General Patient Care Flashcards
What are signs of a mild allergy reaction
Itchy skin, rash, swelling and irritation
What are signs of a severe anaphylactic reaction?
Dyspnea, difficulty breathing/swallowing, weakness, sweating, possible convulsions
When can you give epinephrine to a patient?
When the provider gives you a written or verbal order
What should an MA do prior to giving any medication to a patient?
Check their drug allergy list
What are the steps for preparing a patient for a procedure/examination?
- Review the patient’s medical chart
- Prepare the exam room
- Identify the patient and introduce yourself
- Provide the patient a gown and drape
- Assist the patient with dressing, if requested
What can you do to calm a child nervous for getting an immunization?
Be honest and calm and explain to the child that they will feel a small pinch and that the feeling will not last long. Distract or have the parent or guardian distract the child during the shot. Role play by pretending to administer a shot to a stuffed animal. Reward the child with a treat or toy afterward.
Fowler’s position
sitting position with back at 90 degrees angle to exam table
Supine
lying flat on the back with the arms down to the side
Left lateral
Laying on the left side with the left leg slightly flexed and the right leg flexed at 90 degree angle
Semi Fowler’s
Sitting position with back at 45 degree angle to exam table
Dorsal recumbent
Lying flat on the back with the knees bent
Lithotomy
Lying flat on the table with feet resting on stirrups
Which position would be best for a patient that has dyspnea?
Semi Fowler’s position
Pelvic exam would use what position?
Lithotomy
Parenteral medication
administration is non-oral - generally injected directly into the body, bypassing the GI tract
nonparenteral or entereal medication
Oral administration given by the mouth to the GI tract
Oral
taken by mouth
Sublingual
Placed under the tongue
Buccal
Between the cheek and gums resulting in rapid absorption
Inhalation
Inhaled through the mouth, passes through the trachea into the lungs; inhaled through the nose and absorbed through the nasal mucous membrane
Ocular or Otic
drops of medication are instilled directly into the eye (ocular) or ear (otic)
Transdermal
Applied to the skin and designed to release slowly and systemically into circulation. Administered in an adhesive path in a single layer drug, multi-layer drug, drug in reservoir, or drug matrix
Topical
applied to the skin or mucous membrane (faster) and acts locally. Administered as creams, ointments, or emulsions.
Rectal
inserted into rectum
Equation and units of Calculating an individual dose
(D) Desired Dose
(H) dosage strength/ supply on hand
(Q) medications unit of measurement or quantity of unit
(x) the amount to administer
X = D / H x Q
Converting kg to lb
__lb divided by 2.2
Converting lb to kg
__kg times 2.2
A medication order is for 2 mg/kg of a medication. The patient weighs 77 lb. The medication is supplied as 100 mg/mL. How much should be administered to the patient?
Since the medication order is in kg, you will need to convert the patient’s weight from lb to kg. You should know that 1 kg = 2.2 lb. This makes the patient 35 kg (77 lb ÷ 2.2).
You know that the medication order is 2 mg/kg. This means that for every kg, the patient should receive 2 mg of the medication: 35 kg × 2 mg = 70 mg of medication
You now know that the patient should receive 70 mg of the medication, which is supplied as 100 mg/mL.
Brand names are
usually capitalized and are listed first
Generic name are usually
not capitalized
Checking the medication 3 times helps prevent medication errors
first - comparing medication order to the medication
second - preparing the medication for administration
third - complete when returning the medication back to the shelf
What are the 9 R’s
Right patient, right medication, right form, right dose, right route, right time, right technique, right education, right documentation
Eye instillation
The patient should look toward the ceiling with both eyes open
Ear instillation
with non-dominant hand -
Adults - pull the pinna of the auricle (outer ear) outward and upward
Children - outward and downward for infants and children.
A patient reports a medication allergy - what questions should the MA ask?
What was the reaction?
When did the reaction start after taking the medication?
How many doses have you taken?
Why are you prescribed this medication?
What is surgical asepsis
Techniques to eliminate pathogenic and other potentially harmful microbes related to invasive procedures
What is autoclaving
Process of using high-temperature steam to kill any micro-organisms
How to prep for autoclaving instruments
must make sure all surfaces of instruments are open and loose so all surfaces are cleaned - add indicator strip to ensure temperature was reached, when folding, create lips
A border of at least __ inch around the sterile drape is considered nonsterile
1 inch
Steps for creating a sterile field
- Disinfect the Mayo stand
- Place the packet on the Mayo stand
- Open the flap farthest away from the MA
- Pull both of the side flaps open
- Open the flap closest to the MA
What is a biopsy
The surgical removal of tissue for later microscopic examination
Removal of a foreign object
Surgical removal of an object, such as a small splinter, or a larger object, such as a piece of wood or metal that is embedded in tissue. Splinter forceps are commonly used with this procedure
Removal of a small growth
Surgical removal of a small growth (cyst, wart, mole)
Endoscopy
Procedure that uses an endoscope to view a hollow organ or body cavity, such as the larynx, bladder, colon, sigmoid colon, stomach, abdomen, and some joints.
Colposcopy
Examination of the vagina and cervix performed using a colposcope, which is a specialized type of endoscope. With the patient in the lithotomy position, the colposcope allows the health care provider to observe the tissues of this area in detail through light and magnification.
Cryosurgery
Procedure using local application of intense cold liquid or special instrument called a cryoprobe to destroy unwanted tissue.
Incision and drainage (I & D)
A procedure is performed to relieve the buildup of purulent (pus) material as a result of infection, such as from an abscess. The purulent discharge can be cultured to determine what micro-organism is causing the infection and what antibiotic would be effective in treating it.
Absorption sutures
do not need to be removed, absorption usually occurs 5 to 20 days after insertion
Nonabsorbable sutures (nylon, silk, polyester, stainless steel)
Generally remain in place 5 or 6 days and then must be removed - removal timing depends on site (if it too long, may cause skin irritation and infection)
Size of the suture is measured by
the gauge/diameter - stated in terms of “0” - the more 0s, the smaller the gauge
ex. 0 is thicker than 6-0 (000000)
Which suture would you use for delicate skin? why?
Delicate tissue like face and neck would be 5-0 or 6-0 because these finer sutures would leave less scaring
Which suture would you use for chest or abdomen? Why?
2-0 due to it’s ability to close thick skin, fascia, muscle, and tendon repair
Staples
made of stainless steel and applied with a surgical stapler - allow for wounds under high tension (like on trunk, extremities, and scalp)
need to be removed within 4 to 14 days
What should MAs tell patients when there is suture removal?
Explain the procedure to the patient, remind the patient of a pulling sensation
What should the MA do if there is crusting blood around the sutures?
Usually need soaking with saline prior to removal of the sutures or staple
To remove sutures, what should the MA do
cut the suture with scissors below the knot and as close to the skin as possible - never pull suture material that is outside the skin through the skin - to prevent infection and not touching the germ side of the suture
Which suture should you start with first and what pattern should you follow? Why?
Start with the second and go every other - don’t want the wound to open up prematurely
How to get under the knot of the suture?
Pull up, cut the knot, and over to the side away from the incision until whole suture is out- prevent opening wound
When done with taking out at least (2, 4, 6) sutures/staples, what should the MA do?
Put the antiseptic medicine on holes that sutures were taken out, let it dry, place steri strips and continue taking out the rest
What should the MA do if they removed some sutures and the wound started opening up prematurely?
Stop removing sutures, place sterile bandage on wound, and notify the provider
To remove staples, what should the MA do
Begin with the 2nd staple, carefully place the curved lower tip of the sterile stapler remover under the staple, advance the lower jaw of the staple remover under the staple to be removed
What should the MA not do when removing staples?
Do not lift staple remover when squeezing the handles, the staple remover depresses it for you
What is exudate
a fluid that leaks out of blood vessels into surrounding tissues. It is typically composed of cells, proteins, and other substances.
If there is any gaping, bleeding, or presence of an exudate, what should the MA do
put a sterile bandage on wound and notify the provider
What is the benefits of wound closure
Aids in healing, helps minimize scarring, prevents infection
What post-surgical or discharge instructions include the folllowing
Activity restrictions, Diet restrictions, wound care, mediations
The MA should inform the patient if having any of these symptoms after a surgery are
- unusual pain or burning
- swelling/redness or other discoloration in the area
- bleeding or other drainage (unpleasant odor)
- Fever of 100° F or greater (37.7° C)
- Nausea and vomiting
What information is critical information is needed for an emergency situation
The patient’s name, contact information, and location, What the situation is and when did it start, the status of the patient - conscious, breathing, presence of pulse
How to recognize severe hypoglycemia (low blood glucose levels - an imbalance between insulin levels and blood glucose in the body)
Mild case: irritability, moodiness or change in behavior, hunger, sweating, and rapid heart rate.
Moderate to severe: fainting, seizures, confusion, headache, coma, and potentially death.
How to treat hypoglycemia
Patient needs to consume foods or liquid high in glucose
How to recognize hypovolemic shock (losing excessive amounts of body fluids or blood)
Thirst, muscle cramping, and lightheadedness—symptoms can progress to chest pain, confusion, lethargy, and death if left untreated.
How to treat hypovolemic shock
Control of blood loss, blood transfusion, and IV fluid replacement.
How to recognize hypothermia or frostbite (an abnormal lowering of body temperature, usually resulting from immersion in cold water or being stranded in subzero weather)
Frostbite includes redness and tingling. As damage progresses, the tissue becomes pale and numb.
- Signs and symptoms include shivering, numbness, confusion, paleness, and eventual loss of consciousness.
How to treat hypothermia or frostbite
Individual will need to be removed from cold temperatures. Remove any wet clothing. Cover the individual with a blanket. Provide any available warm/dry compresses and any warm beverages.
Death can result if not treated.
How to recognize an obstructed airway or choking
A patient who is choking usually places their hand at their throat. This is often called “conscious choking.” The patient may not be able to cough or speak.
How to treat an obstructed airway or choking
Abdominal thrusts are effective for forcing an obstruction for the airway for adults and children older than 1 year of age. A combination of chest thrusts and back slaps are effective for infants younger than 1 year old.
How to recognize Syncope or fainting
Pale, perspiring, and complain of nausea or dizziness.
How to treat syncope or fainting
Aromatic spirits of ammonia capsules, which can be easily broken and used to wake the patient. These should not be held directly under the patient’s nose but moved back and forth at least 6 inches away.
What are sprains?
A stretched or torn ligament, which are tissues that connect bones to a joint
What is a strain?
a stretched or torn muscle or tendon - caused by trauma of the tissue
What is a dislocation?
occurs when a bone end slips out of the socket or when the capsule surrounding a joint is stretched or torn –> constitutes an emergency
What is a fracture?
classified as open or closed (closed do not penetrate the skin, open does and require advanced care)
What is shock?
The response of the cardiovascular system to the presence of adrenaline, resulting in capillary constriction
What are signs of anaphylactic shock?
Early signs and symptoms of shock include pale and clammy skin, weakness, and restlessness. The pulse and respiratory rate are rapid, and vomiting can occur. Late signs of shock include apathy, unresponsiveness, dilated pupils, mottled skin, and loss of consciousness, the state of being alert and aware.
What to do when anaphylactic shock occurs?
If a patient is going into shock, emergency medical care is critical, and 911 should be contacted. Then, lay the patient down and elevate the legs and feet slightly, unless this can cause the patient pain or further injury, and try to keep the patient still. Continue monitoring the patient’s pulse regularly until emergency services arrive. If the patient stops breathing, begin CPR.
What to do during a seizure?
During the seizure, steps should be taken to prevent injury to the patient. Help them to the floor if they are sitting or standing. Do not try to restrain them. Move objects out of their way and turn them to the side to prevent aspiration or choking. After the seizure, or the postictal phase, the patient can be confused, complain of headache, and be exhausted. Allow the patient to rest.
What are signs of posioning?
Signs and symptoms of poisoning include discoloration or burns on the lips, unusual odor, emesis (vomiting), or presence of a suspicious container. Emergency care or 911 is needed if the patient presents as drowsy or unconscious, is having difficulty breathing or has stopped breathing, or is having seizures.While waiting for emergency care, try to remove any poison present on the patient, such as in the mouth, on the skin, or in the eye. Be cautious of aspiration or choking if the patient vomits and continue to monitor the patient’s vital signs in the case CPR is needed.
How to treat an open wound?
When applying or changing a dressing, the medical assistant should perform proper hand hygiene prior to donning sterile or nonsterile gloves. The use of sterile gloves is needed when performing a sterile dressing change. A surgical mask worn by the medical assistant can be recommended to avoid exposure of the wound to micro-organisms.
What are the four types of wound classification?
Abrasion / Scrape: outer layers of skin are rubbed away because of scraping; will generally heal without scarring.
Incision: smooth cut resulting from a surgical scalpel or sharp material, such as razor or glass; can result in excessive bleeding and scarring if deep.
Laceration: edges are torn in an irregular shape; can cause profuse bleeding and scarring.
Puncture: made by a sharp, pointed instrument such as a bullet, needle, nail, or splinter; external bleeding is usually minimal, but infection can occur because of penetration with a contaminated object, and there can be scarring.
What is arterial hemorrhaging?
Bright red, spurting blood, high pressure, potentially life-threatening
What is venous hemorrhaging?
Dark red, steady flow, less pressure
What is capillary hemorrhaging?
Minimal bleeding, small and steady flow, clots quickly
What is the first aid for treating a hemorrhage?
Apply pressure with sterile gauze
Elevate the site of bleeding
Use a tourniquet if necessary (with healthcare provider’s advice)
Clean and dress the wound after bleeding is controlled
How to clean and dress wounds?
Clean the wound with antiseptic cleanser (as advised by healthcare provider)
Apply sterile gloves and dressing
Avoid dragging the bandage to prevent introducing microorganisms
Secure the bandage with hypoallergenic tape
How to change bandages and dressings?
Cut the bandage material to the side of the wound and dressing
Remove the bandage without removing the dressing (if possible)
Soak stuck dressings in sterile saline or water before removal
Dispose of used materials in a biohazard waste container
What are the wound healing stages?
Inflammatory phase, proliferating phase, maturation phase
What is the inflammatory phase of the wound healing stages?
(3-4 days)
Pain, swelling, loss of function
Blood clot forms to stop bleeding
What is the proliferating phase of the wound healing stages?
(4-21 days)
Fibrin threads pull edges together
Cells multiply to repair the wound
Eschar or scab forms to keep out microorganisms
What is the maturation phase of wound healing stages?
(21 days-2 years)
Tissue cells strengthen and tighten the wound closure
Scar forms and eventually fades
What are some wound complications?
Infection: Signs of inflammation, swelling, purulent drainage, fever
Hemorrhage or bleeding
Dehiscence: Separation of wound edges
Evisceration: Separation of wound edges and protrusion of abdominal organs
What are the classifications of burns?
First-degree (superficial): Affects only outer layer of skin (epidermis)
Second-degree (partial-thickness): Breaks skin surface and injures underlying tissue (epidermis and dermis)
Third-degree (deep-thickness): Damages nerves and bones (all skin layers, nerves destroyed)
Fourth-degree (deep full-thickness): Goes through both skin layers and underlying tissue (extends down to muscle and bone)
How to treat burns?
Minor burns: Cool with running water, apply lotion, cover with bandage
Major burns: Seek emergency care, protect from further harm, cover with gauze or clean cloth, raise burned area
What are some key takeaways of wound care?
Dressings are sterile, bandages are nonsterile
Care must be taken not to bandage too tightly and restrict circulation
Wounds must be cleaned before applying a sterile dressing
Burns require prompt treatment to prevent infection and promote healing
If the blood is dark red and has a steady flow (caring for a hemorrhage?)
The site should be elevated, the site should be covered with a clean gauze, pressure should be exerted on the site
If a patient is having a seizure, what should the MA do?
move objects out of the way to prevent injury, help patient to the floor if standing, turn the patient to the side to prevent choking
What is an emergency action plan?
Identify patients with life-threatening conditions
Identify when and who should contact emergency medical services
Location of fire extinguishers and emergency evacuation routes
Identify individual to prepare equipment and supplies for provider
What should be in an emergency kit?
Contains supplies needed during an emergency
Can be a crash cart, bag, or container
Many kits can be purchased with necessary items
States have specific requirements for emergency kits
Health care provider can determine items and emergency medication to include
What equipment and medication should the clinic have in case of emergency situations?
Surgical instruments (forceps, oxygen supply, airway and suction device, ambu-bag, heart monitor-defibrillator)
Emergency medications (epinephrine auto-injector, naloxone, morphine, nitroglycerin, albuterol nebulizer, lidocaine, atropine, normal saline, prochlorperazine suppositories)
Automated external defibrillators (AEDs)
Electrodes for AEDs
What should the MAs do for maintenance and training for emergency situations?
Check emergency kit regularly (once a month)
Maintain contents of kit
Create process for restocking, conducting inventory, and replacing contents
Check expiration dates on medications
Remove and replace expired medications
Check defibrillation pads on AED or defibrillator for expiration date
Check battery charge on monitor and/or AED
Document checks
Train all staff members on emergency preparedness and response
Conduct emergency simulation drills to practice emergency protocol and individual lifesaving skills
What are the symptoms of a myocardial infarction (MI)?
Chest pain, heaviness, or discomfort in the center or left side of the chest
Pain or discomfort in one or both arms, the back, shoulders, neck, or jaw or above the belly button
Shortness of breath when resting or doing a little bit of physical activity
Excessive sweating for no reason
Feeling unusually tired for no reason, sometimes for days
Nausea (feeling sick to the stomach) and vomiting
Light-headedness or sudden dizziness
Rapid or irregular heartbeat
Why is a myocardial infarction (MI) a medical emergency?
Because it involves blocked blood flow to the heart, leading to oxygen deprivation and potential heart muscle death.
Why does cardiac arrest require immediate intervention?
Because it causes blood flow to vital organs to stop, leading to rapid death if untreated.
Why is it crucial to check for a pulse and breathing during a suspected cardiac arrest?
To confirm the heart has stopped and determine the need for CPR and AED use.
Why is it important to clear the area around a patient when using an AED?
To prevent interference with the AED’s readings and to avoid accidental shocks to others.
Why are chest compressions performed during CPR?
To manually circulate blood when the heart is unable to do so.
How do you recognize the symptoms of a myocardial infarction (MI)?
Look for chest pain, shortness of breath, sweating, nausea, dizziness, rapid/irregular heartbeat
How do you activate the emergency response team in a medical setting?
Follow the established protocol of the medical facility, usually by calling a specific emergency number or code.
How do you assess a patient for cardiac arrest?
Check for unresponsiveness, absence of breathing, and lack of a pulse.
How do you use an automated external defibrillator (AED)?
Follow the device’s voice prompts, attach electrodes to the patient’s chest, and deliver shocks as directed.
How do you perform chest compressions during CPR?
Place the heel of one hand on the center of the chest, interlock fingers, and compress the chest 30 times at the correct depth and rate.
How do you perform rescue breaths during CPR?
Use the head-tilt, chin-lift method to open the airway, pinch the nose, and deliver two breaths, ensuring the chest rises.
How do you position a patient who has recovered from cardiac arrest but has no spinal injuries?
Turn the patient onto their side.
What are the steps of performing CPR?
- Give 30 chest compressions
- Tilt the head back
- Pinch the nose
- Give two slow breaths mouth-to-mouth
- Continue giving sets of 30 chest compressions and two breaths
Why is it important to define Durable Medical Equipment (DME)?
To ensure patients receive necessary, reusable medical devices and supplies for home use.
Why does DMEPOS need to primarily serve a medical purpose?
To distinguish it from general household items or recreational equipment.
Why must DMEPOS be prescribed or ordered by a healthcare provider?
To ensure medical necessity and appropriate use for the patient’s condition.
Why is the expected lifetime of at least three years a requirement for DMEPOS?
To ensure the equipment is durable and reusable, justifying its classification as “durable.”
Why is it important to document the patient’s diagnosis and medical necessity for DMEPOS?
For insurance reimbursement and to provide evidence of appropriate medical care.
How do you determine if a medical device qualifies as DMEPOS?
By verifying that it meets all the criteria: medical purpose, prescription, repeated use, long lifespan, home use, and injury/disability relevance.
How does a medical assistant assist with DMEPOS in a medical office?
By helping the healthcare provider with the devices and providing patient education and support.
How would a medical assistant teach a patient to use crutches or a cane?
By demonstrating proper use, explaining safety precautions, and allowing the patient to practice.
How does a medical office bill patients or insurance companies for DMEPOS?
If the medical office purchased the item, they can bill for it, provided they have the correct documentation.
How does a healthcare provider document the need for DMEPOS?
By recording the patient’s diagnosis, the specific DMEPOS prescribed, and the medical necessity for its use in the patient’s medical record.
How do you define DMEPOS?
Durable medical equipment, prosthetics, orthotics, and supplies.
What are DMEPOS that requires a prior authorization?
power wheelchairs, powered air flotation beds, powered pressure-reducing air mattresses and more
What would qualify an item as a DMEPOS?
prescribed by a heath care provider, can be repeatedly used, used by a patient with a disability
What type of wound closure would an MA use for an incision under high tension?
Staples
Which steps should the MA take to ensure an instrument packet is sterile?
All instrument packets must show indication of being autoclaved using an indicator strip or autoclave tape that has darkened lines & expiration date
Which wound complication would cause the edge of the wound to separate?
Dehiscence
If a patient collapses and is unresponsive, what’s the first step an MA should take?
Check the patient’s pulse and breathing
If a provider requests additional forceps during a surgical procedure, what should the MA do?
The sterile forceps should be dropped into the sterile field without touching the drape on the Mayo stand
What is the proper technique for removing surgical staples?
To use the sterile staple remover, place the lower tip under the staple and squeeze the handle together until completely closed. This will bend the staple in the middle and pull the edges of the staple out of the skin.
Prior to notifying the provider, which steps should the MA take with a patient who has a deep cut on their arm?
One of the first steps with a deep cut is to control the bleeding by applying pressure to the wound and elevating it
What area is considered sterile?
The Mayo stand should be at least 12 inches away from someone’s body to maintain sterility
If a patient exhibits pale and clammy skin, rapid pulse and respirations, and patient becomes weak and becomes unresponsive with dilated pupils - what does the patient have?
The patient is most likely going into shock and displays the early and late stages of the signs and symptoms
