Clinical Fundamentals 2 Flashcards
Nosocomial infection that results from a particular treatment or therapeutic procedure
Iatrogenic
Leading nosocomial infection
UTI due to catheter use
Bloodstream also at risk due to long term use of __________.
Vascular Access Devices (VAD)
4 microorganisms:
Bacteria
Fungi
Parasites
Viruses
Bacteria is classified by _____ or _____.
Shape
Grouping
Bacteria must be _____ to be seen under a microscope
Stained
Bacteria that takes stain
Gram-Positive
Bacteria that does not take stain
Gram-Negative
Bacteria resistant to colorization by acid alcohol
Acid Fast
Bacteria form a protective ________ until conditions are right to survive.
SPORE
4 EXs of bacteria
TB
Strep Throat
Lyme Disease
Gonorrhea
Fungi exists as ______ and ______.
Yeasts
Molds
(Ex: thrush)
_______ are Protoza that move by Cilia, Pseudopod, or Flagella
Parasites
Parasites are also Helminths. Helminths = ….
Worms
______ are smallest microorganisms known to cause disease
Viruses
______ attach itself to a specific host cell, invades it, then produces new viral particles as host is destroyed (“Lysis”)
Viruses
5 EXs of Viruses
Flu Cold Mumps HIV Hepatitis
4 elements needed to transmit infection
Infectious agent and reservoir
Environment
Portal of exit
Portal of entrance into host
5 means of transmission
Direct or indirect contact Droplet Vehicle (food, water, drugs) Vector (insects, animals) Airborne
Immune-suppressed persons at ______ risk
Greater
3 methods of acquiring immunity
Active
Passive
Artificial Active
Active Acquired Immunity
Antibodies produced in a person’s body
Passive Acquired Immunity
Received from another person - short-term
Artificial Active Acquired Immunity
From vaccination
4 process of infection
Incubation
Prodromal
Full Disease
Convalescent
Acquired Immunodeficiency Syndrome (AIDS) caused by ___________.
Human Immunodeficiency Virus (HIV)
HIV is a retrovirus that destroys ____ cells in immune system
T-4
There are ___ phases of infection.
Person is not diagnosed with AIDS until stage ___.
5
5
4 common opportunistic infections are:
PCP
KS
AIDs dementia
Thrush
No vaccine for AIDs so treatment focuses on _________ virus in bloodstream
Decreasing
Always use ___________.
Standard Precautions
If accidentally exposed…..
Report it immediately
AIDs / HIV transmitted (3)
Blood to blood
Semen to blood
Mother to child
Viral hepatitis
Inflammation of liver
6 types of Viral Hepatitis
A B C D E G
___ and ___ viral hepatitis spread via fecal to oral route, others via blood
A
E
HC workers are at risk for _________.
Avoid ______ sticks and _______ exposure.
Hepatitis B
Needle
Blood
Caused by AFB, mainly affects lungs but can affect other parts of body
Tuberculosis (TB)
______ skin test done to detect TB - also CXR
PPD (Purified Protein Derivative)
If pt is suspected of having TB, HC worker should wear ____ respirator mask and put _______ mask on patient if leaving their room
N95
Regular
Skin infection common in patients
MRSA (Methicillin-Resistant Staphylococcus Aureaus)
MRSA stands for
Methicillin-Resistant Staphylococcus Aureaus
15 second hand wash should ____ and ____ each patient contact
Precede
Follow
Best way to break cycle of infectivity
Hand washing
Standard Precautions Tier 1
Protect against blood / body fluids everyday with PPE
PPE
Gloves
Gown
Goggles
Mask
True or false: it is okay to recap needles
Never
Have sharps container …..
Near work site
Disinfect items appropriately by _____ and ____ means
Mechanical
Chemical
Transmission Based Precautions
Tier 2 - isolation
When microbes are suspended in air and may be inhaled
Airborne precaution
When droplets are in air via coughing or sneezing
Droplet precaution
Touch contaminated body surface
Direct contact precaution
Touch contaminated object = fomite
Indirect contact precaution
Highly susceptible patient (aka strict, protective, reverse isolation)
Expanded Precautions
Clean portable, wear PPE, wash hands for 3 minutes when entering _____.
NICU
Infections that are acquired in course of medical care
Nosocomial
4 Vitals
Pulse
BP
Respirations
Temperature
Do you need a dr orders to take vitals?
No
Physiologic balance between heat produced and heat lost
Temperature
Pyrexia
Fever
Hypoxia
Below normal body temperature
Oral temperature
98.6
Axillary temperature
97.6
Rectal temperature
99.6
Aural temperature
97.6
Ty,panic Thermometer used for _____ temperature
Aural
Has a blunt tip and red cover
Rectal thermometer
Pulse over heart found with stethoscope
Apical
Usually take pulse at ______ artery
Radial
Why should you not use your thumb to take a pulse?
It has a pulse of its own
Normal average adult pulse
60-90 BPM
Abnormally rapid heart rate (+ 100 BPM)
Tachycardia
Abnormally slow heart rate (less than 60 BPM)
Bradycardia
Respiratory System exchanges _____ for carbon dioxide
Oxygen
Deoxygenated blood returns to ____ side of heart through vena cava
Right
Oxygenated blood pumped out of _____ side through Aorta
Left
Average adult respirations
16-20 BPM
Blue discoloration due to less than 10 breaths/min
Cyanosis
Difficult breathing; shortness of breath
Dyspnea
Do NOT tell patient you are assessing their respirations or it may alter their breathing — pretend you are….
Still taking their pulse
Amount of blood flow ejected from left ventricle during Systole and amount of resistance blood meets due to systemic vascular resistance
Blood Pressure
Highest point during contraction of left ventricle (top #)
Systolic / systole
Lowest point to which pressure drops during relaxation of ventricles (bottom #)
Diastole
Normal adult range for systolic
90-120 mm. Hg
Normal adult range for diastolic
50-70 mm. Hg
Baseline pulse and BP should always be taking and recorded prior to ….
Injection of iodine contrast
Use ___________ and ________________ to asses BP
Stethoscope
Sphygmomanometer
Lungs supply ____ and remove _____ from body via alveoli
O2
CO2
Measure blood gases via ______ artery stick
Radial
Inadequate oxygen in arterial blood
Hypoxemia
Excessive carbon dioxide in arterial blood
Hypercapnia
__________ is used to monitor oxygen saturation of Hemoglobin using a sensor on a fingertip or earlobe
Pulse Oximeter
True or false: Oxygen is not volatile
False, it is extremely volatile
Should you set the oxygen first or place the device on the pt first?
Set oxygen first then place device on pt
Too much oxygen in a pt with COPD can ____ them
Kill
Disposable plastic device with 2 nose prongs; used most often; runs on 1-4 LPM
Nasal cannula
Face mask must be run at atleast ____ LPM to flush out carbon dioxide
5
Partially or fully controls patients breathing
Mechanical ventilator
Respirator
Called to summon emergency response team
Stat page
Code blue
Used to asses neurological response
Glasgow Coma Scale
Maximum score for Glasgow Coma Scale
15
Glasgow Coma Scale evaluates… (3)
“Eyes open”
“Motor response”
“Verbal response”
Shock is body’s pathological reaction to… (3)
Illness
Trauma
Stress
______ shock results when patient loses 15-20% of body fluids from hemorrhage, burns, vomiting, diarrhea
Hypovolemic
_______ shock is caused by failure of heart to pump adequate blood to vital organs. (Ex: MI, cardiac tamponade, dysrhythmias)
Cardiogenic
______ shock results from loss of nerve tone causing pooling of blood (Ex: spinal cord injury, depressant meds, anesthesia)
Neurogenic
______ shock is caused by bacteria - most likely seem in ICU/ER portable situations
Septic
_______ shock is from severe allergic reaction to antigen. (Ex: iodine contrast, meds, insects)
Anaphylactic
Most common type of shock seen in X-ray department
Anaphylactic
Student ______ sign as witness but _____ explain consent form
Cannot
Can
Type of diabetes onset before 30 and needs insulin injections
Type 1
Diabetes type that onsets after 40 and can hopefully be controlled by diet and exercise
Type 2
Type of diabetes that occurs in late stages of pregnancy
Gestational
What happens when pt has taken insulin but not eating - they need sugar
Hypoglycemia
What happens when pt has ate but did not take insulin - they need insulin
Diabetic Ketoacidosis
______ shock results when patient loses 15-20% of body fluids from hemorrhage, burns, vomiting, diarrhea
Hypovolemic
_______ shock is caused by failure of heart to pump adequate blood to vital organs. (Ex: MI, cardiac tamponade, dysrhythmias)
Cardiogenic
______ shock results from loss of nerve tone causing pooling of blood (Ex: spinal cord injury, depressant meds, anesthesia)
Neurogenic
______ shock is caused by bacteria - most likely seem in ICU/ER portable situations
Septic
_______ shock is from severe allergic reaction to antigen. (Ex: iodine contrast, meds, insects)
Anaphylactic
Most common type of shock seen in X-ray department
Anaphylactic
Student ______ sign as witness but _____ explain consent form
Cannot
Can
Type of diabetes onset before 30 and needs insulin injections
Type 1
Diabetes type that onsets after 40 and can hopefully be controlled by diet and exercise
Type 2
Type of diabetes that occurs in late stages of pregnancy
Gestational
What happens when pt has taken insulin but not eating - they need sugar
Hypoglycemia
What happens when pt has ate but did not take insulin - they need insulin
Diabetic Ketoacidosis
Coma complication of type 2 diabetes
Diabetic Coma
Caused by occlusion of blood to brain, rupture of brain vessel resulting in blood in brain
CVA / Stroke
Causes hemipariesis, dysphasia, etc
CVA / Stroke
STRoke =
Smile
Talk
Raise arms
When pt is having a stroke, get pt to ER stat for _____ busting drugs
Clot
_____ arrest requires CPR
Cardiac
CABs =
Circulation
Airway
Breathing
4 steps when someone is in cardiac arrest
Look
Listen
Feel
Call 911
_____ compression-to-breaths for adult and child 1 man CPR
30:2
Place electrodes on pt’s chest, follow instructions for shock and compressions as needed
AED
Abdominal thrust (Heimlich) or Chest Thrust if obese or pregnant
Airway Obstruction
_____ do a blind finger sweep
Never
Thrashing on ground, protect from injury
Generalized
Grand Mal Seizure
Facial grimacing, lip smacking, etc
Partial
Petit Mal Complex Seizure
Finger shake, speak unintelligibly
Partial simple
Absence seizure
______ can be caused by flashing lights or video games
Seizures
Fainting; put head below knees or lay pt down and elevate their feet
Syncope
Give pt a guide to demonstrate their pain (2 types)
Numbers (1-10)
Pictures of faces
