ISPN Review Antibacterial Agents – Nursing Interventions 抗菌药 – 护理措施
■ Use measures to prevent and minimize the spread of infection.
采取措施防止和最大限度减少感染扩散
■ Wash hands thoroughly and often. This is probably the most effective method of preventing infections.
彻底、经常洗手。这也许是预防感染的最有效手段
■ Support natural defense mechanisms by promoting general health measures (e.g., nutrition, adequate fluid intake, rest, exercise).
推动一般性健康措施，支持天然防御机制（如，营养，充分的液体摄入，休息，运动）
■ Keep the patient’s skin clean and dry, especially the hands, underarms, groin, and perineum, because these areas harbor large numbers of microorganisms. Also, take care to prevent trauma to the skin and mucous membranes. Damaged tissues are susceptible to infection.
■ Treat all body fluids (e.g., blood, aspirates from abdomen or chest) and body substances (e.g., sputum, feces, urine, wound drainage) as infectious. Major elements of standard precautions to prevent transmission of hepatitis B, HIV, and other pathogens include wearing gloves when likely to be exposed to any of these materials and thorough hand hygiene when the gloves are removed. Wear protective eyewear when a risk of spatter is present. Rigorous and consistent use of the recommended precautions helps to protect health care providers and patients.
按感染要求处理所有体液（如，血液、腹腔及胸腔抽出物）和体内物质（如，痰、粪便、尿液、伤口渗液）。
■ Implement isolation procedures appropriately.
适当实施隔离程序
■ To prevent spread of respiratory infections, have patients wash hands after coughing, sneezing, or contact with infected people; cover mouth and nose with tissues when sneezing or coughing and dispose of tissues by placing them in a paper bag and burning it; expectorate sputum (swallowing may cause reinfection); and avoid crowds when possible, especially during influenza season (approximately November through February). Recommend an annual influenza vaccine to high-risk populations (e.g., people with chronic diseases such as diabetes and heart, lung, or renal problems; older adults; health care personnel who are likely to be exposed). Pneumococcal vaccine is recommended for the same populations.
■ Assist or instruct patients at risk about pulmonary hygiene measures to prevent accumulation or promote removal of respiratory secretions. These measures include ambulating; turning; coughing and deep-breathing exercises; and incentive spirometry. Retained secretions are good culture media for bacterial growth.
■ Use sterile technique when changing any dressing. If a wound is not infected, sterile technique helps prevent infection. If the wound is already infected, sterile technique avoids introducing new bacteria. For all but the smallest of dressings without drainage, remove the dressing with clean gloves, discard it in a moisture-proof bag, and wash hands before putting on sterile gloves to apply the new dressing.
■ To minimize spread of infections, adhere to current established guidelines for isolation precautions to prevent transmission of infections agents in health care settings published by the Centers for Disease Control and Prevention.
最大限度减少感染传播，坚持现已确立的CDC医疗保健机构感染菌传播预防隔离预防指南
■ For patients with infections, monitor temperature for increased or decreased fever, and monitor WBC count for decrease.
对于感染患者，监测体温，检查发烧温度增加或下降，监测WBC计数是否降低。
■ For patients receiving antimicrobial therapy, maintain a total fluid intake of approximately 3000 mL/24 hours, if not contraindicated by the patient’s condition. An adequate intake and avoidance of fluid volume deficit may help decrease drug toxicity, especially with aminoglycoside antibiotics. On the other hand, a patient receiving IV antibiotics, with 50 to 100 mL of fluid per dose, may be at risk for fluid volume overload.
■ Assist patients with hand hygiene; maintaining nutrition and fluid balance; getting adequate rest; and handling secretions correctly. These measures help the body to fight the infection, prevent further infection, and enhance the effectiveness of anti-infective drugs.
本期ISPN Review答案： 1. B. Aminoglycosides. This antibiotic collect in the 8th cranial nerve causing neurotoxicity as manifested by dizziness, vertigo, and loss of hearing. 2. A. Macrolide. Options B, C, and D exert their effect by depriving the invading organisms of the essential substances they need for cell division or reproduction.
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