STUDY!!!!!!!
Hematoma
"Blood tumor" - bruise
Cranial nerves
-2nd = vision -5th = jaw movement and sensation -9th = swallowing -12th = tongue movement
EKG
-Don't place electrodes on the left for kids, too much electrical activity -speed = 25mm/s
Order of draw (Capillary blood)
-EDTA -additives -nonadditives -Serum tubes
How to prepare for EKG?
-Rest for 30 mins before -Empty bladder at least 10 mins before -Inform patient it will not hurt
Business letter layout
-Sender's address at the top right corner -Recipient's address on the left -Reference # below that -Date -Salutation
Appropriate introduction
-Your name -Identification as a medical assistant -Info on what you're about to do
Schedule I drugs Schedule II drugs
-illegal -require written prescription
Weber test Rinne test
-tests if hearing is better in one eat than the other -raise hand when no longer hear; uses tuning fork
QRS interval
0.04-0.10 seconds
Normal breathing rate for a healthy adult
12-20 breaths/minute >20 = tachypnea
RBCs regenerate every ____ days and WBCs regenerate every ___-___ days
120; 7-10
Platelet levels should be in what range
130-400
Sodium levels should be in what range
135-145
Standard processing time for autoclaves
15-20 minutes until the instruments are clean and sterile
At what angle should you insert a needle for venipuncture?
15-30°; mainly 15
Intradermal injection
15° - no aspiration; bevel up 27-28 gauge
What gauge needle is used for phlebotomy?
16-18 gauge
Kidneys process how much waste/day
180 L
Lab disinfectant
1:10 = bleach:water Cidex
Dispose of sharps container when it's how full?
2/3
Intramuscular gauge
20-23
What gauge is needed for IM?
21-22
Statute of limitations with OSHA
24 hours
What gauge is needed for subq?
25
At what angle should an IV be put in?
25 degrees
You shouldn't go past __mm with a lancet in babies' heels; __mm for adults in finger pricks
2; 9
You should get a tetanus booster every ___ years
5
How many stages of grief in the Elizabeth Kubler-Ross Theory?
5 -Denial, anger, bargaining, depression, acceptance
Surgical hand washing should last how long?
6-10 minutes
Proper hand washing requires how many seconds of scrubbing with soap and warm water?
60 seconds
When washing your hands use soap or what percent alcohol rub?
60% - quarter sized drop
Diastolic BP range
60-90 mmHg
Stitches should be removed how many days after being placed?
7-10
Fasting blood glucose range is:
70-130
Insulin injections are administered at what angle
90 degrees
Intramuscular injections are administered at what angle?
90 degrees
Systolic BP range
90-120 mmHg
Normal O2
94-100% Below 94 - medical emergency
Shock
A condition in which blood pressure is too low and not enough oxygenated blood can sustain your body. Often happens to a person after a traumatic experience. -Symptoms = increased HR, pale skin, weakness -Lay patient supine on the floor
Intellectualization
A means of suppressing natural emotions and instead relying on the intellect to overcome a problem. Thus instead of allowing anger or grief to come out, a patient with a terminal diagnosis may become convinced s/he can find an intellectual solution to the problem.
What determines test site for PKU?
Age and development
What determines when to do a capillary puncture?
Age and development
infection control/ chain of command
Agent, portal of exit, mode of transmission, portal of entry, susceptible host
Atrial Fibrillation
Atrial fibrillation is cuased by multiple irritable sites all over the atria firing at a rate exceeding 250 bpm No identifiable P waves can be seen fibrillatory erratic f waves are seen in all the leads Controlled atrial fibrillation uncontrolled atrial fibrillation
Atrial Flutter
Atrial flutter is characterized by rapid depolarization of a single atrial focus at a rate of 250-350 bpm Because the AV node cannot transmit every impulse at excessive rates there is typically a slower ventricular rate Typical saw-toothed waves, named F waves followed by almost normal QRS complexes with a slower rate are seen in all the leads
Third degree AV block
Atrial rate is greater than ventricular rate P waves are normal, there are no measurable PR intervals The atrial rhythm is regular, and the ventricular rhythm is regular there is no relationship between P waves and QRS complexes if the escape rhythm is junctional the QRS complexes may appear normal in width and the ventricular rate may be slightly higher if the escape rhythm is ventricular, the QRS complexes will be abnormally wide with a slower ventricular rate
ABG
Arterial blood gas -Only nurses and above can perform this test -MA's can only transport -Transport in ice (goes for all gasses)
Hematuria
Blood in the urine -For women, ask when their LMP was bc may just be menstrual blood -May indicate kidney infection, kidney stones, or prostate cancer
Hemothorax
Blood in your chest -Internal bleeding
Ventricular repolarization
T wave-the first wave after the QRS complex has the following characteristics;the deflection produced by ventricular re polarization, it is slightly asymmetric no more than 5 mm in height U wave- Is the deflection see following the T wave but preceding the diastole; represents repolarization of Purkinje fibers, Round and symmetric less than 1.5 mm in height, a prominent U wave is due to hypokalemia
Vital signs
Temperature; pulse; respiration; blood pressure
Who has ownership of a patient's records?
The care provider
Normal Interval and Junctions
PR Interval: is defined as P wave and PR segment and is measured from the beginning of P wave to the beginningof QRS complex. The normal interval is 0.12 - 0.2 sec. QT interval: It represents the total centricular activity and it is measured from the beginning of QRS to the end of T wave the normal duration of this interval depends on the age and the HR RR interval: it is important to determine the HR and its regularity, this is the interval between two R waves J(RST) junction: point at which QRS complex ends and ST segment begins ST segment: from J point to the onset of the T wave. this segment is compared to the PR segment to help identify myocardial ischemia or injury
Type I second degree AV blocks (Wenckebach, mobitz I)
PR interval lengthens in each interval until one QRS disappears
V Codes
Part of the ICD-9 -Designed for occasions when circumstances other than a disease or injury result in an encounter or are recorded by providers as problems or factors that influence care
PFSH
Past medical history; Family History; Social History
In the event of patient mortality without payment received who is accountable for the outstanding balance?
Patient's estate
Dipstick
Thin, plastic stick with strips of chemicals on it that's placed in urine to detect abnormalities -Tests for pH, concentration, protein, sugars, bilirubin, evidence of infection, blood
Holter Monitor
This is an ambulatory EKG done to rule out intermittent arrhythmias or ischemia that could be missed on a routine EKG five electrodes are attached to the patients trunk instead of the arms and leg to prevent muscle artifacts
Exercise stress test
This test is performed until atleast 85% of the target heart rate is reached or symptoms or EKG changes develop which requires the test to be terminated. Target heart rate is 220 minus the patients age
TB
Tuberculosis -Transmitted through the air
Red tubes
Used for serology and -Glass tubes - no additives so no inversions -Plastic tubes contain coagulants and require 5 inversions -Used for serum glucose, electrolytes, blood urea nitrogen
Grey tube
Used for testing blood glucose levels -Contains potassium oxalate combined with sodium fluoride which helps prevent glucose deterioration -Require 8-10 inversions
Blood culture
Used to detect the presence of bacteria or fungi in the blood (Hear culture, think bacteria)
Utility software
Used to maintain a computers function
Spiral fracture
Usually caused by a twisting force
Six lead placement (v1, v2, v3, v4, v5, v6)
V1: right of sternum, 4th intercostal space V2: left of sternum, 4th intercostal space V4: left chest, 5th intercostal space midclavicular V3: in between V2 and V4 V5: anterior axillary line V6: midaxillary line
Code white
Disaster -fire, terrorist, flood, etc.
Disposal of a razor
Dispose in the room in which it was used --> not allowed to walk with sharps -Dispose in sharp's container
Snellen
Distance acuity test/vision test
Implied consent
Does not require a form; verbal, nonverbal, gesture
PPD
Purified Protein Derivative -Use 0.1ml for a TB test in an insulin or TB syringe -Mantoux test
Peripheral blood slide
Put blood into one slide and use another to slide it to observe the microscopic component of blood
Ventricular Depolarization
QRS complex represents ventricular depolarization The ventricle is depolarized from the endocardium to the myocardium to the epicardium Normal duration is no more than 0.1 sec Q wave the inital negative deflection produced by ventricular depolarization R wave the first positive deflection produced by ventricular depolarization S wave the first negative deflection produced by the ventricular depolarization that follows the first positive deflection R wave
RAST
Radioallergosorbent test -Blood test using radioimmunoassay test to detect specific IgE antibodies, to determine the substances a subject is allergic to
The best passwords for computers are
Random
Temperature
Rectal- 98.6 F to 100.6 F Oral- 97.6 F to 99.6 F Axillary- 96.6 F to 98.6 F Tympanic Membrane 98.6F
Drawing insulin from a multi-dose vial
First, inject the air equivalent of the dose needed
Intermittent Fever
Fluctuating fever that returns to or below baseline then rises again
FSH
Follicle Stimulating Hormone -A gonadotropin that determines fertility in men and women -Often tested to understand why a couple can't get pregnant -High FSH may be indicative of someone who has just gone through menopause
FDA
Food and Drug Administration -Control all consumed substances to make sure they are safe
Brachial pulse
Forearm -Used for infant CPR
Bundle of HIS
Found at the superior portion of the interventricular septum, it is the pathway that leads out of the AV node and connects to the bundle branches
SA Node
Found in the upper posterior portion of the right atrial wall just below the opening of the superior vena cava. It is the primary pacemaker of the heart and has a normal firing rate of 60- 100 beats per minute
Purkinje fibers
Found within the ventricular endocardium, it consists of a network of small conduction fibers that deliver the electrical impulses from the bundle branches to the ventricular myocardium
V1
Fourth intercostal spac, right sternal border
V2
Fourth intercostal space, left sternal border
Aseptic
Free from pathogenic micro-organisms; reduces germs but doesn't kill
Class B fire
From flammable liquids and vapors - requires extinguisher or method that removes oxygen
Cholecthiasis
Gall stones
G tube
Gastronomy tube - inserted through the abdomen that delivers nutrition directly through the stomach -bypasses esophagus to get to stomach; requires surgery
inspection
General appearance; state of nutrition; body habits; symmetry; posture and gait; speech
GTT
Glucose tolerance test -Drink glucocola after fasting, wait 30-45 minutes, test how one tolerates sugar
Standard Precautions
Guidelines that instruct healthcare providers to minimize risk of disease transmission when giving care - set guidelines for the safe handling of blood and bodily fluids -Originally Universal Precautions
Clinical Lab and Standards Institute (CLIA)
Guidelines to assist the development of a safety program
Sinus Arrhythmia
HR 60 to 100 bpm Normal equal P and QRS in all the leads as well as normal PR intervals Different diastolic pause after each systole I there are changes with the respiration named respiratory sinus arrhythmia otherwise called nonrespiratory arrhythmia
Normal sinus rhythm
HR 60-100 bpm Similar P in all the leads in front of all QRS A constant PR (0.12 to .2 sec interval in all leads regular rhythm
Sinus Bradycardia
HR less than 60 bpm Normal equal P and QRS in all the leads as well as normal PR intervals Diastolic pause is longer Bradycardia decreases the blood flow in the brain and other body tissues
Sinus Tachycardia
HR over 100 Normal equal P and QRS in all the leads as well as normal PR intervals Diastolic pause is very small or non existent Tachycardia reduces the blood supply to the cardiac muscle
HIPAA
Health Insurance Portability Act -Oversees anything and everything having to do with privacy and confidentiality
1500 form
Health insurance claim for -has all of patients demographics -insurance holder is written on it -look on google doc
Identify and examine the P waves
Identify the P waves, PP interval and measure the size of the P wave in different leads
S-T segment
J point
JCAHO
Joint Commission on Accreditation on Healthcare Organizations
KUB
Kidney Ureter Bladder A.K.A UA
Nephrolithiasis
Kidney stones
Ischemia
Lack of O2 and blood supply to a specific area
-pnea
Lacking
EKG rate calculations
Large box = 300 (300/x) Small box = 1500 (1500/x)
Administering oxygen
MA cannot do this without instruction from physician
Homeostasis
Maintaining a stable internal environment - how the internal environment reacts to the external environment
Barrier Protection
Masks; Goggles; Face shields; respirator
MSDS
Material Safety Data Sheet -Every item has a MSDS sheet that explains its intended uses and risks that should be stored alphabetically in a binder
Assess intercals (PR,QRS, QT)
Measure each of these intervals and determine if they are normal
Anthropometric
Measurements of the body -Height, weight, BP, pulse, temp, length, etc.
ED50 stands for
Median effective dose of a drug
The motor cortex of the brain is responsible for the regulation of...
Motor movement
Correcting errors
NEVER use white-out - instead, draw a line through, initial, write error, and re-write
What four pieces of information should go on a urine sample?
Name, DoB, time, MA initials
NG tube
Nasogastric feeding tube - inserted tube through the nose, past the throat, and down to the stomach
Myopia
Nearsightedness
Failure to give appropriate care
Neglect
Normal HR
Normal HR = 72 Range = 60-100 40's for athletes
General evaluation and conclusion
Notify the doctor for any abnormaility that you can find on the EKG strip
What should you avoid before a Papanicolau test (cervical cancer screening)?
OTC vaginal cream
OSHA
Occupational Safety Health Administration -Protects employees in their work environment by setting standards to ensure the workplace is safe
Atrial Depolarization
P wave is the first deflection after the diastole, produced by atrial depolarization it is smooth, round, not more than 2.5mm high and no more than 0.11 sec positive in I, II, and V2 to V6 the normal P wave in standard, limb, and precordial leads does not exceed 0.11s in duration or 2.5 mm in height There is no wave for atrial repolarization, becuase is obscured by the larger QRS complex
Evaluate ST segments and T waves
ST segment elevation or depression and/ or T wave abnormalities can suggest the presence of myocardial ischemia or injury
Iris, Metzenbaum, and Mayo are all types of
Scapels
What position do you put patients in when putting in an NG or G tube?
Semi-Fowler's 45 degrees
Tickler system
Sends out automatic appointment reminders to patients, either through automatically issued letters, emails, SMS or automated telephone calls
Centrifuge
Separates blood
Somatic tremor
Shaking - from anxiety, cold, Parkinson's, etc. -Can cause wandering baseline on an EKG -Give patient a warm blanket
Left Upper Quadrant
Stomach and Spleen
Hemoccult
Stool culture -Use a guaiac card
Streptococcal
Strep throat
Thanatology
Study of ways of coping with death
Allergy shots are given
Subcutaneously
Family History
Summary of health problems of siblings, parents, and other blood relatives that could alert the physician to hereditary and/ or familial disease
Office manager>
Supervisor
Sterile
Surgical
-rrhapy
Suturing
CLIA
Clinical Lab Improvement Act -Control who can and can't perform what procedures and where -Some simple tests fall under wavers from this body
If a patient makes their condition worse by ignoring medical advice, this is considered
Contributory negligence
Quality control
Control quality of environment, specimen, equipment
Phrenic nerve
Controls breathing by signaling the diaphragm to contract and/or relax
CMS
Circulation Motor Sensory or Centers for Medicare and Medicaid
Internodal Pathways
consits of anterior, middle and posterior divisions that distribute electrical impulses generated by the SA node throughout the right and left atria to the atrio-ventricular node
Large Boxes Method
count the number of large boxes between two consecutive RR and divide into 300 for the ventricular rate and count large boxes between two consecutive P waves for the atrial rate. used mainly in regular rhythms
Expired tubes
Vacuum pressure is reduced and can no longer suck out blood
What is candida albicans?
Vaginal yeast infections
Ventricular Tachycardia
Ventricular Tachycardia is characterized by 3 or more PVC's in a row at a rate over 100 bpm regular fast rhythm 100 to 250 bpm no P waves wide, bizarre QRS complexes with T waves pointing in opposite direction from main QRS direction
If your patient has a latex allergy use what kind of gloves?
Vinyl or nitrile
Occipital lobe responsible for
Vision
3 ways urine sample is evaluated:
Visual, dipstick, microscopic
Fat soluble vitamins
Vitamin A, K, and D -Do not require daily consumption because they are absorbed by fatty tissue
Water soluble vitamin
Vitamin B -required daily by the body in small amounts
Medical etiquette
What is regarded as socially acceptable behavior for medical practitioners -includes the way you speak to a patient and body language
For fragile veins use:
Winged infusion; hold by its wings and remove safety device after needle is removed
Aerobic
With oxygen -Always take aerobic blood (blue) before anaerobic blood -blue
Amenorrhea
Without menstrual flow
Anaerobic
Without oxygen; lavender
WHO
World Health Organization -Deal with all different diseases throughout the world and really anything that has to do with health
Order of draw (whole blood)
Yellow Blue Red Green Lavender White Grey (Young Boys Rarely Get Lovely Wholesome Girls)
If a letter is addressed "Dear Sir/Madam" what should the sign off be?
Yours sincerely -Should always use this with someone you don't know
Scabies
a contagious skin infestation because of a burrowing mite; need gloves and gown to treat
Wright stain
a histologic stain that facilitates the differentiation of blood cell types. It is classically a mixture of eosin (red) and methylene blue dyes. It is used primarily to stain peripheral blood smears, urine samples, and bone marrow aspirates which are examined under a light microscope
Contractility
a myocardial cell's ability to shorten(or contract) in response to a stimulus
Fowler's position
a sitting or semi-sitting position where the back of the examination table is elevated to either 45 degrees or 90 degrees the knees maybe raised slightly by placing a pillow underneath, but usually used for patients with cardiovascular or respiratory problems and for the examination of the upper body and head
Cardiovasular agents epinephrine
a sympathetic drug used to manage cardiac arrest, becuase increases heart contractibility
Advance directives can be updated:
any time
Right lower quadrant
appendix
murmurs
are caused by diseases of the valves or other structural abnormalities
The pulmonary arteries
are the only arteries in the body that carry deoxygenated blood
the pulmonary veins
are the only veins in the body that carry oxygenated blood
prn
as needed
Epinephrine reduces:
bleeding
Anthropometric literally means:
body measurements
What's the pulse used for infants?
brachial
albuterol is a
bronchodilator
po
by mouth or orally
If patient has history of thromboses, use what to take blood?
capillary
What's the pulse used for adults?
carotid
What is the database?
collection of associated files that function as a basis for retrieving information; "sort and retrieve"
Agents
infectious microorganisms that can be classified into groups namely: viruses, bacteria, fungi, and parasites
ischemia
insufficient blood supply to the myocardium
Artifacts of ambulatory EKG recording loose connection
intermittently loose connection in the insertion of the electrodes into the recording apparatus can result in the absence of all EKG signals which may mimic bradycardia- tachycardia syndrome
Cold water in the ear can cause
dizziness
Vertigo
dizziness, ear problem, feeling faint
Symptoms of a CVA or stroke
dizziness, mental confusion, difficulty in speaking, loss of vision, headache, difficulty in breathing or swallowing, and potential loss of bowel and bladder control
What position do you put patients in for urinary catherizations?
dorsal recumbant
To identify a person, use their ________ and __________
drivers license/state ID or insurance number
qhs
each night
Conduction blocks
electrical impulses go down the usual pathway to encounter blocks and delays
Ectopic rhythms
electrical impulses originate from somewhere else other than the sinus node
Hyperopia
farsightedness
Presbyopia
farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age
What are the types of ways to perform a GTT?
fasted urine test, oral swab, glucocola (wait 1 hr after drinking)
If blood falls on non-intact skin...
fill out an accident report
Pulse oximetry levels are taken on what parts of the body?
finger, earlobe, nose
Remittent Fever
fluctuating fever that remains elevated; it does not return to baseline temperature
Candidiasis
fungal yeast
cardiovascular agents oxygen
given to all patients with angina pectoris
Redraw for lipid profile
gold top tube
Your middle finger is also called the "__________" finger
great
systole
highest amount of pressure exerted during the cardiac cycle the period of contractions of both arial and ventricles
Kyphosis
humpack, curvature of thoracic spine
For swelling, what's the best method to help it go down/relieve it?
ice
At what time of day is a persons temperature at it's lowest?
in the morning
OSHA form 301
incident report
Past medical history
includes all health problems, major illnesses, surgeries the patient has had, current medications complete with reasons for taking them, and allergies
Social History
includes material status, occupation, educational attainment, hobbies, use of alcohol, tobacco, drugs, and lifestyles
Artifacts of ambulatory EKG recording with an analog system
incomplete tape erasure this can result in EKG tracings belonging to two different patients confounding both the scanner and the interpreter tape drag within the apapratus this will result in recording of spuriously rapid cardiac rhythms a narrowing of all EKG complexes and intervals should give clue to this situation
Height, weight, body mass index (BMI), waist-to-hip ratio, and percentage of body fat
these measures are then compared to reference standards to assess weight status and the risk for various diseases
pericardial sac
thin layer of fluid between the parietal and visceral pericardium
cardiovascular agents dopamine
this drug is indicated and is used in cases with hypotension it causes vasoconstriction it should be used at the lowest dose that produces adequate perfusion of vital organs
Auscultation
this involves listening to sounds produced by internal organs
percussion
this involves tapping or striking the body, usually with the fingers or a small hammer to determine the position, size and density of the underlying organ or tissue
cheyne-stokes
this is a regular pattern of irregular breathing rate
Tachypnea
this is a respiration rate of greater than 40/ min it is transient in the newborn and maybe caused by the hysteria in the adult
Apnea
this is a temporary absence of breathing which may be a result of a reduction in the stimuli to the respiratory centers of the brain
History of Present Illness
this is an explanation of the chief complaint to determine the onset of illness; associated symptoms; what the patient has done to treat the condition
Review of Symptoms
this is an orderly and systematic check of each organ and system of the body by questions. Both positive and pertinent negative findings are documented
orthopnea
this is difficulty of inability to breath unless in an upright position
Movement of electrodes
this may occur during scratching the chest near the electrodes and can produce tracings that look like malignant ventricular arrhythmias
Artifacts of ambulatory EKG recording Battery depletion
this may result in varying QRS amplitude
AV junction
this node is located at the posterior septal wall of the right atrium just above the tricuspid valve. There is normally a .12 to .20 second delay of electrical activity at this level to allow blood to flow from the atria and fill the ventricles with blood
Disinfection
this procedure used in medical asepsis using various chemicals that can be used to destroy many pathogenic microorganisms
Pharmacologic Stress test
this test is appropriate for patients with physical limitations or those who could not exercise to reach the target heart rate. Medications such as adenosine, sipyridamole or dobutamine are given intravenously through an IV line to cause the heart rate to climb to the target level or the same symptoms and EKG changes as the exercise test develop. The test is concluded after 85% of the target heart rate is achieved
mediastenum
thoracic cavity between the lungs just behind the sternum
tid
three times a day
Which hearing test measures hearing by using air and bone conduction?
tuning fork
bid
twice a day
Double booking
two patients scheduled at the same time; one may be seen by a physician while the other gets diagnostic tests--works in urgent patients
Hearing test is called
tympanometry
Micturate and void both mean
urinate
Laser surgery
used for photocoagulation therapy procedures because this surgery uses light waves for thermal vaporization, coagulation, and ablation.
Length, height, weight, weight-for-length, and head circumference
used to assess growth and development in infants, children and adolescents. Individual measurements are usually compared to reference standards on a growth chart
Hydrochlorothiazide
used to remove excess water from the body
Electrosurgery
uses an instrument to deliver an electrical current that can cut tissue.
steam sterilization (autoclave)
uses steam under pressure to obtain high temperature of 250-254 F with exposure times of 20-40 minutes depending on the item being sterilized
chemical sterilization
uses the same chemical used for chemical disinfection but the exposure time is longer
What is a bacteria that resembles a comma shape?
vibrio
Interval
wave plus a segment
Standard Precautions
wear gloves when collecting and handling blood, body fluids or tissue specimen; wear face shields when there is a danger for splashing on mucous membranes; Dispose of all needle and sharp objects in puncture- proof containers without recapping
Cardiovascular agents isoproterenol
produces an overall increase in heart rate and myocardial contractility but newer agents have replaced it in most clinical setting
If a guy takes a pregnancy test and it comes out positive, what does this indicate?
prostate cancer
Whistleblower Protection Act
protects employees from retaliation when reporting unsafe activities
purulent
puss
What's the most common pulse?
radial
pyrexia
raised body temp, fever
Respiration
rate, rhythm, and depth
Right ventricle
receives deoxygenated blood from the right atrium which it pumps to the lungs for oxygenation through the pulmonary trunk and then to the pulmonary arteries
right atrium
receives deoxygenated blood returning to the heart from the body via the superior vena cava which caries blood from the upper body and the inferior vena cava which carries blood from the lower body
left atrium
receives oxygenated blood returning from the lungs via the tight and left pulmonary veins
Standard Bipolar Limb Leads
record electrical activity in the frontal plane
Augmented Unipolar Leads
record the heart electricity from one limb and compare it with a zero voltage lead in the center of the heart
left ventricle
reeceives the oxygenated blood from the left atrium and pumps it to the body through the aorta, the largest artery of the body
HR provides info about the heart's:
rhythm, volume, and vessel elasticity
What's the most important of the 10 rights?
right patient
Electrical impulse are initiated in what node?
sinoatrial node
What is malfeasance?
when a person knowingly commits an unlawful/wrongful act
Arrhythmias of sinus orgin
where electrical flow follows the usual conduction pathway but is too fast, too slow, or irregular
Bowman's capsule
where the kidney filters water and waste from the blood -shaped like a C
What's the most important thing to remember when doing a capillary puncture?
wipe away the first drop of blood bc bacteria
Centimeters to inches
x cm * 0.39 = x inches
Inches to centimeters
x inches * 2.54 = x cm
Event monitoring
some patients have sympotoms very infrequently that a holter monitor yields little useful data. these patients are best suited for an even recorder, a hand held device carried in the patients pocket or purse which is switched only when the patient is actually experiencing the symptom
Mode of Transmission
specific ways in which microorganisms travel from the reservoir to the susceptible host. There are 5 main modes of transmission: contact (direct and indirect), droplet, airborne, common vehicle, vectorborne
Hypoventilation
state in which reduced amount of air enters the lungs resulting in decreased oxygen level and increased carbon dioxide level in blood
Hyperventilation
state in which there is an increased amount of air entering the lungs
Urinary catherizations are used for what kind of samples?
sterile
septum
structure in the middle of the heart divides the heart into two sides
SQ
subcutaneous
sl
sublingual
Assess Rhythm/ Regularity
the HR is considered regular if all the RR or PP intervals on the EKG leads are equal. If there are changes in their duration the rhythm us urregular
Conductivity
the ability to receive and transmit electrical impulses to adjust cells
Excitability
the ability to respond and react to stimulus
Automaticity
the ability to spontaneously trigger electrical impulses without being stimulated by another source
Cardiac Output
the amount of blood ejected outside the heart per minute cardiac output= stroke volume x HR per/min
What happens if an electrode is disconnected?
the baseline is interrupted; the tracing moves into the margins
Muslin
the blue sheet used in sterile fields for surgery
Medical Asepsis
the destruction of pathogenic microorganisms after they leave the body; it also involves environmental hygiene measures such as equipment cleaning and disinfection procedures
Cardiovascular agents lidocaine
the drug of choice for the suppression of ventricular ectopy contractions including ventricular tachycardia and ventricular flutter
Pre-excitation syndromes
the electrical impulses bypass the normal pathway and instead go down an accessory short cut
palpation
the examiner uses the sense of touch to determine the characteristics of an organ system
Blood Pressure
the force exerted by circulating blood volume on the walls of the artery during circulation BP=cardiac output x vascular resistance Higher cardiac output will result in a higher BP High vascular resistance will also result in a higher BP Lower cardiac output Or lower vascular resistance will result in a lower BP
Susceptible host
the infectious agent enters a person who is not resistant or immune
visceral pericardium or epicardium
the inner most layer of the pericardium
endocardium
the innermost layer of the heart
Lead aVL
the left arm is positive and the other limbs are negative
Lead I
the left arm is positive and the right arm is negative
Lead III
the left leg is positive and the left arm is negative
Lead II
the left leg is positive and the right arm is negative
Lead aVF
the left leg or foot is positive and the other limbs are negative
INR means
international normalized ration (1:9 sodium citrate: blood)
Portal of exit
the method by which an infectious agent leaves its reservoir
myocardium
the middle and contractile layer of the heart
Account receivable
the money that a company has a right to receive because it had provided customers with goods and/or services
IM
intramuscular
IV
intravenous
Entering without knocking is considered
invasion of privacy
Stress testing
is a noninvasive diagnostic procedure to determine indirectly the presence and severity of coronary artery disease and the heart muscle lack of blood supply
EKG Basic Concepts Electrode
is a paper, plastic or metal sensor placed on the patients skin on a specific location and transmits it to the cable
EKG Basic Concepts Lead
is a recorded tracing of the heart electricity from one or two electrodes that provides a specific view of the heart
pericardium
is the outermost layer of the heart
Cardiovascular agents verapamil
is used in the treatment of paromxysmal supraventricular tachycardia effective in terminating more than 90% of episodes of PVST in adults and infants
Somatic Tremor
it is a jittery pattern caused by the patients shivering or by shaking wires
Type II second Degree AV block (Mobitz II)
it is a more serious pathology Conducted P waves have a constant PR interval; but there are always non-conducted P waves between cardiac cycles, usually producing a "conduction ratio" between atria and ventricles
Asystole (cardiac arrest)
it is a total absence of ventricular electrical activity.
Supraventricular tachycardias Atrial Tachycardia
it is caused by an irritable focus in the atria that fires electrical impulses after the normal firing of the SA node pacemaker HR is regular between 100 to 150 bpm
Atrio-Ventricular Blocks Type I first degree AV block
it is characterized by a delay of impulses at the level of AV node PR interval is prolonged and is greater than 0.2 sec
Wandering Baseline
it is when the baseline moves up and down on the EKG paper
What is remittance advice?
it notifies the provider if denial of a claim by an insurance carrier occurs
Lbs---> kg kg----> lbs
lbs x.45 = kg kg x 2.2 = lbs
Where do you perform a TB test?
lower forearm -.1 cc -PPD in syringe
diastole
lowest amount of pressure exerted during the cardiac cycle the period of relaxation and filling of all cardiac chambers
S1 first heart sound
lubb occurs during ventricle contraction and the closure of AV valves
What is the most important thing to remember when using a mechanical lift?
make sure the brakes are on!!!
Microgram abreviation
mcg
qid
means four times a day
Blood pressure
measurement of the amount of force exerted by the blood on the peripheral arterial walls and is expressed in millimeters of murcury
ACO
medicare
Diabetes mellitus vs. diabetes insipidus
mellitus is metabolism of sugar and insipidus is an disorder of salt and water metabolism
What is shingling?
method of filing paper medical records involving placing newer reports on top of older ones
Telemetry
monitoring
To properly dispose a needle into the Sharps container, drop it in how?
needle first
repolarization
occurs immediately after depolarization and is the movement of positively charged ions back to the outside of the cell, returning the cell back to its original polarized state
Depolarization
occurs when positively charged ions rapidly move from outside the myocardial cell membrane to the inside changing the overall charge from negative to positive
Gas sterilization
often used for wheelchairs and hospital beds. useful in hospitals but costly for the office
Small boxes
one minute has 1500 small boxes. count the number of small boxes between an RR interval and divide into 1500. This method is more accurate and is used for regular rhythms only
parietal pericardium
outermost layer of the pericardium
Common cardiovascular agents
oxygen epinephrine isoproterenol dopamine beta blockers lidocaine verapamil digitalis morphone sulfate nitroglycerin
Pediculosis/lice is a
parasite
Trendelenburg position
patient is placed flat on the back, face up, the knees flexed and legs handing off the end of the table with the legs and feet supported by a foot board. this position is used primarily for surgical procedures of pelvis and abdomen
Modified wave scheduling
patients are scheduled in 15-minute and 30 minute increments
pr
per rectum or by way of the rectum
To confirm a patient's understanding of insulin administration, have them dow aht
perform a self demonstration and observe the patient
Dorsal lithotomy position
position is similar to the dorsal recumbent position, except that the patient's legs are well separated and thighs are acutely flexed. the feet are usually placed in stirrups and a folded sheet or bath blanket is placed crosswise over thighs and legs so that genital area is easily exposed
The hypothalamus controls the body's temperature through the use of a
positive feedback loop
6 second method
the number of QRS complexes between 6 sec marks on the EKG paper is multiplied by 10. Used generally for estimating slow or irregular rhythms
rate
the number of respiration per minute; normal range for adults is 12 to 20 per minute
Sim's Position
the patiene is on his/her left side with the right knee flexed against the abdomen and the left knee slightly flexed. the left arm is behind the body; the right arm is placed comfortably
Dorsal recumbent position
the patient is on his/her back with knees flexed and soles of the feet flat on the bed
Knee-chest position
the patient is on his/her knees with his/her chest resting on the bed and elbows resting on the bed or arms above head the head is turned to one side. the thighs are straight and lower legs are flat on the bed
Prone position
the patient lies on his/her abdomen with head turned to one side for comfort, the arms may be above head or alongside the body
Horizontal Recumbent position
the patient lies on his/her back with legs extended; Arms may be above the head, alongside the body or folded on the chest
Who owns the medical record?
the provider
Ventricular Fibrillation VF
the rhythm is a chaotic deflection of different waves that vary in size, shape and duration There are no normal visible waves there is no contraction there is no blood ejected in the blood vessels so the blood can clot. this is a medical emergency which requires defibrillation and CPR
Lead aVR
the right arm is positive and the other limbs are negative
Answer the telephone by which ring?
3rd
Polyuria
Excessive urination
Hemoglobin is abbreviated:
Hg
Body mechanisms
How we conduct ourselves when we are working with patients -bend knees -don't reach/twist
Mechanical lift
Hoyer lift is what it used to be called -Originally for obese patients but now used for paraplegics, children, and other populations -Important to lock the wheels when loading a patient!
HCG
Human Chorionic Gonadotropin -Hormone released during pregnancy/pregnancy tests check for presence of this hormone
Phlebitis
Inflammation of the veins
The infection process cycle
Reservoir host --> means of exit --> means of transmission --> means of entry --> susceptible host
Wernicke's area
Responsible for language comprehension
pH of urine for adults should be in what range?
4.5-8
RBC for males: RBCA for females:
4.7-6.1; 4.2-5.4
Subcutaneous injection
45° - aspirate for blood
AMA
American Medical Association
Payment for treatment should be taken when?
Anytime before treatment
Find an unconscious patient - before beginning CPR:
Call for help
TJC recommends healthcare professionals be immunized against
Influenza
Hematocrit
Proportion of blood that consists of packed RBC expressed as a percentage by volume -For men = 40-54% -For women = 36-48%
MI Myocardial Infarction
defined as sudden death of the myocardial tissue due to an abrupt cessation of the blood flow Marked ST elevation with hyperacute T waves reflect complete muscular wall damage in later stages deep Q waves are seen on the leads facing the lesion manifesting necrosis Pathological Q waves and inverted T waves are signs of fibrosis and scar tissue formation
Correcting errors in an EHR
delete it
When a patient's private info is disclosed without their consent it's considered:
A breach of confidentiality
Pulse
adult range is 60 to 100 bpm Radial artery- found in the wrist on the same side as the thumb Apical pulse- taken over the apex of the heart by auscultation using the stethoscope
When should you label a specimen, before, during, or after collection?
after
pc
after meals or not on an empty stomach
How are mumps transmitted?
airborne
Surgical Asepsis
all microbial life, pathogens and non pathogens are destroyed before an invasive procedure is performed
precordial chest unipolar leads
all these elctrodes are positive and record the heart electricity in the horizontal plane
Portal of entry
allows the infectious agent access to the susceptible host. Common entry sites are broken skin, mucous membranes, and body systems exposed to the external environment such as respiratory, gastrointestinal and reproductive.
Leads I,II,and III are
bipolar
Cysto-
bladder
PKUs are tested with a
heelstick
Pinworms are a parasite known as
helminths
PO
"Per os" - taken by mouth
Encounter form
"superbill" -info about services provided, referrals, follow up appt
Starling Law
"the greater the volume of blood inside the heart during diastole, the stronger the heart contraction force during the systole"
CPR
-30 compressions + 2 breaths -100-120 compressions/minute
3 types of patient records
-Active -Inactive -Closed
Urine Collections
-Pregnancy = want 1st morning void -24-hr collection = collect throughout the day, discard 1st sample -Urine should be stored in the refrigerator -Sample should be labeled on the container NOT lid. Should include patients name (last, first), date, and your initials
the specific gravity of urine in adults should be in what range?
1.002-1.028
10 rights of drug amn
1. Right drug 2. Right patient 3. Right dose 4. Right route 5. Right time and frequency 6. Right documentation 7. Right history and assessment 8. Drug approach and right to refuse 9. Right drug-drug interaction and evaluation 10. Right education and information
Four steps to cleaning instruments
1. Sanitization 2. Disinfect 3. Sterilize 4. Autoclave
6 Rights of Medication Administration
1. The right medicine 2. The right route 3. The right time 4. The right client 5. The right dosage 6. The right documentation
When taking a newborn babies heel stick, do not use a lancet longer than...
2.4 mm
What does the Department of Health say that the chance of catching HIV from a single needle stick is?
3 in 1000 or 0.3%
Potassium levels should be in what range
3.5-5
Continuous Fever
A fever that remains constant above the baseline; it does not flucuate
Chain of custody
A form -Required for evidence -Everyone who comes into contact signs -MA's can only transport
PVC- Premature Ventricular complex
A premature ventricular complex arises from an within the ventricles the QRSs of PVC is typically greater than 0.12 sec because the ventricular depolarization is abnormal or aberrant T waves are usually in opposite direction of the QRS complex A full compensatory pause usually follows a PVC
Microhematocrit
A procedure for determining the ratio of the volume of packed red blood cells to the volume of whole blood by centrifuging a minute quantity of blood in a capillary tube coated with heparin
Asthma
A respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually results from an allergic reaction or other forms of hypersensitivity
Seizure
Abnormal electrical activity in the brain
Edema
Abnormal swelling -Skin is puffy and pale -palpate, if it doesn't bounce back, it's edema
Afebrile
Absence of fever
Volume 2
An alphabetical index that contains the same conditions and diseases in alphabetical order
Amoxicillin
Antibiotic that may be used to treat URI
Cardiac cell properties
Automaticity, excitability, conductivity, contractility
Hemostasis
Blood clotting factors that help keep blood levels in check -stopping of blood flow
Aneurism
Blood clot in the brain -Bulging of the artery --> bursts --> hemorrhage --> stroke
Korotoff sounds
Blood pressure sounds
Comminuted fracture
Bone breaks in multiple places
Compound fracture
Break through the skin
Hemolysis
Breakdown of blood cells by bursting open -Never shake test tubes containing blood - only invert
Femoral pulse
By the groin
Chief Complaint
CC the reason why the patient came to see the physician
Diabetes
Cannot control sugar intake - body is unable to produce or respond appropriately to insulin -Diabetes mellitus
Code blue
Cardiac arrest
Individual patient records should be organized by
Category
CDC
Center for Disease Control -Control the spread and containment of diseases in the population
CVA
Cerebrovascular accident -like a stroke (lack of oxygen) -aneurysm (rupture of an artery) -seizure (abnormal electrical activity)
Angina pectoris
Chest pain
COPD
Chronic Obstructive Pulmonary Disease -blockage in lungs
Thrombocyte
Clot
If there is no diagnosis
Code signs and symptoms
Ishihara
Color blind acuity test
COLA
Commission on office laboratory accreditation
Anti-embolic stockings
Compression hose used to avoid deep vein thrombosis (blood clots) and promote circulation -For people who gait (walk)
Transmission- Based precautions
Contact precautions; Airborne precautions;droplet precautions
CPT
Current procedure terminology -Used to bill outpatient and and office procedures -AMA is in charge of CPT -CMS in finance stands for Center of Medicare and Medicaid
Blood vessel (system) that supports the heart
Coronary system
CHAMPVA
Covers the spouse of a veteran
-tripsy
Crushing
Necrosis
Death of tissue in your body
Infarction
Death of tissue in your heart -aka a heart attack
Capillary puncture
Drawing blood from capillaries instead of veins usually in by way of the fingers or heel -Use a lancet -Use middle or ring finger -Most important step = wiping away the first drop of blood
DEA
Drug Enforcement Agency -Handle all drug interactions and distributions whether legal or illegal
Emetics
Drugs intended to cause vomiting
S2 second heart sound
Dupp occurs during ventricular relaxation when SL valves close
At the beginning of the day, you should check appointments with
Each team member
Difference between EMR and EHR
EMR is specific to that location; EHR is for everyone/everywhere
Class C fire
Electrical fire - requires non-conductive extinguishing
The limbic system of the brain is responsible for the regulation of...
Emotion
How often should you move transdermal patches?
Every 30 mins
Diaphoretic
Excessive sweating
Mononucleosis is caused by
Epstein-Barr
V3
Equidistant between V2 to V4
ESR
Erythrocyte Sedimentation Rate -how fast or slow blood separates -lower number, the healthier you are -27 = healthy for girls 20 = healthy for boys -high numbers indicate inflammation
CPT code broken down into 6 sections:
Evaluation & Management - includes physician encounters for all patient visits and services Anesthesia Surgery Medicine Pathology Lab & Radiology
EPO
Exclusive Provider Org -Requires that physician work for them
Every medical institution is required by OSHA to have what kind of control plan?
Exposure Control Plan
You must obtain a release form if you are going to send a patient's medical records by
Fax -DO NOT if by hand or classified mail
V5
Fifth intercostal space, anterior axillary line
V4
Fifth intercostal space, left midclavicular line
V6
Fifth intercostal space, midaxillary line
Mucinex and Albuterol
Improve breathing status
Where do you find the diagnosis for ICD-9?
In the index - then check out the diagnosis in the tabular list
Bronchitis
Inflammation of the bronchioles
Parenteral medication
Injections
Catherization
Inserting a tube into the urethra to obtain urine -Used to obtain completely sterile urine -Position patient in dorsal recumbent -Put on sterile gloves after opening the sterile kit
physical examination
Inspection; palpation; percussion; ausculation
TRICARE
Insurance that covers dependents of those on active duty
ICD
International Classification of diseases -To find specific code look in the tabular list?
Entering a room without knocking is:
Invasion of privacy
Cyrosurgery
Involves freezing
Microsurgery
Involves the use of tiny instruments
Cleaning a site
Inward --> outward
What does "Respondeat Superior" mean?
Let the master answer
Privacy Rule
Limits info given to the minimum possible to receive payment
The only position for women only:
Lithotomy -On back, heels above hips
Bundle Branches
Located at the interventricular septum, the bundle of HIS divides into the right and left bundle branches the function of which is to conduct the electrical impulse to the purkinje fibers throughout the vnetricles
Code pink
Missing infant in the hospital -now they have infant security devices (ankle security devices)
Hemoglobin
Molecular protein in blood that carries O2 to the tissues A1C assay - for diabetics - tracks blood sugar management for ~3 month time period
Account payable
Money owed by a business to its suppliers shown as a liability on a company's balance sheet
Leucocytes
Neutrophils Lymphocytes Monocytes Eosinophils Basophils
Nocturia
Nighttime urination
Business size envelopes
No. 10
Carotid pulse
On the neck -Used in adult CPR
Radial pulse
On the wrist -most common
Class A fire
Ordinary fire with combustable materials - can be put out with water or water based solution
Volume 1 = tabular list
Organized by disease and injuries according to etiology and organ system -Contains 5 appendices, V codes, E codes, and 17 chapters -Diseases and condition listed in numerical order -Sub-classification gives the highest level of specificity and has 5 digits
Organ that produces insulin
Pancreas
PKU
Phenylketonuria -Series of tests 24 hr after any birth in the US -Metabolic disorder than causes brain damage -heelstick
What gland atrophies as we age?
Pineal
If a patient complains of fainting If a patient is have a seizure
Place them gently on the floor in the supine position
Febrile
Presence of fever
Thyroid gland
Produces hormones
PT
Prothrombine -clotting factor
PT/INR
Prothrombine test -light blue tube -how well blood clots -3/4 inversions International Normalized Ratio 1:9 - standardized around the world 9 parts blood 1 part sodium citrate
PTT
Prothrombine time test; how long it takes blood to clot
PFT
Pulmonary Function Test -Spirometer or peak flow meter -For asthmatics or post-op
Informed consent
Requires a signed form -Dr has to sit down with patient to explain procedure and obtain signature -MA cannot explain form, but witnesses signature
Security Rule
Requires special precautions that ensure patient info is stored and transmitted in a way that remains confidential, accessible, and of high quality
Erythma
Redness of the skin
ROI
Release of info
Dentures
Remove dentures top first
-plasty
Repair
R.A.C.E for fires
Rescue/remove, alarm, contain, extinguish/evacuate
SSI
Social Security Income
Broca's area of the brain is responsible for the regulation of...
Speech
Sterile field
Sterilization - to kill and destroy all germs, pathogens, viruses, disease etc
-ostomy
The making of an opening
Who is generally responsible for making sure that medical personnel keep their professional status up-to-date?
The office administrator
A discharge summary report must include...
The patient's final condition
Capitation
The process of using the number of member enrolled in a plan to determine the salary of the physician
An emulsion
Tiny particles of oil suspended in fluid
MA duties
To greet and instruct
Percussion
To listen to a sound by touching
Auscultate
To listen with a stethoscope
Asperate
To pull something back
Primary function of melatonin
To regulate sleep/wake cycles
Metastasize
To spread/enlarge
Oliguria
Too little urine/lack of urine
Parietal lobe responsible for
Touch and body movements
When a physician asks you to write up their record consultation, you're acting as a...
Transcriptionist
TIA
Transient Ischemic Attack -Poor O2 circulation
-lactric
Treatment
Point of care
Treatment done other an intentional treatment
Apical pulse
Under the left chest -Used with infants -Apex of the heart
UTI
Urinary Tract Infection -90% from sex (so considered an STI)
Abnormal urine pH levels may indicate
Urinary tract infection or disorder -Normal = 6-7.4
Sequential compression devices
Use compression to prevent against blood clots -Made for the whole body -For those who don't gait
Peak Flow Meter
Used for PF testing to measure how well air moves out of the lungs -commonly used with asthmatics
Spirometer
Used for PF testing to measure the air capacity of the lungs
Yellow tubes
Used for blood cultures -Contain ACD or SPS -Require 8-10 inversions
Green tubes
Used for chemistry tests that require plasma or whole blood and STAT chemistry tests -Contain heparin -Require 8-10 inversions
Blue tubes
Used for coagulation tests -Contain sodium citrate or CATD -Used for prothrombine tests -Require 3-4 inversions
Lavender tubes
Used for hematology (hemoglobin, hematocrit, white blood cell, red blood cell, and platelet count, reticulocyte count, eosinophil count, body fluid counts, sickle cell test, and erythrocyte sedimentation rate) and some blood banking tests -Contain EDTA which helps maintain the shape of the cell and reduce platelet clumping -Require 8-10 inversions
Analgesic
Used for pain management
Hyperpnea
abnormal increase in the depth and rate of breathing
Allergy tests are performed on the:
back or lower forearm
Why shouldn't you pump when making a fist?
bc of hemoconcentration
Ante-
before
Kohlberg
believed that moral development and ethical behavior relied on the age and problem-solving ability of the individual
cardiovascular agents beta blockers
beta blockers reduce heart rate, blood pressure, myocardial conductibility and myocardial oxygen consumption which make them effective in the treatment of angina pectoris and hypertension
semilunar valves
called semilunar because they have half-moon shaped leaflets, with the following characteristics: three leaflets shallow in depth they have no accessory organs
Broken record
can be cause by a damaged wire or loose electrodes
When conducting an alcohol test, instead of using alcohol to clean, you should use:
chlorohexadine
60-cycle interference
caused by improperly grounded electrical equipment that is directly or indirectly in contact with the patient
ADH
causes the kidneys to become more permeable in order to retain more water.
Largest and uppermost part of the brain
cerebrum
Varicella zoster virus
chickenpox; airborne
Color red indicates
danger , warning
Bradypnea
decrease in number of respiration
A depletion of lipids would lead to...
decreased amount of estrogen produced -Lipids are the precursors to many hormones in the body and with a depletion of lipids, this would result in a decrease in hormones like estrogen.
To clean EKG cables, always:
disinfect
How should wounds be wrapped?
distal to proximal
qd
every day
Supra-
excessive
nocturia
excessive urination at night
Casts
hardened proteins that are washed out in the urine, and may provide many diagnostic values -Sediment = any waste particles in the urine, different than casts
EKG Basic Concepts Cable
is a wire that connects the electrode to the EKG machine
Artifact
is an unwanted interference or jitter on the EKG recording
Supraventricular tachycardia AV reentry Tachycardia
is caused when the elecrtical impulse passes through a passage other than AV node. Cardiac rhythm is regular but up to 250 bpm. P waves are often hidden by the QRS complexes or the QRS complexes that follow a P wave are different and with different P interval
Bicuspid mitral valve
is located between the left atrium and the left ventricle
Tricuspid valve
is located between the right atrium and right ventricle
Heart skeleton
is made up of four rings of thick connective tissue; these rings which surround the base of the heart and large vessels, create the cardiac septum, and provide a solid connection between the heart chambers and strong attachment for the heart valves
Subendocardial ischemic injury
is manifested by ST segment depression in the leads recording in front of the ischemic site
Subepicardial and transmural injury
is manifested by ST segment elevation in the leads recording in front of the lesion
Absolute refractory period
is the 1st phase of repolarization in which a myocardial cell is unable to react to any electrical stimulus
Relative refractory period
is the 2nd phase of repolarization during whcih time a strong enough electrical stimulus might cause new depolarization and contraction
Pediculosis
lice
Liminents vs medicated lotions
liminents have more oil to protect dry/cracked skin
segment
line between two waveforms
Right Upper Quadrant:
liver and gallbladder
heart base
located at the level of the second intercostal and the tip of the heart (apex) is located at the level of the 5th intercostal and mid-clavicular line on the left
Atrioventricular valves
located between the atria and ventricles: they have tough fibrous rings long and strong leaflets(cuspids) they have accessory organs, such as papillary muscles and chordae tendinae
Aortic valve
located between the left ventricle and aorta
pulmonic valve
located between the right ventricle and the pulmonary trunk
Always puncture ________ to the fingerlines when doing a fingerstick
perpendicular
Conjuctivitis
pink eye
wave form
refers to movement away from the isoelectric line either upward (positive) deflection or downward (negative) deflection
Depth of respiration
refers to the amount of air that is inspired and expired during each respiration
Respiratory rhythm
refers to the pattern of breathing
Dry heat sterilization
requires higher temperature that steam sterilization but longer exposure times; used for instruments that easily corrodes
Before administering insulin, what should you do to the bottle first?
roll it
What day do you send a specimen to the lab?
same day
Wave scheduling
scheduling patients on the hour and then taking them in order of who comes
Cluster scheduling
scheduling patients with the sam problems/conditions/symptoms
Normal EKG segments
segments are lines between waveforms PR segment: this segment is measured from the end of the P wave to the beginning of the QRS complex. represents depolarization of AV node and its delay and depolarization of the Bundle of His and the Bundle Branches ST segment: this segment represents the time of ventricular contraction and the beginning of re polarization of both ventricles. It is measured from end of QRS to the beginning of the T wave. The point where QRS complex and the ST segment meet is called the junction or J point. ST segment is the most sensitive part of EKG changed by cardiac ischemia
sequence method
select the R that falls on a dark vertical line. Number the next consecutive dark line as 300-150-100-75-60-50 Note where the next R wave falls in relation to the dark lines
Complex
several waveforms
Impetigo
skin infection that causes sores on the face
Vitiligo
skin pigmentation; lack of reproduction of melanin
Tort Law
slander (what's said), libel (written); falls under HIPAA
Gauges = bigger the number,
smaller the needle
Cancer can present itself by...
suspicious lumps, a chronic cough, persistent indigestion, and coughing up blood.
Enteric-coated tables should ONLY be:
swallowed
Lordosis
swayback; major inward curve of lumbar spine