Question 1.
Clostridium difficile (C. difficile) is a Gram-positive, spore-forming bacterium that is usually transmitted via staff hands or by direct contact with affected patients, contaminated fomites (Surawicz et al. 2013). C. difficile infection (CDI) is one of the common causes of antibiotic associated diarrhoea in hospitals (Surawicz et al. 2013). This is because the decline in health status of hospitalised patients and the close contact between them caused by staying in the same contaminated environment often encourage bacterial colonisation, the development of infection and the spread of bacterial spores (Mitchell, Russo & Race 2014). Patients can be asymptomatic carriers of C. difficile and elderly people are more susceptible to the bacteria than young people (Mitchell, Russo & Race 2014). The two main risk factors of CDI include exposure to the organism and exposure to antibiotics (Surawicz et al. 2013).
Most antibiotics reduce the normal microbiota of the body, which are then
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If left untreated, a urinary tract infection (UTI) can result in serious outcomes (Mayo Clinic 2015). These serious consequences might include recurrence of infections, permanent kidney impairment from a kidney infection due to untreated UTIs (Mayo Clinic 2015). Recurrent infections in the urethra can cause urethral narrowing in men (Mayo Clinic 2015). In addition, sepsis, which is a life-threatening condition of an infection, might occur if the infection travels up the urinary tract to the kidneys (Mayo Clinic 2015).
Question 8.
(i) One of the nursing goals is to reduce voiding interval from less than 2 hours to 2 to 5 hours to alleviate fatigue and distress caused by frequent urination. This is because normal voiding interval would be a minimum of 2 hours, which is common in elderly people, and 3 to 5 hours for other people (Castillo 2014).
(ii) Another nursing goal is to reduce pain on voiding.
Question 9.
Nursing Goal (stated above in Q8) Nursing
Clostridium difficile, otherwise known as C. diff, is a species of spore-forming, anaerobic, gram-positive bacteria that is known to cause watery diarrhea. 1 The genus name, Clostridium refers to the spindle shape of the organism while Difficile means difficult in Latin due to the fact that this organism thrives in unfavorable conditions and is very difficult to isolate.4 The incidence of getting CDI has increased over the years due to new strains of increased toxin production of the bacteria and increased resistance to antibiotics.2 It is a gastrointestinal infection, and the most common cause of infectious diarrhea.1 C. difficile was first identified in the feces of healthy newborns back in the 1930’s and by 1935, it was considered normal flora. 2 During 1974, researchers conducted that about 21% of patients that were treated with an antibiotic called clindamyacin reported diarrhea and about 10% of them reported to have conducted pseudomembranous colitis as a side effect of this treatment. 2 It was in 1978 where C. diff had been known to cause anti-biotic associated diarrhea and pseudomembranous colitis. 2 It is known to form spores that resist many disinfectants; it also survives for several months on different surfaces.1 It is a common form of a nosocomial infection and the prevalence of becoming infected with C. diff is about 0-15% in a health care setting. 3 The spores survive well in environments such as soil, water and animals and is distributed worldwide. 4 CDI produces two toxins (Toxin A and B), which are cytotoxic and cause tissue necrosis.4
There are two types of glomerulonephritis—acute renal failure (ARF) and chronic kidney disease (CKD). The ACF form generally develops suddenly as a result of an infection or illness, such as, group A streptococci bacteria, hepatitis, or in diseases such as lupus or HIV (Mathias, 2013). This type may require dialysis to replace renal function while it lasts, however, kidney function usually returns after the primary illness is treated. Many acute patients will not have any other complications as no permanent damage is done. Whereas CKD is found in a person that has had glomerulonephritis for months to years in some cases and may be asymptomatic until the kidney has become irreversibly damaged. ARF can evolve to become chronic if the glomeruli do not respond to
Many people never find out that they have had stones in their kidneys. Some stones are small enough to flow through the kidney without ever causing any pain. These are called "silent stones"(Ford-Martin & Odle, 2005) Kidney stones cause problems when they get in the way of the normal flow of urine. They can block the flow through the ureter that carries urine from the kidney to the bladder. “The kidney is not accustomed to experiencing any pressure. When pressure builds from backed-up urine, it causes hydronephrosis” (Ford-Martin & Odle, 2005). If the kidney is subjected to this pressure for a while, there may be damage to the fragile kidney structures. When the kidney stone is lodged further down the ureter, the backed-up urine may also cause the ureter to swell. Because the ureter is a musc...
A common hospital acquired condition that nurses see now days is clostridium difficile. This bacterium usually invades patients who have been on long-term antibiotics that have killed off bacteria that protect them from infection. C. diff is passed from host to host by both direct and indirect contact making it readily moved from patient to patient in hospital settings (Mayo, 2013, 1). Nurses can use the QSEN competencies and KSAs to help treat and prevent hospital acquired conditions such as C.diff.
Different studies had different result numbers or different percentage reduction rates which was primarily based on their indifferences in regards to study design utilized and sample size. As evidenced by research results (Magers, June 2013) and (Welden, 2013), these showed a reduction of urinary catheter days resulted in reduced CAUTI rates. Though different outcome results between the different research studies, they all strongly significantly supported the notion that a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter compared with a no protocol is essential to help in the reduction of CAUTIs. Interpreting these results, (Meddings et al., 2013) showed a drop greater than 52% in CAUTIs and a decrease in catheterization by 37%. The study results from the six scholarly research study articles showed nearly similar or corresponding outcomes. The results were significant enough to support the PICO question. In general, though the difference in sample size, the results still strongly supported excellent outcomes when a nurse-driven protocol is used to evaluate the necessity of continued urethral catheter use. (Chen et al., 2013, para.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
C. difficile infection (CDI) is a dangerous healthcare-associated infection as well as a growing burden, especially with the appearance of more potent strains in the early 2000s. Clostridium difficile was initially identified as possessing the ability to initiate pseudomembranous colitis in the late 1970s. Asymptomatic colonization in healthy adults has been detected in only 3% of individuals, whereas the pervasiveness of such colonization among patients in long-term-care facilities is approximately 50%. People colonized with C. difficile act as a reservoir of contamination by infecting the environment with C. difficile spores, consequently leading to an increase of the pathogen in the hands of healthcare professionals or by way of medical equipment (Noorani, Soni, Pitrak, Belinson, & Aronson, 2012).... ... middle of paper ... ...
Clostridium perfringens is a gram-positive spore-forming bacillus involved in foodborne illness and wound infection. It is an obligate anaerobe and the only member of the genus Clostridium that is non-motile. This microorganism is normally present in soil and decaying vegetation and is an inhabitant of animal and human intestines. According to the Centers for Disease Control and Prevention, C. perfringens is one of the most common sources of foodborne illness in the United States, being the cause of an estimated 1 million cases each year. However, it is also prevalent worldwide. This bacterium has the shortest reported generation time of any organism at 6.3 minutes in thioglycollate medium, making it particularly virulent after initial inoculation.
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Cystitis is the medical term for inflammation of the urinary bladder. Most of the time, the inflammation is caused by a bacterial infection, and it’s called a urinary tract infection. A bladder infection can be painful and annoying, and it can become a serious health problem if the infection spreads to your kidney.
can block the urinary tract. This blockage will probably cause a lot of pain. If
A urinary tract infection is a very common infection that can happen to anybody. A urinary tract infection usually occurs when bacteria enters the urethra and multiples in the urinary system. The Urinary tract includes the kidneys, the thin tubes that carry urine from the kidneys to the bladder (ureters), and the main tube that carries the urine from the bladder (urethra). Women, men, and children are all immune to this infection. Women have the highest chances of getting it. In the Urinary tract, the main links of the ureters help get rid of any bacteria that tries to enter the urine, and the bladder helps prevent urine from backing up into the kidneys.
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase in the number of days the patients stay in the hospital. Hospital acquired infections make the patients worse or even cause death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
The scientific name of a kidney infection is known as pyelonephritis. There are two types of pyelonephritis infections, acute and chronic. Acute pyelonephritis is sudden and limited and can be cured/treated using antibiotics. However, if it is a chronic infection, it is long-lasting and occurs due to birth defects; it can lead to scarring in the kidneys, as well. Kidney infections can occur in both men and women. Although, according to Chih-Yen’s study of chronic infection, “Females (36.1%, 60/166) were more prone to have upper UTIs than males (11.8%, 13/110)” (Chih-Yeh, 2014; Chih-Yeh et al., 2014). In addition, age is not an important number due to the presence of Escherichia coli present in everyone’s body. It is dependent on time and health of an individual for the infection to present itself. Moreover, a study on children and adolescent transplantation concluded that, “UTI was uncommon in children after the first month of transplantation. Two significant risk factors for UTI were female gender and neurogenic bladder in this transplant population” (Fallahzadeh, 2011; Fallahzadeh et al., 2011). From the peer-reviewed papers, it is clear that females are more prone to UTI infection, overall, than
Deep within our gastrointestinal tract, known affectionately as the gut, exists a community like no other which helps maintain the essence of who we are and helps us maintain the balance us humans yearn and depend on to live. Bacteria, archaea, protists, fungi and viruses all interact around each other keeping the boring and uneventful that the body likes full of abundance. Upon some sort of shake up whether there are maleficent bacteria charging the intestinal landscape threatening to wipe out the community, or a change in the environment due to movement or destruction of the community members the microbiome’s ability to weather the storm and keep its intestinal home straight is essential. One of these shake ups, in the case of excessive antibiotic use through indirect infection, members of the intestinal microbiome community are wiped out and allow for Clostridium difficile, a normal inhabitant of the gastrointestinal landscape to thrive unchecked by the previous order and create a new dysfunctional world, creating a state of dysbiosis.