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Patient Care I > patient care exam 1 > Flashcards

patient care exam 1 Flashcards

1
Q

what elements are required for the chain of infection?

A
  • source of infection (reservoir) such as fomites, air, and water
  • susceptible host with portal of entry that can be entered and is exposed to enough of virulent organisms to become infected
  • mode of transmissions from source/ reservoir
    NOTE - infection control strategies intend to break a link in the chain
    NOTE - pathogens associated with healthcare infections are derived primarily from human sources
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2
Q

what are the three various modes of transmission of pathogens?

A
  • direct contact = transmission occurs between individuals (via broken skin or mucosal contact)
  • indirect contact = transmission between individuals via a contaminated person, object, or surface (surface or dirty instruments)
  • respiration = inhalation of droplet nuclei (airborne transmission)
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3
Q

what is the term used to describe the ability to infect and damage? characteristics include easily colonizes, grows rapidly, produces harmful substances, evades/ counters body’s defenses

A

virulence

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4
Q

what are the ways that resistance cam be acquired?

A
  • innate - physical, mechanical, and chemical
  • acquired - cell-mediated through antibodies
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5
Q

what is the term used to describe resistance to a disease through preventing development of a pathogen?

A

immunity

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6
Q

what stage of an infection is characterized by when exposure to a pathogen occurs to when symptoms appear?

A

incubation

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7
Q

what stage of an infection is characterized by the period between the appearance of initial symptoms and before full development?

A

prodromal

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8
Q

what stage of an infection is characterized by the signs and symptoms of the disease being most obvious, specific and severe?

A

acute, period of illness

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9
Q

during what stage of an infection number do the number of pathogens begin to decrease, the signs/ symptoms of illness decline, and patients may become susceptible to developing secondary infections due to weakened immune systems?

A

convalescent or decline

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10
Q

what is the term used to describe the process of physical cleaning to reduce quantity of microbes and bioburden via disinfectant and paper towel, soap and brush, ultrasonic instruments?

A

sanitization
NOTE - THIS IS DONE PRIOR TO STERILIZATION AND DISINFECTION

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11
Q

what is the term used to describe the process of killing ALL microbial forms including spores via heat, filtration, radiation, chemicals?

A

sterilization
NOTE - most common in dental office is steam under pressure or dry heat - CONVEYS ABSOLUTE MEANING

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12
Q

what is the term is used to describe the cleaning process applicable to living tissue, mucous membranes. this should stop or slow microorganism growth (alcohol to coagulate protein in bacteria, 30% with water will penetrate bacteria and is more effective than 100%)

A

antiseptics (alcohol pads)

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13
Q

what is the term is used to describe the cleaning process that kills less than sterilization (no spores killed, or resistant microorganisms). it can be used on inanimate objects or surfaces (this is what we try to do to our cubicles)?

A

disinfection
NOTE - not used for tissue = toxic for skin

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14
Q

what level of disinfectant is used to kill all pathogens not all spores, requires 3-10 hours of contact (chemical sterilant), and is only used on objects – medical items, endoscope, not in dentistry, not environmental surfaces?

A

high-level disinfectant

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15
Q

what level of disinfectant is used to at UMKC in operatories to kill TB, most viruses, fungi, vegetative bacteria, NOT spores, “tuberculocidal disinfectants” (CaviCide)?

A

intermediate level disinfectant

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16
Q

what level of disinfectant is used (dual quaternaries). alcohol – bad for surfaces and instruments, doesn’t kill spores, quick evaporation, and doesn’t work with blood or saliva?

A

surface disinfectants

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17
Q

what level of disinfectant is used to kill most vegetative bacteria, some viruses and fungi (used on floors and walls of dental setting and housecleaning)

A

low-level disinfectant

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18
Q

what does Spaulding’s classification system describe?

A

categorizes patient care items by their potential risk of infection

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19
Q

what level of Spaulding’s classification system describes those that can penetrate hard and soft tissues, vascular damage? (high risk = sharp dental and surgical instruments, including burs) - these should be sterilized if heat tolerant

A

critical items

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20
Q

what level of Spaulding’s classification system describes items that contact but do not penetrate (non-sharp items that enter the oral cavity) examples include - amalgam condensers, mirrors, reusable impression trays
- if heat tolerant they must be heat sterilized – includes hand pieces
- if not heat tolerant – high level disinfect

A

semi-critical items

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21
Q

what level of Spaulding’s classification system describes items that don’t enter the mouth, but are touched and contact skin, basically all surfaces we clean in the operatory, disinfect or plastic wrap

A

non-critical items

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22
Q

what type of control describes the policies, procedures, and enforcement measures that reduce risk of occupational exposure to infectious persons (postponing non-emergency treatment or passing sharp instruments correctly)

A

administrativecontrols

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23
Q

what type of control describes the devices that reduce the risk of exposure to bloodborne pathogens in the workplace (cassettes, sharps, needle recapping devices)

A

engineering controls

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24
Q

what type of control describes the procedures that reduce the likelihood of exposure to infectious materials by altering the manner in which a task if performed (recapping needle using one-handed scoop technique and replacing sharps containers when they are full)

A

work-practice controls

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25
Q

what type of waste is characterized by:
- blood or other potentially infectious material (OPIM) in liquid or semi-liquid state
- items caked w/ dried blood or OPIM that may release it
- contaminated sharps
- pathological/microbiological waster w/ blood or OPIM

A

OSHA regulated waste

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26
Q

what type of waste is characterized by:
- solid waste soaked or saturated w/ blood or saliva
- contaminated sharps
- anesthetic carpules
- scalpel blades
- surgically removed hard and soft tissue

A

UMKC regulated waste
NOTE - should be placed in red biohazard bags

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27
Q

what type of sterilization/ disinfection method is 16x more effective than hand scrubbing, uses high-frequency sound waves and cavitation to loosen and remove debris, less potential to injure self w/ instrument (if visible debris not removed, interferes w/ disinfection process)

A

ultrasonic cleaners

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28
Q

what type of sterilization/ disinfection method involves steam under pressure, is the cheapest and dependable (most common), disadvantages: dulls cutting edges and rusts instruments
- (standard cycle: 250 deg F 15 psi 20 min cycle)

A

steam autoclave

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29
Q

what type of sterilization/ disinfection method involves steam (273 degs 30 PSI) and should not used as sole sterilization method?

A

flash sterilizers

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30
Q

what type of sterilization/ disinfection method involves a standard cycle of 322 for 2 or 338 degs for 1 hour
- advantages : doesn’t dull cutting edges or rust them
- disadvantages : long cycle, can’t be used on handpieces, poor penetration

A

dry heat

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31
Q

what type of sterilization/ disinfection method involves steam with chemical vapor (formaldehyde) under pressure
- advantages : shorter cycle not much corrosion
- disadvantages : hazardous vapor is the downside

A

chemical vapor (chemiclave)

32
Q

what is the protocol for sterilization monitoring?

A
  • test weekly to ensure everything is running smoothly, change the location for better accuracy, overloading the sterilizer is main reason to fail spore test
  • if the test is failed - take machine out of service, review loading and running procedures, retest, have it inspected if it fails again.
33
Q

what type of latex reaction is characterized by non allergic skin reaction, least threatening, repeated exposure, dryness, itchy, burning, irritated?

A

irritant contact dermatitis

34
Q

what type of latex reaction is characterized by type IV delayed reaction, 23-48 hours to develop, red rash usually confined to the skin, more severe and can spread to more parts of the body?

A

allergic contact dermatitis

35
Q

what type of latex reaction is characterized by type I immediate hypersensitivity to rubber latex proteins, can include: nasal allergy with hay fever, urticaria, bronchospasm, anaphylaxis?

A

immediate latex allergy (latex hypersensitivity)

36
Q

how can you minimize latex contact dermatitis?

A
  • dry hands completely before donning gloves
  • use only latex-free gloves
  • use only gloves without power
37
Q

what two instruments do you hand the doctor at the beginning of a procedure?

A

mirror and explorer

38
Q

what is the RIGHT HANDED clock position for a doctor and assistant?

A
  • R-hand operator seating position = 8-12
  • assistant is 2-4
39
Q

what is the LEFT HANDED clock position for a doctor and assistant?

A
  • L-hand operator seating position = 12-4
  • assistant is 8-10
40
Q

how is the assistant positioned in respect to the doctor / operator?

A

assistant’s hips are in line with patients shoulders – above operator, transfer in the transfer zone, with parallel instrument

41
Q

what are the three primary functions of the high speed oral evacuator?

A
  • keep back of mouth free of debris, saliva, water
  • retract the tongue and cheek
  • reduce bacterial aerosols form the handpiece
42
Q

what are the 4 vital signs?

A
  • temperature
  • pulse
  • respirations
  • blood pressure
43
Q

which method for taking a temperature is described by placing the thermometer far back under tongue, >20 min after food/drink, wait for beep?

A

oral (Avg = 98.6 oral)
NOTE - lowest at 6AM, highest 4-6PM, axillary = oral -1; rectal = oral + 1

44
Q

which method for taking a temperature is accurate if used properly, good enough for daily needs?

A

digital

45
Q

if a temperature is taken incorrectly, how can it affect the results?

A

generally LOWER THAN TRUE TEMPERATURE

46
Q

what bodily response can indicate inflammation, and misery, patient may be flushed?

A
  • fever : temp = or greater than 100.4 F / 38 C
    NOTE - low-grade fever = 99.6-100.3 F
47
Q

what vital sign is described as one’s heart rate, or the number of times your heart beats in one minute?

A

pulse

48
Q

what are some key items to remember when taking a person’s pulse?

A
  • pay attention to strength and rhythm
  • females 12 and older have higher pulse than men.
  • taken on: radial, brachial, carotid
  • measure for 30 sec X 2 = BPM
49
Q

what is considered a normal heart rate?

A

normal = 60-100 resting BPM
NOTE - (children higher, athletes lower)

50
Q

what is the term used to describe a pulse > (greater than) 100 bpm?

A

tachycardia

51
Q

what is the term used to describe a pulse < (less than) 60 bpm?

A

bradycardia (BORING)

52
Q

what are some factors that can influence one’s pulse?

A

anemia, exercise, anxiety, drugs, fever
NOTE - may be a sign of cardiovascular disorder

53
Q

what is considered the normal respiratory rate?

A

normal = 12-16 breaths/minute
NOTE - (children higher, athletes lower)

54
Q

what term is used to describe rapid respiration?

A

tachypnea

55
Q

what term is used to describe slow respiration?

A

bradypnea

56
Q

what term is used to describe the max pressure the heart exerts when beating, contraction of the muscle pumping blood into arteries from chambers?

A

systolic pressure

57
Q

what term is used to describe the pressure in arteries when heart is at rest, chambers filling with blood (pressure in your arteries between beats)

A

diastolic pressure

58
Q

what would the blood pressure of an individual suffering from systolic hypertension need to be?

A
  • systolic = higher than 130
  • diastolic = under 80
    NOTE - both numbers are important, but a greater risk of stroke/heart disease is related to a higher systolic as opposed to a higher diastolic
59
Q

what term is used to describe the force the heart generates with each contraction?

A

pulse pressure
NOTE - · important for dialysis patients
- greater than 60mmHg = risk factor
- less than 45 mmHg = normal/safe

60
Q

how do you manually take a person’s blood pressure?

A
  • remove shirt covering arm, uncross ankles (systolic + 7%; diastolic + 2%), seated, not speaking and resting for 2+ minutes arm at level with heart (if not, BP will be higher)
  • prior to test, find antecubital region and place “artery arrow” on it, snug not tight, double check artery
  • inflate cuff 20-30 mmHg above normal systolic = 120/80; stethoscope placed over palpated brachial artery, release pressure at 2-3 mmHg per second, systolic pressure = point at which operator hears beating sounds = Korotkoff sounds. Diastolic = point at which sounds disappears.
61
Q

what are some common mistakes that people do when taking manual blood pressure?

A
  • rushing through procedure
  • cuff too large (low reading) or small (elevated reading)
  • cuff too loose or tight
    -arm not at heart level or not supported
    • if arm is not at heart level, pressure is elevated as a result of increase hydrostatic forces!!!
  • patient has legs crossed
62
Q

identify the risk factors for hypertension

A
  • prior to 45 men are more at risk
  • post-meopausal women have higher BP bc of lack of estrogen
  • 74% of adults in U.S. with a cardiovascular event had BP >140/90
  • stress (+6-12 BP, down after 5-10 minutes, or white coat syndrome)
  • distended bowel or bladder
  • drugs (caffeine, tobacco, amphetamines, meth)
63
Q

what are the ranges for blood pressure categories (normal, elevated, hypertension stages 1/2, hypertensive crisis)?

A
  • normal = less than 120/80mmHg
  • elevated = 120-129/80mmHg
  • HTN stage I = 130-139/80-89
  • HTN stage II = 140 or greater/ 90 or greater
  • HTN crisis = higher than 180/ higher than 100 = should go to emergency room or call cardiologist ASAP
64
Q

what are the ASA classifications?

A
  • ASA I = totally health patient, no smoking or significant drinking
  • ASA II = Mild systemic disease: smoker, pregnant, obese, CONTROLLED DM/HTN, mild lung disease
  • ASA III – Severe systemic disease: UNCONTROLLED DM/HTN, COPD undergoing dialysis
  • ASA IV - severe systemic disease that is constant threat to life: MI < 3 months prior, TIA < 3 months prior
  • ASA V – not going to live > 24 hours without an operation = moribund patient
  • ASA VI – Patient declare brain dead, organs being harvested for donor purposed, etc.
65
Q

what are the 5 goals of a physical evaluation?

A
  • ability to mentally handle stress
  • ability to physically handle treatment
  • change to treatment indicated?
  • sedation indicated? what type?
  • contraindications for pre-medication?
66
Q

what are the 6 indicated signs of anxiety?

A
  • elevated BP and pulse
  • trembling
  • sweating (diaphoresis)
  • restlessness
  • hyperventilation
  • dilated pupils
67
Q

what is the protocol for patients with high anxiety (7)?

A
  • PM/AM oral sedation
  • intraoperative sedation if the issue is serious enough
  • good pain control through local
  • appt in the morning and short
  • hot/humid weather can make stress worse
  • post-op RX for pain
  • post-op phone call to put patient at ease and address any issues
68
Q

what type of medical emergency is the MOST COMMON and described as:
- vascular and neurogenic reaction marked by sweating, nausea, pallor, bradycardia, rapid fall drop in BP = loss of consciousness from cerebral ischemia
- usually caused by emotional stress with fear/pain, rapid head up, sight of blood, RECOVERY TAKES 24H, hunger, exhaustion, hot humid crowed, all can worsen it

A

syncope
NOTE- place patient in Trendelenburg position

69
Q

what type of medical emergency is characterized by systolic BP down by 20mmHg or diastolic BP down by 10 mmHg within 3 min of standing, compared to bassline BP?

A

orthostatic hypotension
NOTE - risk associated with age

70
Q

what type of medical emergency is described as a sudden rapid drop in HR and BP leading to fainting?

A

vasovagal syncope
NOTE - IT IS MOST COMMON FORM OF SYNCOPE (32%)
- most experience first episode as teenager or child

71
Q

warmth, loss of color, sweating, feels bad, nausea, BP at baseline, tachycardia all describe what type of manifestation of syncope?

A

EARLY

72
Q

yawning, difficult breathing, pupillary dilation, cold hands and feet, dizziness, loss of consciousness, hypotension and bradycardia all describe what type of manifestation of syncope?

A

LATE

73
Q

horizontal position, airway and breathing, circulation (vitals), oxygen, cool compress, smelling salts, loosen clothing, emotional are done when treating what common medical emergency?

A

syncope

74
Q

rapid and shallow breathing, rapid pulse and respirations, confusion, dizziness, cold hands, tightness in chest, carpal-pedal spasms – can lead to seizures, numbness of hands or lips, carpopedal spasm are all signs/ symptoms of what medical emergency?

A

hyperventilation

75
Q

what do you do in case of someone experiencing hyperventilation?

A
  • stop procedure
  • position upright
  • emotional support
  • DO NOT give oxygen
  • breathe into paper bag (or with lips pursed and hands over mouth)
  • count 10 between breaths
  • IV or IM valium if severe
76
Q

what is the proper order for donning (putting on PPE)?

A
  1. gown
  2. mask
  3. goggles
  4. gloves
77
Q

what is the proper order for doffing (taking off PPE)?

A
  1. gloves
  2. goggles
  3. gown
  4. mask

Patient Care I (1 decks)

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