Contraindications and Precautions Flashcards
Metabolic equivalent of task (MET)
Measurement system commonly used in cardiac rehab that indicates the energy expenditure required during a physical activity or daily task
Anterolateral THR precautions
No hip extension
No external rotation
No crossing midline
Posterior THR precautions
No hip adduction
No hip flexion past 90º
No internal rotation
Extrapyramidal symptoms
Movement disorders that may be a result of side effects from medications
Characterized by:
- akathisia
- dystonia
- dyskinesia
- peudo Parkinsonism
Contact precautions
A type of transmission-based, infection control method used in conjunction with standard precautions to prevent the spread of disease or infection by contact
Precautions include but are not limited to:
- wearing personal protective equipment, such as gloves and a gown
- providing intervention within the patient’s room when possible
- only using equipment intended for single-patient use or that can be disinfected
Droplet precautions
A type of transmission-based, infection control method used in conjunction with standard precautions to prevent the spread of disease or infection by droplets
Precautions include but are not limited to:
- wearing a surgical mask
- providing intervention within the patient’s room when possible
- only using equipment intended for single-patient use or that can be disinfected
Airborne precautions
A type of transmission-based, infection control method used in conjunction with standard precautions to prevent the transmission of disease or infection that is spread by fine particles
Precautions include but are not limited to:
- wearing an N-95 mask or respirator
- providing intervention in an isolation room
- only using equipment intended for single-patient use or that can be disinfected
Hand hygiene
A type of infection control approach used to prevent the spread of germs and infection
Two methods:
- washing hands with antiseptic soap and water (typically used when hands are visibly dirty)
- alcohol-based hand sanitizer (typically used when hands are not visibly dirty)
Infection control
Policies and procedures used in healthcare intended to minimize or prevent nosocomial infections and the spread of health-related diseases, methods include:
- hand hygiene
- isolation systems
- sterilization
Standard precautions
Infection control procedures used by healthcare workers to prevent the spread of infections
Procedures include but are not limited to:
- effective hand hygiene
- wearing gloves, gowns, protective eyewear, and other personal protective equipment when contact with body fluids is anticipated
- applying a bandage to minor cuts or skin lesions
- properly handling and disposing of sharp objects
- routinely cleaning and disinfecting environmental surfaces and equipment before and after each patient interaction
Basic first aid for first-degree burn
Basic first aid that involves but is not limited to the following actions:
- immediately immerse the affected area in cool water or apply a cool compress
- apply a sterile dressing to cover the area
Universal precautions
An infection control method used in healthcare settings where all human blood and certain human body fluids are managed as if they were known to be infectious
Basic first aid for bleeding
Basic first aid that involves but is not limited to the following actions:
- assess the situation and, if possible, wash hands and don gloves
- place a clean or sterile dressing over the wound and firmly apply direct pressure
- elevate the wound surface above the heart level
- encourage the patient not to move the extremity with wound
Fire safety: RACE
An acronym that describes the steps used when responding to a fire
Includes:
R - rescue
A - alarm
C - contain
E - extinguish/evacuate
Pulse rate
Normal: 60-100bpm
Bradycardia (slow): <60bpm
Tachycardia (fast): >100bpm
What types of pressure are measure when taking BP?
Systolic: pressure when heart is contracting
Diastolic: pressure when heart is at rest
What is normal BP?
<120/<80
Prehypertension
120-139/80-89
Stage 1 hypertension
140-159/90/99
Stage 2 hypertension
≥160/≥100
What are the norms for RR?
Newborn: 30-60 bpm
Adults: 12–20 bpm
What are the norms for temperature?
98.6˚F or 37˚C
What are the norms when measuring pain?
0 = nonexistent
1–3 = minimal
4–6 = moderate
7–10 = severe pain
What are anthropometrics?
Size
Weight
Proportions of human body
Body mass index (BMI)
When is activity contraindicated with BP?
Systolic doesn’t rise in proportion with activity
A decrease in systolic > 10
Systolic is >240
Increase in diastolic >20 with activity
Describe a patient with a sedentary activity level.
<1.5 METs
Can perform activities that usually involve sitting or reclining and that have little additional movement
Describe a patient with a light activity level
1.6-2.9 METs
Can perform activities that don’t cause a noticeable change in breathing heart rate
Walking slowly (from living room to kitchen), cooking (can of soup)
Describe a patient with a moderate activity level.
3-5.9 METs
Can perform activities that can be conducted while maintain a conversation uninterrupted
Walking at 3-4.5mph, vacuuming, mowing lawn
Describe a patient with a vigorous activity level.
6+ METs
Can perform activities which a conversation generally cannot be maintained and uninterrupted
Walking at 5+ mph, jogging, cycling at 10+ mph
What is the difference between the generic and trade name of medications?
Generic:
- Less expensive
- Safe and effective provided within the specific range criteria through testing on active ingredients (bioequivalent)
- “Off label”
- May still experience different affects than with the brand name drug
Trade (brand):
- More expensive
- Very specific effect for given conditions
- Preferred for those drugs that have a wider range of therapeutic and adverse effects when tested
Schedule I drugs
Ex: marijuana, LSD, ecstasy (MDMA), heroin
Highest potential for abuse and no accepted medical use and are not safe under medical supervision
Schedule II drugs
Ex: cocaine, opium, high grade morphine, oxycodone, methamphetamines (adderall)
High potential for abuse, despite having an accepted medicinal use in the US
Schedule III drugs
Ex: low grade morphine, anabolic steroids, ketamine, certain codeine mixtures
Can lead to moderate physical dependence or high psychological dependence
Schedule IV drugs
Ex: ambien, valium, xanax, rohypnol, zolpidem, soma, darvon, darvocet, ativan, talwin
Has accepted medical use in the USE, but abuse of the drug may lead to limited physical or psychological dependence
Schedule V drugs
Ex: cough syrup, lomotil, motofen, lyrica, parepectolin
Substances with limited quantities of certain narcotics that have less potential for abuse and have accepted medical use in the US with limited risk of physical/psychological dependency
Losartan potassium
Generic name: Losartan Postassium
Brand name: Cozaar
Used to treat hypertension
Can also be used to help protect the kidneys from damage due to diabetes.
Alendronate
Generic: Alendronate
Brand name is Fosamax and Binosto
Prevent osteoporosis
Side effect: nausea, heart burn
Never take alendronate at bedtime it will not fully absorb in the system.
Digoxin
Generic: Digoxin
Brand name: Lanoxin
Used to control the rate and rhythm of a pt heartbeat.
Reduces swelling of hands and ankles in pts with heart problems
Should avoid taking OTC antacids
This is also used to treat angina (heart pain) and may be used after a heart attack
Tylenol
Generic name: Acetaminophen
Brand name: Tylenol
Mild-moderate pain reliever
Should be avoided if you have liver disease
Can be taken to reduce fever.
Can cause instant renal failure after having consumed alcohol within 72 hours
Warfarin
Generic name: Warfarin
Brand name: Coumadin, Jantoven
Helps prevent blood clots from forming.
Aspirin and warfarin are two commonly prescribed blood thinners they should not be taking together due to increase bleeding.
Vitamin K is the antidote for warfarin.
Can not take Warfarin before surgery due to risk of increased blood loss during surgery
Lasix
Generic: Furosemide
Brand: Lasix
Treats fluid retention
Used for pts with congestive heart failure, liver disease, or a kidney disorder
This medication can make your skin sensitive to sunlight; protective clothing, sunglasses, and sunscreen are highly recommended when taking this medication
Can be injected instead of in a pill
Thyroxine
Generic name: Levothyroxine
Brand names include: Synthroid, Unithyroid, and Levoxyl
Can also treat thyroid cancer and enlarged thyroid
Used to treat hypothyroidism, an under active thyroid
Nitroglycerin
Generic: Nitroglycerin
Brand Name: Nitrostat
Prevents and treats chest pain
Lowers blood pressure as well.
When used rectally, it can treat pain caused by tears in the skin around the opening for bowel movements (anal fissures).
This medication allows more blood to flow to the heart
Metformin
Generic name: Metformin
Brand Name: Glumetza
Helps to restore the body’s response to insulin, used for type 2 diabetes
Can be used to treat PCOS
Esomeprazole
Generic name: Esomeprazole
Brand name: Nexium
Used to treat indigestion, heartburn, and acid reflux
Patients taking PPIs have a higher risk of developing kidney disease
NSAID
Generic (brand) name: Aspirin (excedrine), Ibuprofen (advil, motrin), Naproxen (aleve, midol)
Relieves pain, reduces inflammation, reduces fever
Chronic use of NSAIDs may also present higher risks for people with heart disease, high BP, or diabetes
Chronic use can lead to anemia
Avoid taking NSAIDS if you have: kidney disease, liver disease, heart failure, history of stroke or heart attack, HBP if it’s difficult to manage
Levodopa
Generic name: levodopa
Brand name: Sinemet
Used for Parkinson’s
