Microorganism , infection control etc Essay Example

  • Category:
    Nursing
  • Document type:
    Case Study
  • Level:
    Undergraduate
  • Page:
    3
  • Words:
    1534

EYE INFECTION AND INFECTION CONTROL 7

Eye Infection and Infection Control

Eye Infection and Infection Control

This template must be used to answer the case study.

(Please type your answers within the box underneath each question)

  1. Background of the case study (Total: 5 marks)

    1. What is infectious conjunctivitis?

      Hd It is an inflammation of the conjunctiva commonly the bulbar, follicular or periauricular conjunctiva caused by bacteria or viruses resulting in symptoms such as reddening of the eye, discharge, and itchiness and capable of spreading from one eye to another across different people (Boustcha & Nicolle, 1995).

    2. listed below, justify which one is more likely to be the cause of Brian’s eye infection. Indicate why the other micro-organisms from the list are least likely to cause the infection. microorganisms
      fourOf the

Legionella pneumophila

Yes or no, with reason:

Because this bacteria has not been demonstrated to colonise the eye but commonly affects the respiratory tract with the potential to cause pneumonia infection when body immunity is compromised (Lee & Bishop, 2013).

Plasmodium ovale

Yes or no, with reason:

Bacause Plasmodium ovale is a parasite that can cause malaria infection with its life-cyle revolving around the liver and bloodstream but it has not been shown to colonise the eye or cause any eye infection (Lee & Bishop, 2013).

Adenovirus

Yes or no, with reason:

It is the commonest virus implicated in infectious conjunctivitis. The virus can be spread easily from one infected eye to another through contact and cause self-limited conjunctivitis (Lee & Bishop, 2013).

Escherichia coli

Yes or no, with reason:

E coli is a gram-negative bacteria that is part of the normal flora of the gut but can be virulent in the gut, urinary tract, neonatal meninges and the gall bladder but has not been demonstrated to infect the eye (Lee & Bishop, 2013).

  1. Mechanism of action and adverse reactions (Total: 5 marks)

    1. ? Describe the mechanism of action of gentamicin

      Gentamicin is an aminoglycoside antibiotic and it exerts its antibacterial activity by inhibiting bacterial protein synthesis. Bacterial protein synthesis begins with an initial stage characterised by dissociation of the two ribosomal subunits, that is, the 30S and the 50S (Lee & Bishop, 2013). The dissociation is aided by Initiation factor 3 (IF3). After the dissociation, mRNA containing the codons for the aminoacids to be transcribed to form a given protein binds to the 30S subunit readying the delivery of N-formyl Methionine tRNA into the peptidyl site of the 30S subunit. Gentamicin, therefore, acts by binding to this 30S subunit of the ribosome and inhibiting the delivery of N-formyl methionine, to the peptidyl site and complete the formation of the initiation complex of bacterial protein synthesis (Bullock & Manias, 2014; Lehne, Moore, Crosby & Hamilton, 2013). The result is inhibited protein formation causing bacterial death.

    2. ? Name two adverse reactions of this drug

      Neurotoxicity and ototoxicity (Lehne et al., 2013)

      Nephrotoxicity (Bullock & manias, 2014).

  2. Mediators of Signs and Symptoms (Total: 10 marks)

    1. sign/symptom 1:

Eye redness.

Explanation of this phenomenon:

Injury to the eye may result in an accidental inoculation of virus or bacteria into the eye in such quantities that overwhelm the natural body immunity. Their presence causes damage to the conjunctiva triggering an inflammatory reaction resulting in a release of cytokines such as nitric oxide that cause vasodilation of blood vessels and capillaries supplying the eye increasing blood supply to the conjunctiva that presents as a red eye (Porth & Matfin, 2014).

    1. sign/symptom 2:

Discharge

Explanation of this phenomenon:

This can be purulent commonly in bacterial conjunctivitis, but it is less purulent and can be serous and mucopurulent in viral conjunctivitis. The exudate is a product of the dead tissue damaged by the bacteria or viral antigens and eliminated by macrophages (Craft et al., 2011).

    1. sign/symptom 3:

Itchy eye

Explanation of this phenomenon:

This is also a result of release of inflammatory cells especially mast cells that destabilize at the antigen site in the conjunctiva to cause release of mediators such as prostaglandins some of which are responsible for the itching (Craft et al., 2011).

  1. Infection control issues (Total: 5 marks)

High susceptibility to infections

Discussion:

Aged care facilities have most of its residents been advanced in age. With advanced age, such as for Brian, the body’s natural defence mechanisms ranging from the skin, epithelial lining of most tissues and the immunological cells have a weakened ability to defend the body against infectious microorganisms (Marieb & Hoehn, 2014). This is attributable to the physiological changes associated with ageing such as the decreased regeneration of new white blood cells and increased apoptosis of the same cells (Marieb & Hoehn, 2014). Therefore, a smaller inoculum of pathogens is capable of causing sufficient contamination to result in virulence compared to a young adult host.

Risk of increased transmission among the residents of aged care facilities due to their population in the facility.

Discussion:

Residents in these facilities require supportive management to handle some or most of their activities of daily living. They move around supporting themselves and touching most surfaces in their areas of care. Some may have neurodegenerative diseases that impair their memory and exercise of basic hygiene such as hand cleaning (Marieb & Hoehn, 2014). Therefore, one resident with an infectious disease such as conjunctivitis can touch their eyes and touch other surfaces in the facility that can potentially be touched by other residents consequently contaminating the others too (Lee & Bishop, 2013). The infection risk is enhanced by their high numbers.

  1. Transmission of infection (Total: 5 marks)

    1. Describe transmission from Brian to Mary:

      The source of infectious conjunctivitis transmitted to Mary was Brian’s infected eye. The possible mode of transmission is through contact with fluids or droplets from Brian’s eye (Boustcha & Nicolle, 1995). Brian might have touched his sick eye contaminating his hands or body parts with the infectious discharge from the eye. During his movement in the facility, he might have supported himself or hold onto the walls or corridors, or door handles of the building contaminating the walls. So when Mary happened to support herself or touch the same walls containing fresh discharge, and touch or rub her eyes with the same contaminated hand, transmission of the infection was possible (Boustcha & Nicole, 1995).

      Another possible way is through indirect contact by a staff who may have gotten contaminated with the infectious fluids from the eye while attending to Brian then on proceeding to attend to Mary as the next resident, the fluids might have been transferred to Mary’s beddings, clothing or body through which she got the infection after her eyes came into contact with the contaminated surfaces (Boustcha & Nicolle, 1995).

  2. (Total: 5 marks)Breaking the chain of infection

    1. Identify procedure 1:

Exercise excellent hand hygiene

Describe how this effectively breaks the chain of infection:

Hand hygiene involves nurses cleaning their hands appropriately at certain moments that include prior to and after touching clients or handling their immediate environment, and before and after procedures or exposure to body fluids (Boland, Wilson, Santall, & Video Education Australasia [VEA], 2011). Hands should be washed or cleaned using an alcohol-based hand rub or soap and water. Proper hand cleaning at the mentioned moments eliminates any microbial contaminants on the nurses’ hands that may be transmitted to another resident if hand-handled by the nurses. Therefore, exercising hand hygiene breaks the transmission element of infection chain (Boland et al., 2011).

    1. Identify procedure 2:

Appropriate environmental cleaning

Describe how this effectively breaks the chain of infection:

The environment that the residents reside in is at risk of contamination by infectious microorganisms such as from the Brian’s infected eye (Lee & Bishop, 2013). Nurses are expected to clean routinely the resident’s environment and immediately after spills to prevent or lower the risk of a resident acquiring the contaminants (Boland et al., 2011). Frequency of cleaning should be increased for hard surfaces that are frequently touched such as light switches, door knobs, wall areas and over-bed tables. Disinfectant solutions and detergents should be employed. Cleaning such surfaces prevents transmission of microorganisms to other residents at risk of acquiring infections (Boland et al., 2011).

  1. Presentation (Total: 5 marks)

    1. Ed. Referencing style.thReferencing in-text and in reference list conforms to APA 6

    2. Critique supported by relevant literature as prescribed.

    3. Correct sentence structure, paragraph, grammatical construction, spelling, punctuation and presentation.

References

Boland, M., Wilson, J., Santall, J. & Video Education Australasia. (2011). Infection control in healthcare (Videorecording). Bendigo, Vic: VEA. Retrieved from http://www.worldcat.org/title/infection-control-in-healthcare/oclc/808309911

Boustcha, E. & Nicolle, L.E. (1995). Conjunctivitis in a long-term care facility. Infection control. Infection Control and Hospital Epidemiology, 16(4), 210-216.

Bullock, S. & Manias, E. (2014). Fundamentals of Pharmacology. Frenchs Forest: Pearson.

Craft, J., Gordon, C., Heutherm S., McCance, K., Brashers, V. & Rote, N. (2011). Understanding pathophysiology 2. Chatswood: Elsevier.

Lee, G. & Bishop, P. (2013). Microbiology and infection control for health professionals (5th ed.). Frenchs Forest: Pearson.

Lehne, R.A., Moore, L., Crosby, L. & Hamilton, D. (2013). Pharmacology for nursing care (8th ed.). St. Louis, MO: Saunders/Elsevier.

Marieb, E.N., & Hoehn, K. (2014). Human anatomy and physiology (9th ed.). Boston, MA: Pearson.

Porth, C.M. & Matfin, G. (2014). Pathophysiology: Concepts of altered health states (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

microorganism , infection control etc