 ❌ — 반드시 soap & water
🧤 PPE Donning & Doffing 순서
| Sequence | Order | Mnemonic |
|---|---|---|
| Donning (착용) | Gown → Mask/Respirator → Goggles/Face Shield → Gloves | "Go ME Go Gloves" |
| Doffing (제거) | Gloves → Goggles/Face Shield → Gown → Mask | "GGGM" (Reverse order, farthest last) |
💡 Exam Tip:
- Always remove **gloves first**, mask last.
- Hand hygiene after each step.
- If contaminated gown touches scrubs → change immediately.
- Always remove **gloves first**, mask last.
- Hand hygiene after each step.
- If contaminated gown touches scrubs → change immediately.
🧫 Common Infectious Diseases (주요 감염질환)
| Disease | Transmission / Key Findings | Nursing Precautions |
|---|---|---|
| 1️⃣ Tuberculosis (TB) | Airborne; night sweats, hemoptysis, cough >3wk. |
• N95, negative room. • 6–9 months therapy (INH, Rifampin, Ethambutol). • Monitor LFTs. • Rifampin → orange body fluids. |
| 2️⃣ Meningitis | Droplet; neck stiffness, photophobia, fever, +Kernig/Brudzinski sign. |
• Droplet isolation for 24hr after antibiotics. • Monitor ICP, seizure precautions. • Vaccination: meningococcal for college students. |
| 3️⃣ HIV / AIDS |
Bloodborne / sexual contact. ↓ CD4 count, opportunistic infections. |
• Standard precautions only. • Antiretroviral therapy (ART) adherence. • Prevent infection, no live vaccines if low CD4. • Emotional & confidentiality support. |
| 4️⃣ C. difficile | Contact; watery diarrhea after antibiotics. |
• Hand wash with soap (not sanitizer). • Use bleach-based disinfectant. • Stop causative antibiotic, start metronidazole/vancomycin PO. |
| 5️⃣ MRSA / VRE | Contact; skin/wound infections. |
• Contact isolation. • Mupirocin nasal ointment (MRSA). • Strict hand hygiene. |
| 6️⃣ COVID-19 | Droplet + Airborne (aerosol). Fever, cough, dyspnea, anosmia. |
• N95 for aerosol procedures. • Standard + Droplet + Airborne precautions. • Monitor O₂ sat, D-dimer, mental status. |
💊 Antibiotic Nursing & Resistance
| Category | Key Nursing Points |
|---|---|
| General Antibiotic Rules |
• Obtain culture **before** antibiotics. • Complete full course (no skipping). • Monitor for allergy, anaphylaxis (rash, SOB). • Encourage yogurt/probiotics (prevent C. diff). • Check renal/hepatic function for nephrotoxic drugs. |
| Aminoglycosides (Gentamicin) |
• Ototoxicity, nephrotoxicity. • Monitor peak/trough levels. • Report tinnitus or dizziness. |
| Vancomycin |
• Infuse ≥60 min (prevent Red Man syndrome). • Check trough before next dose. • Report flushing, hypotension, rash. |
| Penicillin/Cephalosporin |
• Cross-allergy risk. • Observe for anaphylaxis. • Take with water (not juice). |
⚠️ NCLEX 핵심포인트:
- Culture first → Antibiotics later!
- Red Man syndrome ≠ allergy, just slow infusion.
- Contact isolation = MRSA, VRE, C. diff.
- Alcohol-based hand rub ❌ for spores (C. diff).
- Culture first → Antibiotics later!
- Red Man syndrome ≠ allergy, just slow infusion.
- Contact isolation = MRSA, VRE, C. diff.
- Alcohol-based hand rub ❌ for spores (C. diff).
🏥 Hospital-Acquired Infection (HAI) Prevention
- Hand hygiene before & after every patient.
- Change IV tubing q96h, remove Foley ASAP (within 48h if possible).
- Oral care for ventilated patients q2–4h (VAP 예방).
- Change wound dressing using sterile technique.
- Single-use vials preferred; label multi-dose vials.
- Immunocompromised patients → private, positive-pressure room.
💡 Exam Tip:
- “Restlessness + fever + hypotension” → early sepsis.
- “Hand hygiene” = always the first nursing action!
- “N95” = TB, Varicella, Measles only.
- “Soap & water only” = C. diff.
- “Restlessness + fever + hypotension” → early sepsis.
- “Hand hygiene” = always the first nursing action!
- “N95” = TB, Varicella, Measles only.
- “Soap & water only” = C. diff.
정리: 오늘의 간호사 Haley
📌 본문 내용은 오늘의 간호사 Haley의 저작물로 무단 복제·배포를 금합니다.
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