A patient with a central venous catheter develops a bloodstream infection. Which link in the chain of infection could the nurse target to prevent this infection in the future?

Infectious agent

Mode of transmission

Susceptible host

Portal of entry

Answer and Explanation

The Correct Answer is D

A. Infectious agent: While targeting pathogens is important, nurses typically do not directly eliminate all infectious organisms in the environment. Strategies such as hand hygiene and aseptic technique focus on preventing access rather than eradicating microbes entirely.

B. Mode of transmission: Interventions like hand hygiene, wearing gloves, and using sterile technique reduce transmission, but in this scenario, the infection occurred via the catheter. Targeting transmission alone may not fully prevent bloodstream infections.

C. Susceptible host: The patient’s immune status contributes to risk, but modifying inherent susceptibility (age, comorbidities) is not always feasible. Interventions more directly target controllable factors related to infection risk.

D. Portal of entry: The central venous catheter provides a direct pathway for pathogens into the bloodstream. Using strict aseptic technique during insertion and maintenance, proper dressing changes, and catheter care directly addresses this portal, making it the most effective link to target for prevention.

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Correct Answer is B

Explanation

A. Supine: Remaining in the supine position places prolonged pressure on the sacrum, heels, and occiput, increasing the risk for pressure ulcer development in patients who cannot reposition themselves.

B. Lateral: The lateral (side-lying) position redistributes pressure away from the sacrum and heels and is commonly used as part of a regular turning schedule to prevent pressure injuries.

C. Trendelenburg: This position increases pressure and shear forces on the sacral area and is not recommended for pressure ulcer prevention, especially for immobile patients.

D. Prone: While it offloads pressure from the back, the prone position is difficult to maintain, uncomfortable for most patients, and increases pressure on the face, chest, and knees.

A. Change the dressing to maintain aseptic conditions. B. move the dressing to examine the wound bed. C. Reinforce the dressing and notify the physician D. Inspect the drainage for color, odor, and amount.

Correct Answer is D

Explanation

A. Change the dressing to maintain aseptic conditions: While dressing changes are important, immediately removing or changing the dressing without assessment may disrupt the wound and impede monitoring of drainage characteristics. Assessment should come first.

B. Move the dressing to examine the wound bed: Lifting or removing the dressing prematurely can expose the wound to infection and trauma. Initial observation should rely on visual inspection through a transparent dressing if possible or minimal disturbance.

C. Reinforce the dressing and notify the physician: Reinforcing the dressing may be appropriate if drainage is heavy, but before notifying the physician, the nurse should first assess and document the drainage characteristics to provide accurate information.

D. Inspect the drainage for color, odor, and amount: Assessing the drainage is the first and most appropriate action. Serosanguinous drainage is expected in the early postoperative period, and documenting its color, odor, and volume helps distinguish normal from abnormal findings and guides subsequent interventions.

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A patient with a central venous catheter develops a bloodstream infection. Which link in the chain of infection could the nurse target to prevent this infection in the future?

Nursing Test Bank

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