Mod 3: Gen Pt Care 1 (56%) Flashcards
dermal punch biopsies, dermal cutter, scalpel, gauze, Incision and drainage tray, and specimen collection swabs & containers are most likely used in
dermatology
3 channel EKG, electrodes, EKG paper, and a holter monitor are most commonly used in
cardiology
glucometers, alcohol pads, adhesive strips, test strips, and lancets are most likely found in
endocrinology
otoscope, ophthalmoscope, percussion hammer, penlight, tuning fork, safety pin, small vials containing hot & cold liquids, vials w/different scents & tasting liquids, and cotton balls are most likely found in
neurology
vaginal speculums & retractors, cytology kits, stitch removal sets, dressing kits, ultrasound, and fetal doppler machine are most likely found in
OB/GYN
a peak flow meter spirometry machine, and disposable mouthpieces and nose clips are most likely found in
pulmonology
this position relieves strain on lower back and relaxes the abdominal muscles. it is used to inspect the head/neck/chest/vagina/rectal/perineal areas and for digital vagina and rectal exams
dorsal recumbent
this position is used for exams of the head/neck/upper body, for those with breathing difficulties, or eating
Fowler’s
this position is used for postsurgical exams, breathing difficulties, lower back injuries
semi-fowler’s
aka: left lateral
lateral semi-prone recumbent or sims
this position is used for rectal exams/temperatures, enemas, perineal & pelvic exams
left lateral
this position is used for proctologic exams, sigmoidoscopy procedures, and rectal & vaginal exams
knee-chest
aka: nonparenteral
enteral
define parenteral
non-oral; does not go through GI
what is the difference between transdermal and topical meds
transdermals are generally administered via patch for slow release and topical usually comes in creams/ointments/emulsions for faster release
list the times the medication should be checked with the order
- when collecting meds
- when preparing meds
- when putting meds back
list the original rights of medication administration
pt, medication, form, dose, route, time, and technique
what are the 2 additional rights of medication administration
education and documentation
proper documentation of medication administration should include these elements
date, time, quantity, medication, strength, lot number, manufacturer, expiration date, consent obtained and pt outcome
aka eye instillation
ocular/ophthalmic administration
describe how to provide an eye instillation
- use nondominant hand to gently pull down lower lid with thumb or 2 fingers
- gently rest dominant hand on pt forehead while administering
- release the lid and ask pt to close eyes and blot away any meds w/tissue
how should an eye drop be dispensed
about 1/2 inch above sac
how should eye cream/ointment be administered
even thick ribbon along inside edge of lower lid on conjunctiva moving from medial to lateral
describe how to perform an ear instillation
- pt lies on side w/affected ear up
- hold applicator 1/2 inch above ear canal and administer
- have pt remain in position at least 5 min
t/f: anaphylaxis may occur hours after exposure to allergen
true
when performing an ear instillation for a child, how should you adjust the auricle of the ear?
pull auricle outward and down
after administrating epinephrine to a person experiencing anaphylaxis, what should be done
massage injection site and call 911
what should be asked and documented regarding medication allergies
- name of suspected meds (rx & otc)
- timeframe of reaction from initiation
- strength & formulation
- description of reaction
- indication for meds being taken
- number of doses taken/days before reaction
- route of administration
how long should a pt wait after receiving a medication to observe any adverse reactions
20-30 min
how long should the epipen stay in the thigh upon injection
at least 10 seconds
all instruments and equipment that penetrate skin/enter body/come in contact with other normally sterile bodies of body need to undergo
sterilization
what are the 3 categories of reusable medical devices
- critical
- semi critical
- non critical
define critical devices
reusable medical devices that come in contact w/blood or normally sterile tissue
define semi-critical devices
reusable medical devices that come in contact w/mucus membranes
define non-critical devices
reusable medical devices that come in contact w/unbroken skin
t/f: needles have an expiration date that need to checked
true
how many mL is 1 cc
1
the higher the gauge the
smaller the lumen
what common medications are injected via subQ
insulin, heparin, immunizations, allergy medications
subQ injections are generally less than
1.5 mL
list subQ injection sites
- upper outer arm
- abdomen
- upper thigh
- scapula
- lower back/upper buttocks
describe the process of injecting subQ
pinch at least 1 in of skin and inject below it at a 45 degree angle
list ID injection sites
mid forearm, upper chest under clavicles, scapulas
what is the max amount of medication injection in an ID
0.1 mL
common medications injected via IM are
- antibiotics
- hormones
- vaccines
common IM sites are
- deltoid
- ventrogluteal
- dorsogluteal
- vastus lateralis
the deltoid can only hold
1 mL medication
deltoid IMs should be avoided for pts younger than
3
what is the preferred injection site for oily and irritating solutions
ventrogluteal
the ventrogluteal IM site can hold
up to 3 mL medication
what needle gauges should be used for subQ
23-25
what needle length should be used for subQ
5/8 in
what needle gauge should be used for ID injections
25-27 G
what needle length should be used for ID injections
3/4 to 1/2 in
what needle gauge should be used for IM injections
22-25 G
what needle length should be used for IM injections
1-1 1/2 in
this medication is generally supplied in 30-, 50-. or 100- unit measurements
insulin
from most to least, what sites absorb insulin the fastest
abdomen, arms, thighs, and buttocks
providers should be notified immediately if pts experience any of these after receiving an injection
- severe pain at site
- tingling/numbness
- redness/swelling/warmth at site
- prolonged bleeding
- signs of allergic reaction
should air be injected into a vial before drawing medication
yes
t/f: inject air, invert vial, withdraw meds
true
what is the purpose of a filter needle
prevent withdrawal of lass or rubber particulate especially from ampule
when drawing from an ampule, what should be prevented
prevent shaft and tip of needle from touching rim of ampule
these syringes generally vary from 0.5-60 mL
hypodermic
these syringes generally vary from 0.5-1 mL
tuberculin
100 units from an insulin syringe is equal to
1 mL
t/f: insulin syringes do not have detachable needles
true
define controlled substance
any medication that has the potential for abuse or addiction
refrigerated medication should be stored at
between 2-8 C (35-46 F)
frozen medications should be stored at
-50 to -15 C (-58-5 F)
how may medications be stored
alphabetically or by classification
define MEDICATION ADMINISTRATION RECORD
report serving as legal record of medications administered to pt
the MAR should include
- medication name
- dose
- date and time
- route administered
- special instructions
- any reaction to medication
- name of prescribing provider
define TRANSCRIBING
taking info from order and transferring it to the MAR
medications stored at room temp should be kept at
20-25 C (68-77 F)
in addition to the elements required on all prescriptions, electronically generated ones must have
- DEA # of prescribing provider if it is a controlled substance
- phone number of provider
- time and date of transmission
- name of pharmacy sent to
define SPECIALTY PHARMACIES
pharmacies that provide medications not commonly found in community/retail pharmacies for more complex, chronic, and rare health conditions
list all the subsections of a pt medical record
- demographic
- health history
- physical exam
- allergies
- medication record
- problem list
- administrative data
- correspondence
- schedule/financial/billing info
- progress notes
- lab data
- diagnostic procedures
- continuity of care
what is the difference between EMR and EHR
- EMR is an electronic pt medical history
- EHR has the EMR and can be incorporated across more than 1 health care organization
define INCIDENCE
new cases
define PREVALENCE
existing cases
define COMPUTERIZED PROVIDER ORDER ENTRY (CPOE) system
electronic process allowing provider to enter medical orders electronically into system
what is the benefit of a clinical decision support system (CDSS)
enhance decisions with targeted clinical knowledge & pt information such as checking for medication interactions/allergies/errors
t/f: a CPOE can correct misplaced decimals
false
what is the difference between telemedicine and telehealth
- telemedicine includes online health care provider & remote service visits
- telehealth is more expansive and includes non-pt, non-clinical services, and education