Module 9 - Patient Care Flashcards

Question

Lithotomy position

Answer 1

Lying flat on the table with buttocks at the end of table and feet resting in stirrups. Female pelvic exams

Answer 2

Lying flat on back with knees bent. Catheterizations Genital examination of younger children

Answer 3

Lying flat on the abdomen with the arms above the head. Exams involving the back of the body, including bottoms of feet.

Answer 4

Lying flat on the back with the arms down to the side. Exams involving the front of the body, administration of CPR.

Answer 5

Legs elevated above the head to force circulation to vital organs Shock (requires a specific table)

Answer 6

Name of medication, dosage, time, route of administration. Need consent for administration. Tell the patient what the medication is, what it is given for, dosage, and route. Check the medication three times: first to compare order to medication, second after medication is prepared, and third immediately prior to administering medication

Answer 7

Correct syringe and needle, alcohol swabs to wipe off vial/skin preparation, gauze pad to apply pressure after administration. Adhesive bandage available if there is bleeding at the site. Sharps container located nearby. Biohazard container for disposal of other contaminated items. Nonsterile gloves and appropriate PPE for invasive procedure.

Answer 8

Easily accessible sharps container, self-sheathing or safety needles. Never recap a used needle.

Answer 9

Needles and syringes must be sterile. Check expiration date of solutions, evaluate container integrity. Use alcohol swabs on vial stopper. Do not introduce the needle into the vial more than once - dulls the needle and increases likelihood of contamination. Do not allow solutions to run down needle. Do not place exposed needle on tray or countertop. Only recap clean needle if absolutely necessary.

Answer 10

Gauge range from 14 (largest) to 31 (smallest) Length ranges from 3/8 to 4 inches Intradermal: 27-28 gauge, 3/8 in Subcutaneous: 25-26 gauge, ~1/2 in Intramuscular: 20-23 gauge, 1-3 in

Answer 11

Deltoid: 1-2 inches below acromion; used for many vaccines, > 3 yrs old, dose usually less than 1ml Ventrogluteal: Palm over greater trochanter of femur, use opposite hand for hip (thumb facing anterior). Place middle finger on posterior iliac crest and spread index finger. Give injection where the V is made between the index and middle finger; site is used when deep IM injections are prescribed or when larger quantities of medicines are needed Vastus lateralis: mid to upper outer thigh; used for vaccines and medication < 3yrs old

Answer 12

90* angle, do not aspirate vaccines but do aspirate most other types of medications Either Deltoid, Ventrogluteal, or Vastus lateralis depending on use case

Answer 13

45* angle, do not aspirate for vaccines, insulin, or heparin but do aspirate for most other types of medications Do not massage site for heparin or insulin When used regularly, sites should be rotated; common sites are upper outer arm, abdomen, thigh

Answer 14

10*-15* angle, do not aspirate; used for testing, do not massage or apply presssure, presence of wheal is expected When using the forearm, measure using one hand width from the wrist and one hand width from the elbow. Any area within the anterior forearm is acceptable. Upper back may also be used

Answer 15

Read liquids at lowest point of curve of the liquid (meniscus)

Answer 16

Between the cheek and gums, rapid absorption bypassing digestive system (lower doses required) Medication is designed to melt there, patient should not chew, swallow Eating, drinking, or smoking can influence absorption rate.

Answer 17

Under the tongue, nitroglycerin tablets/spray are common forms of medication administered, bypasses digestive system (lower doses required) Eating, drinking, or smoking can influence absorption rate.

Answer 18

Typically used for targeted areas such as the bronchial passages, can be delivered via a nebulizer. For the medication to be effective, patient must hold the medication in lungs as long as possible. Coach on proper breathing techniques

Answer 19

Designed to react locally and systemic absorption is minimal. Can serve as a barrier to prevent irritants from damaging skin or used to treat a local skin condition. Monitor for skin irritation or reaction.

Answer 20

Designed to absorb into and through mucous membranes. Can be nasal, vagina, rectum, eye, or ear. Can cause irritation to the mucosa, ensure patients understand the correct procedure for administering the medication based on the medication and route.

Answer 21

For continuous slow absorption of various medication; used for smoking cessation, pain medication, hormone delivery. Avoid touching medication, dispose of carefully, rotate sites and monitor for irritation.

Answer 22

According to directions in original container - may need to be refrigerated or protected from light. Controlled substances must remain locked and secured. Log book and daily count by two people required for controlled substances.

Answer 23

Ensure medication is at room temperature, wear gloves. Do not allow tip of containers to come in direct contact with the patient

Answer 24

Solution should be room temperature, patient should be positioned based on the route of irrigation. Do not allow eye irrigation to flow down the tear duct. Do not irrigate ear if ruptured tympanic membrane

Answer 25

Define the sorting of patients according to a system of priorities, designed to maximize the success of treatment

Answer 26

Superficial scrape or rub; apply pressure if bleeding -> clean/flush to remove debris -> apply bandage

Answer 27

Open injury typically caused by a sharp object causing a straight cut, bleeding can be profuse; apply pressure until bleeding is controlled -> clean gently to not reinitiate bleeding -> apply bandage

Answer 28

Open injury jagged in nature, caused by sharp object, bleeding can be profuse; apply pressure until bleeding is controlled -> clean gently -> apply bandage

Answer 29

Open wound caused by stabbing instrument, usually small with limited bleeding; apply pressure if bleeding -> clean or flush to remove debris -> apply bandage

Answer 30

Close injury/bruise, caused by blunt-force trauma, ranges in severity based on trauma received and the location; Apply cold pack or ice -> Elevate limb if affected -> observe for signs of increased intracranial pressure if on head (would require immediate emergency care)

Answer 31

Closed head trauma in which the brain has been jolted or shaken; Measure vital signs -> observation -> Provider assessment and possible CT scan

Answer 32

Strain is muscle <-> bone tearing/stretching, Sprain is bone <-> bone; Emergency procedure RICE (Rest, Ice, Compression, Elevation)

Answer 33

Break in bone, open indicates a break in skin; Control bleeding -> Immobilize area -> Apply ice -> Check pulse below site -> Treat for shock

Answer 34

Severe allergic reaction with circulatory shutdown and respiratory distress, results in shock; Extreme emergency!: provide life support, administer oxygen and epi based on provider order, call 911

Answer 35

General potentially life-threatening symptom; obtain chief complaint, keep patient NPO, have emesis basin available, keep patient warm but do not apply heat, monitor vital signs, observe for signs of shock -> describing severity, quadrant, or abdominal regions assists in diagnosing the condition

Answer 36

Internal or external, bleeding depends on blood supply in location. Arterial bleed is more of a crisis; Apply pressure, elevate the site if possible, apply ice, limit movement, keep the patient quiet, monitor vital signs and observe for signs of shock

Answer 37

Severity is based on location, extent of body surface affected, degree of tissue involvement. Can be electrical, chemical, thermal First degree: first layer of tissue Second degree: subcutaneous tissue, blister Third degree: muscle and possibly bone, appear dry and charred Remove patient from source -> Flush profusely with cool water -> do not remove clothing unless chemical burn -> monitor vital signs, observe for shock -> Assess body area using Rule of Nines

Answer 38

Allows easy estimation of body percentage covered by burn by estimating back or front 18%, each arm 9%, each leg 18%, head 9%, groin 1%

Answer 39

Obstruction of airway, patient unable to breathe; Ask the patient "are you choking" -> do nothing if patient can speak or cough, perform Heimlich if patient cannot -> if patient is unconscious, perform CPR, look for foreign body in the mouth

Answer 40

Diabetic coma (hyperglycemia) is characterized by malaise, dry mouth, polydipsia, polyuria, nausea, vomiting, dyspnea Insulin shock (hypoglycemia) characterized by sweating, anxiety, irritability, tachycardia, headache, hunger Can lead to seizures, coma, death if left untreated Administer glucose for insulin shock, administer insulin for diabetic coma, when in doubt give glucose. Monitor vital signs and call 911 if no rapid improvement

Answer 41

Can result from trauma or alterations in metabolism such as with fever; can be idiopathic (spontaneous), can be generalized (grand mal) to short staring episode (petit mal) Assist patient to lying position -> protect from injury -> tilt head to side to prevent aspiration -> time the seizure -> stay with patient and observe -> call 911 if seizures continue

Answer 42

Results from hypoxia in the brain, usually due to blood clot or rupture/occlusion of blood vessel. Patient can be aphasic or dysphasic. experience weakness on one side of body/drooping of mouth, lose consciousness Protect the patient -> Keep NPO -> Obtain vital signs -> Collect as much medical history as possible -> Administer oxygen -> Call 911

Answer 43

patient education: call provider if infection is suspected

Answer 44

Redness/swelling Hot to touch Drainage (not clear) Foul odor Red streaks extending from wound Fever Maliase

Answer 45

1. Wash hands 2. Don gloves 3. Soak dressing in sterile saline/water if stuck to wound 4. Remove dressing (sterile) and bandages (nonsterile). Discard all waste contaminated with body fluids in biohazard container. 5. Use applicator to apply medications to wound, avoid touching container to wound, do not reinsert applicator into container. 6. Open dressing packages without touching contents, touch only edges of dressing. 7. Place bandage or tape

Answer 46

Fracturing ribs of patient, exposure to bodily fluids (gloves, CPR mouth barriers)

Answer 47

1. Ascertain responsiveness 2. Activate emergency medical systems (EMS) 3. Check carotid artery for pulse If no pulse: CPR at rate of 100 to 120 chest compressions per minute with a ratio of 30 compressions to 2 breaths. With two rescuers alternate role to decrease fatigue

Answer 48

AED is a device that provides automatic voice instruction on how to convert patient back to sinus rhythm. 1. Chest leads need to be connected: Remove clothing and attach one pad on upper right side of chest, other pad on lower left side of chest, a few inches below left armpit. Plug connector cable into AED 2. "CLEAR!" - allow AED to analyze heart rhythm, do not touch person 3. "CLEAR!" - Press button to deliver a shock if necessary 4. Start CPR

Answer 49

Obtaining chief complaint Collecting vital signs Assist provider: clean wounds, prepare sterile fields, bandage wounds, administer injections, instruct patients on signs of infections, provide wound care, schedule follow-up appts

Answer 50

1) Prepare surgical area and assist provider during procedure - 1) open packages to easily drop onto sterile field without touching outer wrapper - 2) lip the bottle of liquids prior to pouring into sterile containers - 3) do not leave unattended, reach over, turn your back - 4) medication vials should be cleaned with alcohol 2) Provide education and support to patient - explain the procedure and obtain consent

Answer 51

Exposing tissue to extreme cold to destroy cells; warts, cervical dysplasia; patient should expect some discomfort

Answer 52

Using an instrument to inspect vaginal or uterus area, deliver treatments; patient in lithotomy position and will experience discomfort, specimens may be collected

Answer 53

A pulse of electrical current to cauterize tissue, used to minimize bleeding or destroy small polyps, etc; Inspect pad and cable prior to usage, avoid placing the pad on areas with excessive hair, over bony parts, or over pacemakers or metal implants

Answer 54

Completed with local anesthetic, need sterile scissors and forceps or hemostats, anesthetic, bandaging materials; patient will experience throbbing/discomfort, soaking in warm salt water facilitates healing and reduces discomfort, bandage wound

Answer 55

Small tube with a light and camera inserted into GI tract or through small incision; assist with patient position, avoid touching skin with light source

Answer 56

Local anesthetic, scalpel or punch device, suture supplies; obtain a detailed history, family history (melanoma), all specimens should be sent to the laboratory for evaluation, instruct the patient to monitor wound for infection and return for follow-up suture removal and care

Answer 57

1. Thoroughly inspect wound to approximate edges, absence and presence of drainage. If crusting blood is present soaking with saline may be necessary 2. Need stitch/suture scissors and forceps, staple removal device for any staples. Remove every other suture or staple while observing the site for any gaping (if there is any, notify provider). 3. Account for the total number of staples and sutures used to close the wound. When cutting, sutures, cut close to the knot and pull the suture out with forceps, observing to ensure the entire suture was removed.

Answer 58

Activity restrictions: bathing/exercise Diet restrictions Wound care: dressing change, applying medication to wound, observing for signs of infection Medications: How and when, possible side effects Follow up appointments: When to return to the office, how to contact

Answer 59

Only licensed or credentialed individuals (including CCMA) may send prescriptions electronically. Controlled substances may not be called, patient must deliver physical prescription to the pharmacy. Speak clearly, full name and birthdate of the patient, identify medication, avoid abbreviations

Answer 60

Prescriber information DEA number Patient information Medication prescribed Instructions Signature

Answer 61

Name, address, birthdate, SS#, phone, insurance. Review each visit.

Answer 62

Medications, including over-the-counter and supplements, allergies. Review each visit.

Answer 63

Where chief complaint or SOAP note (subjective, objective, assessment, plan) is located

Answer 64

Houses laboratory reports and EKG or other tests

Answer 65

Medical necessity is used by third-party payers to identify that a specific procedure is necessary. Documentation is required to support the necessity for the procedure/test and for the insurance company to remit payment

Answer 66

Universal language of numbers used for billing/reimbursement. Accurate coding maximizes provider reimbursement, upcoding for more than what was performed is fraud

Answer 67

Computerized physician order entry, allows for completion of medical documentation at time of visit

Module 9 - Patient Care Flashcards

(91 cards)