RISK FOR INFECTION r/t inadequate secondary defenses and

immunosupression secondary to chemotherapy

I- Place the patient in private room. Observe reverse isolation.

R- This reduces the number of organisms in patient’s environment and restricts
visitation by individuals with any type of infection to reduce the transmission of
pathogens to the patient.

I- Limit visitors as indicated. Prohibit use of live plants or cut flowers. Restrict fresh
fruits and vegetables or make sure they are washed or peeled.
R- Protect patient from potential sources of pathogens or infection.

I- Require good handwashing protocol for all personnel and visitors.

R- Prevents cross-contamination or reduce risk for infection.

I- Inspect oral mucous membranes. Provide good oral hygiene. Use a soft toothbrush,
sponge, or swabs for frequent mouth care.
R- The oral cavity is an excellent medium for growth of organism and is susceptible to
ulceration and bleeding.

I- Provide meticulous skin care.

R- Reduces skin/tissue breakdown and infection

I- Monitor vital signs especially temperature.

R- Reflective of inflammatory process/ infection, requiring evaluation and tretment.

I- Encourage frequent turning and deep breathing.

R- These measures reduce stasis of secretions in the lungs and bronchial tree. When
stasis occurs, pathogens can cause upper respiratory infections, including pneumonia.

I- Coordinate procedures and tests to allow for uninterrupted rest periods.

R- Conserves energy for healing, cellular regeneration.

I- Encourage intake of protein- and calorie-rich foods.

R - This maintains optimal nutritional status.

Collaborative

I- Prepare for or assist patient with treatments such as chemotherapy.

R- Chemotherapy includes the combination of therapeutic agents, each requiring
specific safety precautions for patient and care providers.

I- Obtain specimens for culture and sensitivity,as indicated.

R- Verifies presence of infection, identifies specific pathogen and influences choice of
treatment.

I- Administer antibiotics as indicated.

R- May be given prophylactically or to treat specific infection.