The nurse is working for a postsurgical unit. He is caring for four postsurgical patients, all of whom have been in the hospital for 3 days or more

Question

Which of the following patients should he be most concerned about regarding a health care–associated infection? a. An asymptomatic elderly patient with bacteria in his urine
b. A middle-aged woman with a white blood cell count of 10,000/mm3
c. A young adult woman who is 1 day postoperative with redness at incision site
d. A middle-aged man with temperature of 101.3° F and complaints of malaise

Answer 1

D
By assessing existing signs and symptoms (e.g., the condition of a wound, the presence of fever), you will determine whether a patient's clinical condition indicates the onset or extension of a systemic infection. The patient with an elevated temperature such as 101.3° F and a feeling of malaise is demonstrating signs of infection. When assessing laboratory data, consider the age of the patient. For example, in an older adult, bacterial growth in urine without clinical symptoms does not always indicate the presence of a urinary tract infection. Normal white blood cell count is 5000 to 10,000/mm3, so a patient with that level would not be showing a sign of infection unless he or she were already immunosuppressed. Redness at the incision site is a sign of inflammation, and the body's inflammatory response is a protective reaction that neutralizes pathogens and repairs body cells.