Module 9: General Patient Care Flashcards
Proper Idenification
Patient state their full name and date of birth
Personal Protective Equipment
PPE
barrier equipment used to prevent exposure to blood and other body fluids
gloves, goggles, masks
Active Listening
using techniques that allow the receiver to fully undrstand the message being communicated
Open-Ended Questions
questions that lead to further explanation
vs. a yes or no response
Restatement
repeating or paraphrasing information relayed by sender to confirm accuracy
Reflection
when the receiver focuses on the main idea of the message bit incorporates feelings the sender might be exhibiting or possibly feeling
Clarification
summarizing the information relayed by the sender to clear up any confusion
Nonverbal Communication
gestures and actions that leave interpretation up to the receiver
Chief Complaint
reason for the office visit
Subjective Information
information that is personal or what someone is feeling
Objective Information
information collected that is observed by someone other than the patient
Audiometry
test to determine level of hearing
Visual Acuity Testing
use of tools such as a Snellen chart to screen for visual impairments
Urinalysis
screening tool that evaluates the urine for the presence of dissolved substances/assists with diagnosis
Anthropometric Measurements
screening test that include height/weight
circumference of head for infants
Vital Signs
cardinal signs
temp, heart rate, resprations, blood pressure
Denver Developmental Screening Test
series of activities used to determine the developmenal stage of children
Mini-Mental State Exam
tool used to determine the level of awareness of current events and recall of past events to screen for orientation or dementia
Systolic Pressure
first sound heard during BP
Diastolic Pressure
last sound heard during BP
Korotkoff Sounds
5 phases of articular relaxation that are audible while obtaining a manual BP
140/90 over is hypertension
Fowler’s
90 degree
exams of eyes, ears, nose, throat, chest
Semi-Fowler’s
45 degree
exams chest or shortness of breath
Sims
lateral
exams involving rectum, enemas
laying on left side with LL flex/RL at 90*
Knee-Chest
gynecological or rectal exams
treatments of spinal adjustments
prone/bent at the waist resting knees with arms above head
Jack-Knife
rectal exams or instrumentation
lying over exam table that is lifited in middle
Lithotomy
femal pelvic exam
lying flat on table with butt at end of table/feet rsting in stirrups
Dorsal Recumbent
catheterizations, genital exam of younger kids, adolescents
lying flat on back with knees bent
Prone
exams involving back of body including bottoms of feet
lying flat on abs with arms above head
Supine
exams involving front of body
CPR
lying flat on back with arms down to side
Trendelenburg/Modified
SHOCK
legs elevated above head to corce circulation to vital organs
Instruments for General Exam
Ophthalmoscope
Otoscope
Stethoscope
Needle
Intradermal
ID
Gauge: 27 to 28
Length: 3/8 inch
Needle
Subcutaneous
SC
Gauge: 25 to 26
Length: 1/2, 5/8 inch
Needle
Intramuscular
IM
Gauge: 20 to 23
Length: 1 to 3 inch
many adult/older children vaccines are given via route
Deltoid Muscle
intramuscular injection site (IM)
DO NOT USE SITE FOR YOUNGER THAN 3
90* angle
DO NOT aspirate vaccines
2 to 3 mL
1 to 2 inch below acromion, DOSAGE NEVER OVER 1mL
apirate most other types of meds administered via route
Ventrogluteal Muscle
intramuscular injection site (IM)
located by placing heel of hand on (right hand placed on right hip) middle finger placed on iliac crest then spread, give injection where V is made
90* angle
DO NOT aspirate vaccines
site used for deep injections are prescribed or larger quanities of meds are needed
good for viscous meds
Ventrogluteal Muscle
intramuscular injection site (IM)
located by placing heel of hand on (right hand placed on right hip) middle finger placed on iliac crest then spread, give injection where V is made
90* angle
DO NOT aspirate vaccines
site used for deep injections are prescribed or larger quanities of meds are needed
good for viscous meds
Vastus Lateralis Muscle
intramuscular injection site (IM)
administration locations in Mid to Upper thigh
90*angle
Do NOT ASPIRATE VACCINES
use site for vaccines/meds administration for infants/children younger than 3
Subcutaneous
Subcutaneous/Intradermal Injection SQ,ID
insulin or heparin
45* angle
Sites should be rotated
upper outer arm, abdomen, thigh
Intradermal
Subcutaneous/Intradermal Injection SQ,ID
10* to 15* angle
used for testing, common site for TB testing mid forearm
Oral
in the mouth
solids: multiple dose bottles, por pills into lid first then med cup
liquid: read lowest point of curve (meniscus) and palm the label to prevent distortion of med drip down bottle
Buccal
eating, drinking, smoking influence absorption
between cheek and gums rapid absorption
meds bypasses the digestive system, resulting in smaller doses
DO NOT CHEW OR SWALLOW
meds designed to melt while held in cheek area
Sublinqual
under tongue, nitroglyerin tablets/spray common for of meds
med bypasses digestive system, smaller doses
solids: meds melt/absorbs into bloodstream
liquids: spray are used to deliver
Inhalation
typically used for targeted areas such as bronchial passages
delivered via nebulizer
meds to be effective, must hold meds in lungs as long as possible
inhalers, or nebulizers, patients can tend to be shaky, dizzy
Topical
designed to react locally/systematic absorption in mini
serve barrier to prevent irritants from damage the skin or used to treat skin
monitor for skin irritation or reaction
Mucosal
designed absorb into/through mucous membranes
vagina, rectum, eye, ear, nose
Transdermal
slow absorption of meds
used for quitting smoking, pain meds, hormone delivery
avoid touching meds when applying, dispose of patch where children can’t get, monitor skin for irritation, rotate sites
Abrasion
scrape or rub
superficial wound often affecting
(knee, elbows)
apply pressure if bleeding, clean/flush debris, apply bandage
Incision
open injury typically caused by sharp object causing straight cut
bleeding can be profuse
apply pressure until bleeding controlled, clean gently, apply bandage
Laceration
open injury that is jagged in nature and caused by a sharp object
bleeding can be profuse
apply pressure until bleeding controlled, clean gently, apply bandage
Puncture
open wound that is caused by an instrument that deliver a stab
usually small with limited bleeding
apply pressure, clean to remove debris, apply bandage
Contusion
closed injury, also known as bruise
caused by a blunt-force trauma
ranges in severity based on the trauma received/location
apply cold pack or ice, elevate limb if affected, observe for signs of increased intracranial pressure if head contused
Concussion
closed head trauma in which the brain has been jolted/shaken
meaure vital signs, observation, provider asessment/possible computed tomography scan (CT)
Strain
stretching/tearing of a muscle/tendon that connects a muscle
RICE
Sprain
stretching/tearing of ligament
RICE
Fracture
break bone, open fracture: skin is broken, closed fracture: no break in skin
control bleeding, immobilize area, apply ice, check pulse, treat for shock
Anaphylaxis
severe allergic reaction where circulatory shutdown/respiratory distress results in shock
extreme emergency provide life support, give oxygen, epinephrine call 911
Acute Abdominal Pain
general symptom that can be life threatening
obtain detail CC, keep them warm, NPO,
Bleeding Emergencies
occur intern/extern, amount depends on blood supply
arterial bleeding is more crisis than capillary
apply pressure, elevate site, apply ice, limit movement, keep quiet,
Burns
severity based on location
first: sunburn
second: blister
third: dry/charred
electrical, chemical, thermal
remove patient, flush with cool water, DO NOT remove clothes unless chemical burns,
Rule of Nines
head: 9%
arms: 9%
body: 18%
genitals: 1%
legs: 18%
cryosurgery
process of exposing tissue to extreme cold temp to destory cells
may be performed for warts or cervical dysplasia
canister w liquid nitro, cryoprobe
provide instructions, assist
colposcopy/hysteroscopy
using instrument to inspect vagnial, cervix, uterus
cryosurgery, conization, biopsies
colposcope/hysteroscope exam stirrus
electrosurgery or elctroauterization
stop bleeding, destroy small polys, break scar tissue
foot pedal, grounding cable, pad
inspect pad/cable,
toenail removal/ingrown treatment
sterile scissors/forceps/hemostats/anesthetic
endoscopy
small tube w/ camera in gastro system
gastroscope, laparoscope, hyterscope
mole or cyst removal
moles change color, size evalute for cancer
local anesthetic, scalpekl,m or punch device, suture supplies
SOAP note
subjective, objective, assessment, plan
most commom pulse sites
radial-located on wrist
brachial-inside upper arm
carotid-neck
5 phase of Korokoff Sound
- systolic pressure, first sharp sound
- swishing sound blood flows thru artery
- sharp tapping as more blood surges
- sound chnages to soft then muffles
- diastolic pressure last sound