CCMA Certification study guide – Flashcards
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Chief complaint CC
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The reason a patient called for help. Also, the patient's response to questions such as "What's wrong?" or "What happened?"
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History of present illness HPI
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Explains the chief complaint. A chronological description of the development of the patient's present illness from the first sign or symptom or from the previous encounter to the present.
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Vital Signs
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Temperature, pulse, respiration, and Blood pressure are all ___________ ___________.
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Normal oral temperature
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97.6F - 99.6F
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intermittent fever
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Fever that alternates between elevated and normal or subnormal body temperatures.
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Remittent fever
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fever in which temperature fluctuates greatly but never falls to the normal level.
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Continuous fever
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A fever that remains constant above the baseline, does not fluctuate.
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60-100 BPM
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Normal pulse rate
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Respirations
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Rate, rhythm, and depth are taken into account when measuring what?
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Systole
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contraction of the heart
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Diastole
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relaxation of the heart
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Anthropometric measurements
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Measurement of height, (length rather than height is used in infants because they cannot stand.), weight, BMI, head circumference in infants, waist to hip, % of body fat.
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Inspection
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General appearance, state of nutrition, body habits, symmetry, pasture and gait, speech.
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palpation
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to examine by touch
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Percussion
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physical examination method of tapping over the body to elicit vibrations and sounds to estimate the size, border, or fluid content of a cavity such as the chest.
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Ausculation
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the act of listening to sounds arising within organs (as the lungs or heart) as an aid to diagnosis and treatment.
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OSHA
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a government agency in the Department of Labor to maintain a safe and healthy work environment
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cardiopulmonary resuscitation
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an emergency procedure for life support consisting of artificial respiration and manual external cardiac compression
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SHOCK
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This is caused by inadequate blood flow to the heart and in turn to the rest of the body.
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Symptoms of shock
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Pale, cold, clammy skin rapid, weak pulse increased shallow breathing expressionless face or staring eyes are all ____________ ___ _________.
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First aid for Shock
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maintain open airway for the victim, call for assistance, keep victim lying down w/ head lower than rest of body; attempt to control bleeding or other cause of shock if known; keep victim warm until help arrives
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Portal of exit
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Method in which a infectious agent leaves the reservoir. Ex: contact with body fluids such as blood or saliva.
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mode of transmission
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contact, droplet, air, vehicles, or vectorborne
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Portal of entry
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A pathway by which the causative agent enters the host. The area in which a microorganism enters the body. They may be cuts, lesions, injection sites, or natural body orifices.
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Susceptible host
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An individual who has little resistance to an infectious agent.
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Disinfection
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Process used to destroy microorganisms; destroys all pathogenic organisms except spores, can only be used on inanimate objects. Will not be used for invasive procedures, and will not be inserted into body orifices nor be used in sterile procedure.
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Chemical sterilization
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Uses the same chemical used for disinfection, but exposure time is longer.
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Steam sterilization (Autoclave)
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uses steam under pressure to obtain higher temperature (250-254F) with exposure time of 20-40 minutes depending on item being sterilized.
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hand washing
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What is the most important means of preventing the spread of infection?
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hand antisepsis
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the removal & destruction of transient microorganisms using antimicrobial soaps.
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PPE Personal protective equipment
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mask, goggle, face shield, respirator
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Intradermal Injection
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ID; 15 degrees no aspiration; used for TB test, allergy test, and local anesthetic
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Intramuscular Injection
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IM; 90 degress with aspiration
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Subcutaneous Injection
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SQ; 45 degress
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pericardium
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protective sac enclosing the heart composed of two layers with fluid between
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Right atrium
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The upper right chamber of the heart, where deoxygenated blood is received from the vena cava and then sent to the right ventricle.
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Right ventricle
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the chamber on the right side of the heart that receives deoxygenated blood from the right atrium and pumps it into the pulmonary trunk
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Left atrium
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the left upper chamber of the heart that receives oxygenated blood returning from the lungs via the right and left pulmonary veins.
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Left ventricle
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the chamber on the left side of the heart that receives oxygenated blood from the left atrium and pumps it into the aorta
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Aorta
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The largest artery of the body
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Pulmonary arteries
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The only arteries in the body that carry deoxygenated blood.
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pulmonary veins
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the only veins in the body that carry oxygenated blood.
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atrioventricular valves
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Separate the atria and the ventricles. Right sided tricuspid, left sided mitral
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tricuspid valve
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between right atrium and right ventricle
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mitral valve
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between left atrium and left ventricle.
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Pulmonary valve
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between right ventricle and pulmonary trunk.
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Aortic Valve
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Between left ventricle and aorta
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depolarization
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sodium rushes into neuron through membrane, potassium ruses out; results in a positive charge
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repolarization
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when the K+ ions leave the inside of the axon, making the inside charge negative. Myocardial relaxation.
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SA NODE
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the pace-maker of the heart; where the impulse conduction of the heart usually starts; located in the top of the right atrium just below superior vena cava
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AV node
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Located at the posterior septal wall at the right atrium just above the tricuspid valve. There is a 1/10 second delay of electrical activity at this level to allow blood to flow from the atria to the ventricles.
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Lead I
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Left arm is positive and right arm is negative (LA-RA)
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Lead II
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Left leg is positive and right arm is negative (LL-RA)
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Lead III
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Left leg is positive and left arm is negative (LL-LA)
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aVR
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The right arm is positive and the other limbs are negative
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aVL
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The left arm is positive and the other limbs are negative
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aVF
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The left leg (or foot) is positive and the other limbs are negative
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V1
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4th intercostal space, right sternal border
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V2
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4th intercostal space, left sternal border
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V3
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equidistant between v2 and v4
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V4
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5th intercostal space, on the left midclavicular line
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V5
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5th intercostal space at the anterior axillary line
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V6
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5th intercostal space, midaxillary line
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1mm
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1 small square on eKG grid is equal to
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5mm
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1 large square on EKG grid is equal to
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1mv
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2 large squares on EKG grid is equal to
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.04 seconds or 40m seconds
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1 small square on eKG grid is equal to how much time?
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.2 seconds or 200m seconds
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1 large square on eKG grid is equal to how much time?
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1 second or 1000 m seconds
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5 large squares on eKG grid is equal to how much time?
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25mm per second
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The running speed of an EKG is?
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Horizontal axis
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What represents time on an EKG?
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Vertical axis
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What represents amplitude on an EKG?
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P Wave
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Deflection produced by Atrial depolarization. Normal range does not exceed 0.11s in duration or 2.55mm in height.
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T wave
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Deflection produced by ventricular repolarization
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QRS complex
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Ventricular depolarization
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Somatic tremors
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Patients tremors or shaking the wires can produce jittery patterns on the EKG tracing.
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Wandering baseline
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sweat or lotion on the patients skin or tension on the electrode wires can interfere with the signal going to the EKG apparatus causing the baseline of the tracing to move up and down on the EKG paper.
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60-cycle interference
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can produce deflections occurring at rapid rate that may mimic atrial flutter. this is caused by electrical appliances or apparatus being used nearby while the tracing is taken.
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broken recording
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the stylus goes up and down trying to find the signal. tis can be caused by loose electrode or cables, or by frayed or broken wires
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arrhythmia
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abnormal heart rhythms
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Ischemia
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decreased blood flow to tissue caused by constriction or occlusion of a blood vessel can cause chest pain or angina
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Myocardial infarction
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Death of myocardial cells
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PR segment
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.16 mm/s; line from the end of the P wave to the onset of the QRS complex
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ST segment
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From J point to the onset of the T wave; if elevated above base line could indicate myocardial infarction (STEMI)
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Beta Blockers
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Reduce heart rate, blood pressure, myocardial oxygen consumption, effectively treat angina pectoris and hypertension. Contraindicated for cardiac stress test.
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5-6 liters
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The average adult has __ - ___ _______ of blood.
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55%
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How much of our blood is plasma?
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45%
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How much of our blood is made up of formed elements? RBC, WBC, Platelets
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99%
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____ Of formed elements are Red Blood cells
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Erythrocytes
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Oxygen carrying protein RBC's
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120 days
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What is the normal lifespan of an RBC?
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4.2-6.2 Million
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How many RBC's are the per microliter of blood?
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Thrombocytes
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Platelets are irregularly shaped packets of cytoplasm formed in the bone marrow from megakaryocytes. Promote blood coagulation.
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140,000-440,000
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What is the average number of platelets per microliter of blood?
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Leukocytes
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WBC that proves the body protection again infection.
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5,000-10,000
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What is the normail amount of Leukocytes for an adult per microliter?
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Leukocytosis
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Increased WBC's
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Leukopenia
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Decreased WBC's
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Neutrophils
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These WBC's are the most numerous and they comprise between 40-60%. of the WBC's
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Lymphocytes
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THe second most numerous WBC, comprise between 20-40% of the WBC's
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Monocytes
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Makes up 3-8% of WBC's population they are the LARGEST WBC's.
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Eosinophils
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Represent 1-3% of WBC populations. fight antibody foreign materials.
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Basophils
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Account for 0-1% of WBC's in the blood. They carry histamines to be released in case of an allergic reaction.
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Hemostasis
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The process by which blood vessels are repaired after injury. Prevents blood clot formation after venipuncture
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vascular stage, Platelet phase, coagulation phase, fibrinolysis
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Name the four stages of Hemostasis.
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guage, needle
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The smaller the needle ________ is the larger the diameter of the _______ is.
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needle adapters
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Also known as hubs or needle holders; one end has a small opening that connects the needle, and the other end has a wide opening to hold the collection tube.
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Winged infusion sets
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They are used for venipuncture on small veins such as those in the hand. The are also used for venipuncture in the elderly and pediatric patients.
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median cubital vein
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The vein of choice because is it large and does not tend to move the the needle is inserted.
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Cephalic vein
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The second choice for venipuncture. It is usually more difficult to locate and has a tendency to move, however, it is often the only vein that can be palpated in the obese patients.
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Basilic Vein
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The third choice for venipunctures. It is the least firmly anchored and located near the brachial artery. If the needle is inserted too deep, this artery may be punctured.
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3-4 inches above the venipuncture site
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Where should the tourniquet be placed when performing venipuncture?
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1. Blood cultures, 2. light blue top tubes 3. Serum (red or gray tubes) 4. green top tubes 5. lavender top tubes 6. Gray top tubes.
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What is the correct order of Draw?
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Fasting specimens
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Glucose Tolerance Test; Patient must have fasted and refrained from strenuous exercise for 12 hours prior tot he drawing.
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2 hour postprandial
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This test is used to evaluate diabetes melitus. Fasting glucose level is compared with the level 2 hours after eating a full meal of ingesting a measured amount of glucose.
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Blood cultures
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8-10 mL; Are measured to detect the presence of microorganisms in the patient's blood. Tests for septicemia.
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PKU
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To test for mental retardation or brain damage.
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Cold Agglutinins
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Red topper tubes, and must be kept warm.
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Chilled specimens
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Arterial blood gases ammonia lactic acid pyruvate, acth gastrin parathyroid
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Light sensitive specimens
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Bilirubin beta-carotene Vitamins A&B6 porphyrins
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Infant dermal puncture
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Use the lateral aspect of the heel (dorsal pedis lateralis), do not exceed more than 2.0mm.
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Older children & adult dermal puncture
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Use the distal segment of the third and fourth finger of the non dominant hand. Go perpendicular to the lines of the fingerprint.
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Lavender Tubes
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Contains EDTA. The tubes are used for CBC, RBC count, WBC & platelet count, WBC differential count, Hemoglobin and hemoaocrit determinations, ESR (erythrocyte sedimentation rater), Sickle Cell screening.
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Light blue tubes
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Contains sodium citrate, which prevents coagulation, tube must be completely filled. Test for coagulation studies.
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Green top tubes
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Chemistry tests. Heparin. tube should be inverted 8 times.
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Gray top tube
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Fasting blood sugar, Glucose tolerance test, blood alcohol levels, lactic acid measurement. Potassium Oxalate/Sodium Fluoride
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Red/gray speckled or gold top tube
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Serum Seperator Gel; Chemistry tests. Contain clot activators, glass particles, silica and celite. Must invert tubes 5 times.
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Red top tube
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Serum chemistry test, serology tests, blood bank. This is a plain vacuum tube that contains no additives
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Yellow top tube
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Sterile; Contains SUP sodium polyanetholesulfatonate; blood cultures; invert 8 times/
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At least once a day
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How often should tests be checked for accuracy?
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Toxicology
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Analyzes poison levels of drugs and poisons
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Blood type AB+
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is Universal Recipient
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Blood type O+
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Universal Donor
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ABGs
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analysis of aterial blood to determine the adequacy of lung function in the exchange of gases; transport on ice
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Anuria
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The absence of urine
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Hematuria
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The presence of blood in the urine
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Polyuria
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The passage of large volumes of urine
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First morning urine sample
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The type of specimen that is most commonly used for routine analysis and HCG (pregnancy) test
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Mid-stream Specimen
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A C&S specimen that is collected not at the beginning of end of voiding, but in the middle of urination.
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Clean-catch specimen
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A C&S specimen that requires special cleaning of the external genitalia prior to collection.
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anuria
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Little to no urine output.
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Hemoccult fecal occult test
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Detect imperceptible blood in stool. The first and last portion of the stool after a bowel movement.
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Invasion of privacy
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This is the release of medical records without the patient's knowledge and permission.
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C&S stool specimen
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specimen needs to be protected from contamination; instruct patients to avoid urinating while collecting the specimen
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nocturia
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urination at night
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Appendix A
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Section where special coding instructions are found
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peak flow meter
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A take home device used to test respiratory function
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transdermal patches
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A method of administering topical medication slowly and cosistently
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Hematemesis
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vomit blood
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sigmoidoscope
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An instrument used to view the sigmoid portion of the large intestine that is inserted rectally
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Apical pulse
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A method of determining heart rate by placing the stethoscope over the apex of the heart; commonly used for infants
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Hypoglycemic emergency
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A serious condition in which a patient's blood sugar drops critically low; giving the patient orange juice is a common method used to restore appropriate blood sugar level
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POL testing
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Physician office lab testing that is usually CLIA waved and can be performed by a medical assistant
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VDRL and TB
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Communicable diseases in which the infected patient 's information can be released to an outside source
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Hemothorax
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Blood in the chest cavitiy
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Nephrolithiasis
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kidney stones
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sterilization
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free of all microorganisms
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diaphoresis
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profuse sweating
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Nosocomial infections
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Infections derived from the patient staying in the hospital
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V codes
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identify conditions other than a disease or injury, but are not necessarily a primary diagnosis
