Module 5 - General Patient Care 2 Flashcards
Surgical Asepsis
- requires surgical handwashing or scrub, sterile gloves, and sterile technique when handling materials.
- Techniques to eliminate pathogenic and other potentially harmful microbes related to invasive procedures.
sterile field
rea free of micro-organisms and is used as a work area during a surgical procedure.
What the primary method of sterilization of instruments and equipment
Autoclaving, the process of using high-temperature steam to kill any micro-organisms.
How to know if an item was properly autoclaved?
- check for the sterilization indicator and confirm the date
- sterilization indicator should show a change of color
A border of at least ___ inch around the sterile drape is considered nonsterile
1
Biopsy
- The surgical removal of tissue for later microscopic examination.
- to Diagnose cancer, skin conditions, or other diseases of the body
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.
- To Evaluate a patient having stomach pain, difficulty swallowing, gastrointestinal bleeding, diarrhea or constipation, and colon polyps.
Colposcopy
- Examination of the vagina and cervix performed using a colposcope, which is a specialized type of endoscope
- To Examine abnormal tissue development during a routine pelvic examination, when a Papanicolaou (Pap) smear result is abnormal, and to obtain a biopsy specimen.
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 (cyst, wart, mole)
Conduct further examination of the growth, prevent future growth.
Cryosurgery
- Procedure using local application of intense cold liquid or a cryoprobe to destroy unwanted tissue.
- used to destroy abnormal cells and tissues, and as a treatment of cervical erosion and chronic cervicitis
Incision and drainage (I & D)
- Lancing a pressure buildup caused by pus or other fluid under the skin.
- performed to relieve the buildup of purulent (pus) material as a result of infection, such as from an abscess.
- discharge can be cultured to determine what micro-organism is causing the infection and what antibiotic would be effective in treating it.
types of wound closure materials
sutures, surgical staples, skin closure tapes, and adhesives
Absorption of absorbable sutures occurs how many days after insertion ?
5-20 days
when should nonabsorbable sutures be removed?
5-6 days
the more 0s, the smaller or thicker the gauge of a suture material?
smaller
Which suture is thicker between 0 and 6-0 (000000)
0
Delicate tissue, such as areas on the face and neck, would be sutured with what suture sizes?
5-0 to 6-0 because these finer sutures would leave less scarring.
Heavier sutures, such as 2-0, would be used for what?
the chest or abdomen
Staples allow for the closure of wounds under which high tension areas of the body
trunk, extremities, and scalp
Using a specialized set of extractors, staples need to be removed within how many days?
4-14 days
In which instances are skin adhesives used instead of sutures?
when not much tension will be applied to a wound, such as on a small facial cut.
Which wounds will usually need soaking with saline prior to removal of the sutures or staples
Wounds with crusting blood or exudate
What do you inspect prior to performing a suture and staple removal?
absence or presence of drainage
What do you use to cleanse the skin prior to performing a suture and staple removal?
alcohol or povidone-iodine (betadine) solution
Where do you cut the suture with scissors?
below the knot and as close to the skin as possible
What do you do if there is gaping, bleeding, or presence of an exudate when performing a suture and staple removal?
stop and notify the health care provider
What can be used to provide reinforcement of the wound after removal of the sutures or staples depending on the condition and location of the wound.
Butterfly closures
What are some instructions that a patient may need for wound care at home?
- Activity restrictions: includes bathing and exercising.
- Diet restrictions: in cases of abdominal pain, diarrhea, or vomiting, a liquid diet with progress as tolerated.
- Wound care: changing the dressing, applying medications to the wound, and observing for signs of infection.
- Medications: If the patient has an rx for antibiotics, instruct the patient on how and when to take the medication, how it should be stored, and possible side effects.
In which cases should a pt notify the HCP of postop problems?
- Unusual pain or burning
- Swelling, redness, or other discoloration in the area
- Bleeding or other drainage, including unpleasant odor
- Fever of 100° F or greater (37.7° C)
* Nausea and vomiting
What is the ‘golden hour’ in emergency/critical situations?
the first 4 hours
The MA’s first step in an emergency situation on the phone is to ….
obtain critical information including
- 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
emergency medical services (EMS)
System that provides urgent pre-hospital treatment and care.
Severe hypoglycemia
- Description
- Signs
- treatment
D: can occur when there is an imbalance between insulin levels and blood glucose in the body.
S: mild - irritability, moodiness or change in behavior, hunger, sweating, and rapid HR.
moderate - fainting, seizures, confusion, headache, coma, and death
T: consuming foods or liquid high in glucose for mild cases and glucagon for severe cases
hypovolemic shock
- Description
- Signs
- treatment
D: when a pt loses an excessive amount of body fluids or blood. Can result from internal or external hemorrhaging, prolonged vomiting or diarrhea, or severe dehydration
S: Thirst, muscle cramping, and lightheadedness
T: Control of blood loss, blood transfusion, and IV fluid replacement.
heat stroke
- Description
- Signs
- treatment
d: body temperature varies too much over its normal range.
S: Muscle cramping or death
T: pt needs to be removed from warm temperatures. Apply any available cold compresses such as ice pack
Hypothermia
- Description
- Signs
- treatment
D: occurs when the skin and tissue are exposed to freezing temperatures. Tissues of the nose, ears, fingers, and toes are the most susceptible.
S: shivering, numbness, confusion, paleness, and eventual loss of consciousness.
T: remove pt from cold temp. Remove wet clothes, Cover the individual with a blanket.
Syncope
- Description
- Signs
- treatment
D: brief episode of unconsciousness
S: Pale, perspiring, and complain of nausea or dizziness.
T: Aromatic spirits of ammonia capsules
Difference bw sprain and strain
- Sprains are caused by a stretched or torn ligament
- A strain is a stretched or torn muscle or tendon
How can you get a sprain
Falling, twisting, or landing on an uneven surface
How can you get a strain
Trauma to the tissue, such as excessive twisting or pulling these tissues
What are the Treatment of both sprains and strains?
resting and elevating the injured area, applying cold compresses, wearing a bandage or brace, and the use of anti-inflammatory medications.
Dislocation treatment
manipulations to reposition the bones, medication, a splint or sling, and rehabilitation.
Difference between closed and open fractures
- Closed, fractures do not penetrate the skin.
- In open fractures, the bone breaks through the skin and is exposed
What is Shock
The response of the cardiovascular system to the presence of adrenaline, resulting in capillary constriction
- causes inadequate circulation of blood to the body tissues, lowered blood pressure, and decreased kidney function
Hemorrhage
Escape of blood from a rupture blood vessel
Early signs and symptoms of anaphylactic shock include
- pale and clammy skin, weakness, and restlessness
- HR & RR are rapid
- apathy, unresponsiveness, dilated pupils, mottled skin, and loss of consciousness in late signs
seizures can be caused by
high body temperature, head injuries, drugs, and epilepsy
How can someone be poisoned?
ingested, inhaled, absorbed, injected, or obtained by radiation
Signs and symptoms of poisoning include
discoloration or burns on the lips, unusual odor, emesis (vomiting), or presence of a suspicious container.
4 types of wound classifications
- Abrasion: outer layers of skin are rubbed away because of scraping; generally heals without scarring.
- Incision: smooth cut resulting from a surgical scalpel or sharp material; can result in excessive bleeding and scarring
- 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.
three types of hemorrhaging based on the blood vessels affected:
- arterial; most severe and urgent type of bleeding. Bright red and high pressure. put pressure on the wound with gauze and elevate
- venous; steady flow of dark red blood. put pressure on the wound with gauze and elevate
- capillary; bleeding is minimal. clot on its own within minutes.
How to clean a wound
- Cleanse the center of the incision line or wound from the top to the bottom and discard swab. Repeat this step for both sides of the wound
- Don sterile gloves and use sterile dressing
- Wrap bandage material over wound and securely fasten the bandage with hypoallergenic tape and check circulation
3 phases of wound healing
- Inflammatory phase (3 to 4 days): Marked by pain, swelling, and loss of function at the site of the wound. blood clot formation
- Proliferating phase (4 to 21 days): Fibrin threads extend across the opening of a wound and pull edges together; cells multiply to repair the wound
- Maturation phase (21 days to 2 years): Tissue cells strengthen and tighten the wound closure, forming a scar
Signs of inflammation are
redness (erythema), swelling, warmth, and pain
Different types of burn
- first-degree (superficial) burn affects only the outer layer of skin tissue
- second-degree (partial-thickness) burn is one that breaks the surface of the skin and injures the underlying tissue
- third-degree (deep-thickness) burn is deep enough to damage the nerves and bones.
- fourth-degree (deep full-thickness) burn goes through both layers of the skin and underlying tissue as well as deeper tissue, possibly involving muscle and bone.
Most emergency kits contain what?
forceps; an oxygen supply; AED; an airway and suction device; an ambu-bag; a heart monitor-defibrillator; and emergency medications.
emergency medications in a crash cart
Epinephrine auto-injector: treatment for anaphylactic shock
Naloxone: rapidly reverses an opioid overdose
Morphine: treatment for pain
Nitroglycerin, sublingual or spray: treatment for chest pain
Albuterol nebulizer: treatment for difficulty breathing, shortness of breath, wheezing
Lidocaine: to treat or prevent localized pain
Atropine: treatment for bradycardia
Normal saline for IV administration: treatment for dehydration
Prochlorperazine suppositories: for nausea and vomiting
common symptoms of a myocardial infarction
- Chest pain
- Pain or discomfort in one or both arms, the back, shoulders, neck, or jaw or above the belly button
- Shortness of breath
- Excessive sweating
- Feeling unusually tired for no reason
- Nausea and vomiting
- Light-headedness or sudden dizziness
- Rapid or irregular heartbeat
What to do if someone has a myocardial infarction
Check for breathing and a pulse. Palpate for a pulse for no more than 10 seconds. If there is no pulse, use an AED. If an AED is not available, cardiopulmonary resuscitation (CPR) should be initiated.
durable medical equipment
Includes medical devices and supplies that can be used repeatedly outside of a hospital.
most common examples of durable medical equipment used outside of a hospital
dialysis machines, continuous positive airway pressure (CPAP) machines, oxygen concentrators and ventilators, orthotics and prostheses
Difference between a remittent fever and intermittent fever.
- r: fluctuates above normal temp but does not return to normal
- I: fever that comes and goes but does return to normal body temp in bw spikes
Difference bw palliate care and hospice care
- p: symptom management for chronic non-terminal patients
- h: symptom management for terminal illness
Symptoms of congestive heart failur
- edema (swelling) - mostly lower leg
- Fatigue
- Shortness of breath
underweight BMI
less than 18.5
normal BMI
18.5-24.9
Overweight BMI
25-29.9
Obese BMI
30 or more
