Exam Prep #3 Flashcards
Clinical Patient Care
Checking exam rooms for cleanliness, restocking items and equipment, and reviewing daily schedules to familiarize yourself with patient medical records is which part of an MA’s shift?
Preparing for shift of day.
How to maintain safety in the clinical setting?
Avoid cluttered hallways, spills, sharp corners (furniture), dimly lit areas. Report any hazards to the supervisor.
Describe 5 comprehensive clinical intakes.
- Obtain and document for today’s reason, chief complaint. Use open ended questions.
- Medication Reconciliation on every patient visit.
- Allergies should be assessed on every patient visit.
- Complete personal and family history. Will help the provider assess and address patient concerns.
- Screenings (visual acuity testing, urinalysis, hearing tests, anthropometric measurements and VS are performed during routine exams.
- Infants and small children growth charts should be completed to assess developmental progress (Denver Developmental Screening Test).
- Teens should have scoliosis screenings. Adults should have mini-mental state exams for dementia.
List the 6 vital signs
- Temperature
- Heart rate
- Respirations
- Blood Pressure
- Pulse Oximetry
- Pain Scale
What is the average temperature for vital signs?
97.5 - 99.5 F
Which pulse for adults and which for children for heart rates?
Radial pulse for adults. Brachial pulse for children and babies.
In an emergency, where should the pulse be taken from?
Carotid pulse
Heart pulse is evaluated on which 3 traits?
Rate, rhythm, and strength.
Average heart rates for adults, children, infants, and neonates are?
Adult: 60 to 100
Children (1 to 8 yrs): 80 to 100
Infants (1 to 12 mth): 100 to 120
Neonates (1 to 28 dys): 120 to 160
Average respirations for adults, children, infants, and neonates are?
Adult: 12 to 20 breaths per minute
Children (1 to 8 yrs): 15 to 30
Infants (1 to 12 mth): 25 to 50
Neonates (1 to 28 dys): 40 to 60
Average blood pressure for adults, children, infants, and neonates are?
Adult: 90 to 140 mmHg / 60 to 90 mmHg
Children (1 to 8 yrs): 80 to 110 mmHg
Infants (1 to 12 mth): 70 to 95 mmHg
Neonates (1 to 28 dys): > 60 mmHg
Average pulse oximetry oxygen level is?
95% or higher
1 kilogram is equivalent to how many pounds?
2.2 lbs
How should BMI be calculated?
Weight in lb/height in inches x 703 = BMI
Use the WHO growth standards to monitor growth for patients of what age?
Infants to children 2 and under.
Use the CDC growth charts for children of what ages?
2 years and older.
A bed position where head and trunk are raised 40 - 90 degrees. Used for patients with cardiac issues, trouble breathing, or nasogastric tube in place. What position?
Fowler’s position
Involves the patient lying on either left or right side. Right lateral = patients right side touching bed, left lateral = patients left side touching bed. What position?
Lateral position
Involves the patient lying flat on back while legs elevated to hip level or above. Common use in childbirth. What position?
Lithotomy position
Where the patient lies on their stomach with their back facing upward. Allows full flexion of knee and hip joints. What position?
Prone position
When the patient is supine with the head of the bed elevated and foot of the bed is down. Used in surgery to promote perfusion in obese patients. Helpful treating venous air embolism and preventing pulmonary aspiration. What position?
Reverse Trendelenburg position
Prone/lateral position where the patient lies on their side with upper leg flexed and drawn toward chest, while upper arm is flexed at the elbow. Useful for administering enemas, perineal examinations, and comfort in pregnancy. What position?
Sim’s position
When the patient is flat on their back. Most natural resting position. What position?
Supine position
Involves a supine patient and sharply lowering the head of the bed and raising the foot end., creating an upside down effect. Helpful during gynecological and abdominal hernia surgeries. What position?
Trendelenburg position
An instrument used to examine interior structures of the eye. Consists of a light, magnifying lens, and opening for the doctor to view through.
Ophthalmoscope
Instrument used to view the ear canal and tympanic membrane. Consists of a light, magnifying lens, and cone shape insert.
Otoscope
Instrument used for listening to body sounds including heart, lungs, and intestines. Also used while taking blood pressure. Consists of diaphragm and ear piece.
Stethoscope
Instrument used for neurological reflex testing by striking the tendon of ankle knee, wrist, and elbow.
Percussion Hammer
Instrument used for testing hearing. Striking the prongs causes a vibration, which produces a humming sound. The prongs are placed near the skull and ear while the patient describes the sound.
Tuning Fork
Instrument used to measure blood pressure. Consists of inflatable rubber cuff, bulb to inflate and deflate, and the use of a stethoscope simultaneously.
Sphygmomanometer
How long should patients wait before leaving after a medication had been administered?
15 minutes
List 9 supplies needed for an injection.
- Medication
- Syringe
- Needle
- Topical anesthetic
- Nonsterile gloves
- Antiseptic wipe
- Cotton ball or gauze
- Adhesive bandage
- Sharps container
What is the largest and smallest needle gauges?
14 G is largest. 31 G is smallest.
What gauge of needle for an IM injection?
20 to 23 G
What gauge needle for a SQ injection?
25 - 26 G
Process of flushing the external canal with sterile water or saline. Used to treat foreign bodies or cerumen (ear wax). What is this called?
Ear irrigation
Process of flushing the eyes with solution to remove secretions, foreign bodies, or dilute chemicals. What is this called?
Eye irrigation
List 6 common injuries.
- Abrasions
- Incision
- Laceration
- Punctures
- Contusion
- Concussion
Name 3 common limb injuries.
- Strain
- Sprain
- Fracture
Fevers, chills, fatigue, foul smell odor from wound, drainage, redness, swelling, increased pain, hot to touch, red streaks extending the wound are signs of what?
Infection
List the 10 steps for changing a sterile dressing.
-Wash your hands with soap and water.
-Put on non-sterile gloves.
-Carefully remove the tape.
-Soak the dressing with saline or sterile water prior to removal.
-Remove the old dressing.
-Remove the gauze pads or packing tape from inside the wound.
-Apply any medications to the wound if necessary with an applicator.
-Open dressing packages without touching contents.
-Only touch the edges of the dressing to apply to the wound.
-Label date and initials after dressing is complete onto tape.
What are the 4 steps of CPR?
- Check for response: Shout “Are you okay?!
- Call for help: Instruct others to call 911/bring AED.
- Check circulation: Best place is the carotid artery.
- Begin compressions: 30 compressions/ 2 breaths (100-120 compression per minute).
- Compress chest 2 to 2.4 inches. Allow the chest to fully recoil.
List 3 things on how to assist with traumatic injuries.
- Obtain the chief complaint
- Collect vital signs
- Assist the provider: cleaning wounds, preparing sterile fields for minor surgeries, bandaging wounds, administering injections, educating patients, wound care, scheduling appointments.
2 ways to assist with surgical interventions?
- Prepare the surgical area and assist the provider during the procedure.
- Provide education and support to the patient.
Name 6 factors in setting up a sterile field.
- Perform hand hygiene before implementing the sterile field.
- Wear appropriate PPE.
- Always face the sterile field. Facing away is considered contaminated.
- When side by side in the sterile field, reaching around the back of someone else to try to reach something.
- If gloves are contaminated, they must be removed and replaced immediately.
- Consider a sterile field sterile or not, no guessing.
What does pre-operative education include?
Preparing for surgery, pain, pain medications, and post-operative factors.
What does post-operative education include?
Pain control, care of incision, signs of infection, assessing mood and quality of life.
6 factors when removing staples and sutures.
- Complete inspection of wound, edges are approximated and there are no signs/symptoms of infection.
- Soak wounds that have dry blood with saline solution first.
- Suture scissors and forceps or staple remover will be needed.
- Remove every other suture/staple while inspecting the site.
- Count the staples and sutures removed.
- When cutting sutures, cut close to the knot and remove with forceps by the knot.
5 instructions for discharging patients.
- Go over any activity restrictions
- Review diet restrictions
- Educate pepper wound care
- Cover any changes to medications
- Follow up appointments
What are 3 guidelines for prescription and refills over the phone.
- MA are not allowed to write prescriptions. They can send medication prescribed by the provider to the pharmacy either electronically or by phone.
- Speak clearly, provide full name and date of birth, identify the medication and do not use any abbreviations when phoning a prescription.
- Controlled substances can not be called to the pharmacy. Patient must deliver the prescription to the pharmacy personally.
What are the 5 Chain of Infections?
- Reservoir
- Portal of Exit
- Mode of Transmission
- Portal of Entry
- Susceptible Host
A host which allows the microorganism to live or grow and multiply. Which chain of infection is this?
Reservoir (Source)
Path for the microorganism to escape from the host. Can happen through mouth, droplets, open wounds, blood, or fecal/urine matter. Which chain of infection is this?
Portal of Exit
How the agent is transmitted from one person to another. In forms of droplets, direct or indirect contact, or airborne. Which chain of infection is this?
Mode of Transmission
How the microorganism gets into the new host. Similarly to the portal of exit. What chain of infection is this?
Portal of Entry
An infant, elderly person, or someone with a weak immune system that is susceptible to the agent. Which chain of infection is this?
Susceptible Host
Define asepsis.
The absence of any microorganisms, including bacteria.
Define medical asepsis.
Medical practice designed to reduce contamination of microorganisms.
Define surgical asepsis.
Sterile techniques used in surgeries. A sterile field is to remain sterile until the patient has left the room or at the end of the procedure. Appropriate surgical scrubs, PPE, as well as methods to maintain a sterile field and draping techniques
How long should you lather hands when hand washing?
30 seconds
Alcohol based sanitizer should be a minimum of what percentage of alcohol?
60 %
What does disinfection and sterilization do to microorganisms?
- Disinfection eliminates or reduces harmful microorganisms.
- Sterilization is the process of killing all microorganisms.
Which disposal should waste containing blood and bodily fluid be disposed in?
Biohazard waste
Which document provides information about the hazards of material being handled?
Safety Data Sheets
Patient voids into the toilet, then all urine is collected for the next 24 hours. Used to measure substances (steroids, white cells, electrolytes, urine osmolarity). What testing is this?
24 hour Collection
First specimen of the morning. Best for pregnancy tests. What testing is this?
First-Morning Specimen
The second voided specimen after fasting. What testing is this?
Fasting Specimen
Used to obtain for bacterial culture. First and last part of the urine stream is not used. What testing is this?
Mid-Stream Urine (MSU)
For chemical or microscopic examination. For most screening purposes. What testing is this?
Random Specimen
From urinary catheter for testing UTI or bacteria. What testing is this?
Catheter Specimen
Name 2 types of stool samples.
Fecal Occult and Tape Test
What is fecal occult testing for? How many testing’s?
Testing for blood in stool. 3 testing’s.
What is tape test used for?
Testing for pinworms typically in small children.
A test to detect and identify bacteria/fungi that infects the lungs/breathing passages. What test is this?
Sputum Culture
5 guidelines for culture specimens.
- Collect at appropriate time
- Collect from site of suspected infection
- Minimize transport time to lab
- Collect appropriate quantity
- Appropriate containers
A regulation including federal standards applicable to all U.S facilities that test human specimens for health assessment or to diagnose, prevent, or treat disease. What is it called?
The Clinical Laboratory Improvement Amendments
CLIA regulations establish standards for lab testing in specimens such as blood, bodily fluids, and tissue. T/F?
True
When the provider uses a needle to prick the skin (forearm or back) with 10 to 50 potential allergens. Or by placing droplets of potential allergens on the skin and using a device to scratch/puncture the area which causes the liquid to enter the skin. Reactions occur within 15 minutes. What kind of allergy test?
Scratch Test
If skin prick testing is negative or inconclusive, the provider may run an intradermal skin test. The provider injects a small dosage of allergens in the epidermis. What kind of allergy test?
Intradermal Skin Test
Provider sends a sample of blood to the lab. The lab adds allergens to the blood sample and measures the levels of Ige antibodies in it. What kind of allergy test?
RAST
Occurs only under provider’s (allergist) direct supervision. When a patient is suspected to have food or drug allergies ingest a small amount of allergen. If anaphylaxis is developed, the provider gives an epinephrine injected to stop the reaction. What kind of allergy test?
Challenge Test
Test to measure air flowing out of the lungs. Measurement is called the peak expiratory flow rate (PEFR) or peak expiratory flow (PEF). What kind of test?
Peak Flow Testing
Testing that helps diagnose lung disease.
Spirometry Testing
6 instructions before spirometry testing include.
- No smoking 1 hour before testing.
- No alcohol 4 hours before testing.
- No large meals 2 hours before testing.
- Wearing loose clothing.
- No excessive exercise 30 minutes before testing.
- No puffer medications a few hours before testing.
What are 5 reasons for performing venipuncture?
- Acquire blood samples.
- Monitor levels of blood components.
- Administer therapeutic treatments intravenously (medication, nutrition, chemotherapy).
- Removing blood (high levels of iron, red blood cells).
- Blood transfusions.
Single use needle stick for drawing blood. Limited to blood sample collections is called what?
Phlebotomy
Steps for venipuncture
- Explain procedure and reason for blood draw to patient.
- Identify patient using 2 identifications (DOB/full name).
- Confirm the ordered blood tests.
- Check for allergies.
- Position patient and hyperextend the arm.
- Hand hygiene and appropriate PPE.
- Apply a tourniquet 3 to 4 inches above the selected site. Closely monitor arm for numbness, change of color or pain.
- Ask the patient to make fist (not pump hand).
- Prep the site with an alcohol pad for 30 seconds and allow it to air dry for 30 seconds.
- Grab below the site firm to draw the skin taut and anchor the vein from rolling. Insert needle 15 to 30 degrees into the vessel. Blood should flash into the catheter.
- Attach the needed tube/syringe to remove the proper volume of blood. Remove the tourniquet as the last amount of blood is drawn.
- Remove the needle from the site and press down with gauze.
- Dispose of the contaminated material into designated containers.
- Label tubes and place them into transport bags.
- Deliver blood to the lab.
List venipuncture supplies
- Collection tubes
- PPE
- Needles and syringes
- Tourniquets
- Hand sanitizer
- Alcohol swabs
- Laboratory labels
- Gauze
- Blood transfer device
- Tape or adhesive bandages
- Laboratory forms
- Biohazard transportation bags
- Sharps container
What are 3 preferred vein sites for venipuncture?
- Median cubital vein
- Cephalic vein
- Basilic vien
List 6 complications of venipuncture
- Cellulitis: Bacterial infection of the skin. Typically swollen and red.
- Phlebitis: Inflammation of the vein. Due to blood clots.
- Diaphoresis: Perspiring from sweat glands which is a response to heat, exercise, or stress.
- Hypotension: Low blood pressure. Result in fainting or dizziness.
- Syncope or Near Syncope: Fainting, temporary loss of consciousness.
- Seizure Activity: Uncontrolled electrical disturbance in the brain. Alter behavior, movements, or feelings.
What does EKG testing help diagnose?
- Irregular heart rhythms (arrhythmias)
- Blocked or narrowed arteries in the heart (coronary artery disease) are causing chest pain/heart attack
- Previous signs of heart attacks
- How treatments are working (pacemakers)
How many electrodes are placed on the body for ECG testing?
10 electrodes
ECG Electrode for the 4th intercostal space (Right Sternal Edge) is which number electrode?
V1
ECG Electrode for 4th intercostal space (Left Sternal Edge) is which number of electrode?
V2
ECG Electrode for midway between V2 and V4 is which number of electrode?
V3
ECG Electrode for 5th intercostal space (Midclavicular Space) is which number of electrode?
V4
ECG Electrode for left anterior axillary line (same horizontal level as V4) is which number of electrode?
V5
ECG Electrode for left mid-axillary line (same horizontal level as V4 and V5) is which number of electrode?
V6
List the limb electrodes by colors.
- White on right arm.
- Black on left arm.
- Red on left leg.
- Green on right leg.
What does a Holter Monitor do?
Provides continuous measurements of the heart’s electrical activity for up to 30 days.
Exercise test on a treadmill/bicycle to measure how the heart responds, diagnosing blocked arteries in the heart. Provides measurement of oxygen consumption is called what?
Stress Test
