NHA Clinical Medical Assistant Study Guide (Virginia College) – Flashcards
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Depolarization
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Contraction of the heart (-)
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Repolarization
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Relaxation of the heart (+)
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Sympathetic Nervous System (SNS)
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Affects both the atria and the ventricles by increasing heart rate. conduction, and irritabilty.
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Autonomic Nervous System (ANS)
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Is subdivided into the sympathetic and parasympathetic nervous system.
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Parasympathetic Nervous System
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Affects the atria only by decreasing heart rate, conduction and irritability.
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Atrioventricular Valves (AV)
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Located between the atria and ventricles.
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Tricuspid Valve
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Located between the right atrium and the right ventricle.
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Mitral Valve
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Located between the left atrium and the left ventricle (also called the bicuspid valve).
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Murmurs
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Caused by diseases of the valves or other structural abnormalities.
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S1
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The first heart sound that occurs with the closure of the AV valves and signals the beginning of systole.
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S2
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The second heart sound which occurs when the semilunar valves (aortic and pulmonic) close.
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Aortic Valve
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Located between the left ventricle and the aorta
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Pulmonic Valve
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Located between the right ventricle and the pulmonary trunk
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Right Atrium
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Receives deoxygenated blood
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Superior Vena Cava
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Carries the blood from the upper body
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Inferior Vena Cava
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Carries the blood from the lower body
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Pulmonary Arteries
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Arteries that carry deoxygenated blood from the heart to the lungs (left and right)
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Left Atrium
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Receives oxygenated blood returning from the lungs via the right and left pulmonary veins.
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Pulmonary Veins
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Only veins that carry oxygenated blood.
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Left Ventricle
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The chamber on the left side of the heart that receives arterial blood from the left atrium and pumps it into the aorta
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Upper Chambers of the Heart
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Left and right atria (atrium is singular)
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Lower Chambers of the Heart
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Left and right ventricle.
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Endocardium
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The innermost layer of the heart.
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Myocardium
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The middle layer of the heart.
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Epicardium
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The outermost layer of the heart.
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qd
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every day
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bid
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twice a day
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tid
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three times a day
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qid
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four times a day
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qod
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every other day
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pc
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after meals or not on an empty stomach
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qhs
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every night
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prn
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as needed
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mg
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milligram
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mcg
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microgram
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g
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gram
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po
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by mouth or orally
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pr
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by way of the rectum
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sl
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sublingual
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IV
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intravenous
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IM
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intramuscular (in the muscle)
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SQ
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short for subcutaneous (meaning under the skin)
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Transmission-Based Precautions
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The second tier of precautions and are to be used when a patient is known or suspected of being infected with a contagious disease.
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Contact Precautions
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Are designed to reduce the risk of transmission of microorganisms by direct or indirect contact.
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Airborne Precautions
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are measure that reduce the risk for transmitting airborne infectious agents.
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Isolation Precautions
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A method of infection control that assumed that all human blood and body fluids were potentially infectious.
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Standard Precautions
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An infection control method designed to prevent direct contact with blood and other body fluids and tissues by using barrier protection and work control practices.
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Handwashing
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The most importanat means of preventing the spread of infection.
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Barrier Protection
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Refers to placing a physical barrier between the patients body fluids (such as blood and saliva) and the healthcare personnel (HCP) to prevent disease transmision.
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Disinfection
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A procedure used in medical asepsis using various chemicals that can be used to destroy many pathogenic microorganisms.
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Surgical Asepsis
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All microbial life, pathogens and nonpathogens, are destroyed before an invasive procedureis performed.
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Gas Sterilization
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Often used for wheelchairs and hospital beds. Useful in hospitals, but costly for offices.
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Dry Heat Sterilization
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Requires higher temperature than steam sterilization, but longer exposure times. Used for instruments that easily corrode.
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Chemical Sterilization
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Uses the same chemical used for chemical disinfection, but exposure time is longer.
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Steam Sterilization
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Uses steam under pressure to obtain high temperature of 250 - 245F with exposure times of 20 - 40 minutes depending on the item being timed as it hits the correct temperature listed above-maximum shelf life is 30 days for a sterile pack.
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Medical Asepsis
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Invovles enviromental hygiene measures such as equipment cleaning and disinfection procedures.
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AMS
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Agent...Mode of Transmission...Susceptible Host
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Agent (Portal of Exit)
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The method by which an infectious agent leaves its reservoir.
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Mode of Transmission (Portal of Entry)
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Specific ways in which microorganisms travel from the reservoir to the suseptible host.
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Suseptible Host
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The infectious agent enters a person who is not resistant or immune.
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Types of Mode of Transmission
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Contact of direct and indirect, Droplet, Airborne, Common, Vectorborne
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External Hemorrhage
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Controlling the bleeding is most effectively accomplished by elevating the affected part above the heart level and applying direct pressure to the wound.
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Sim's position
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Lying on the side with the right knee and thigh drawn upward toward the chest.
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Dorsal Lithotomy position
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Like dorsal recumbant (patient flat on back) but feet are in stirrups, placed farther apart and abducted (pelvic exams).
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Prone position
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Lying on the abdomen with the head turned to one side.
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Dorsal Recumbent positoin
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Patient in on his/her back with knees flexed and soles of the feet on the bed.
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Fowler's position
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A sitting or semi-sitting position; the head of the bed is raised between 45 and 90 degrees.
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Horizontal Recumbent position
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The patient is positioned lying flat on the back with the legs close together.
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Palpitation
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The examiner uses the sense of touch to determine the characteristics of an organ system.
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Percussion
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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.
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Auscultation
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This invovles listening to sounds produced by internal organs.
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Common errors in blood pressure measurement
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Improper cuff size / The arm not at heart level / Cuff not completely deflated before use / Deflationof the cuff is faster than 2 - 3 mmHg per second
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Tachypnea
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This is a respiration rate of greater than 40/min.
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Bradypnea
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Decrease in numbers of respirations.
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Respiratory rhythm
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Refers to the pattern of breathing.
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Cheyne Stokes (Death Rate)
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A regular pattern of irregular breathing rate.
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Orthopnea
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Difficulty or inability to breath unless in an upright position.
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Axillary temperature
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Temperature taken at the armpit.Tympanic te
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Tympanic temperature
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Temperature near tympanic membrane, ear.
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Oral temperature
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The temperature reading obtained by placing the thermometer in the patient's mouth under the tongue.
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Rectal temperature
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A temperature taken in the rectum.
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Pulse
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Ranges from 60 and 100 beats per minute.
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Pulse
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The site most commonly used, found in the wrist on the same side as the thumb.
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Apical Pulse
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A more accurate measurement of the heart rate and it is taken over the apex of the heart by auscultating using the stethoscope.
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Respiration
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The normal range for adults is 12 to 20 per minute.
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4 Vital Signs of Body
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Temperature / Pulse / Respiration / Blood Pressure
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Intermittent Fever
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Fluctuating fever that returns to or below baseline then arises again.
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Remittent Fever
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Fluctuating fever that remains constant above the baseline; it does not return to baseline temperature.
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Continuous Fever
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A fever that remains constant above the baseline; it does not fluctuate.
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Automaticity
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The ability of the heart to generate and conduct electrical impulses on its own.
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Excitability
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The ability of the heart muscle cells to respond to an impulse or stimulus.
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Conductivity
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The ability of an object to transfer heat or electricity to another object.
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Contractility
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The ability of the cardiac muscle to shorten in response to an electrical impulse.
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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.
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AV Node
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Located at the posterior septal wall of the right atrium just above the tricuspid valve.
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Bundle of His
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Located at the superior portion of the interventricular septum, it is the pathway that leads out of the SA node.
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Lead I
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The left arm is positive and the right arm is negative. (LA, RA)
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Lead II
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The left leg is positive and the right arm is negative. (LL, RA)
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Lead III
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The left leg is positive and the left arm is negative. (LL, LA)
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Augmented Unipolar Lead
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Are designated as aVR, aVL, aVF. These unipolar leads that require one elctrode from one limb to make a lead.
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Lead aVR
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The right arm is positive and the other limbs are negative.
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Lead aVL
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The left arm is positive and the other limbs are negative.
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Lead 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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Fourth intercostal space, right sternal border.
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V2
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Fourth 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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Fifth intercostal space, left midclavicular line.
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V5
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Fifth intercostal space, anterior axillary line.
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V6
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Fifth intercostal space, midaxillary line.
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25mm/sec
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The running speed of the EKG.
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Horizontal Axis
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Represents the time: 1mm
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Vertical Axis
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Represents amplitude measured in millivolts.
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Complex
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Several waveforms
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P-Wave
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The deflection produced by atrial depolarization.
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QRS Complex
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Represents ventricular depolarization (activation).
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Q-Wave
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The initial negative deflection produced by ventricular depolarization.
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R-Wave
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The first positive deflection produced by ventricular depolarization.
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T-Wave
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The deflection produced by ventricular repolarization.
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S-Wave
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The first negative deflection produced by ventricular depolarization that follows the first positive deflection, (R) wave.
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Segment
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The line between two wave forms.
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Waveform
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Refers to movement away from the isoelectric line either upward (positive).
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Interval
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Waveform plus a segment.
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Wandering Baseline
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Muscle movement and mechanical problem
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Flatline
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Loose disconnected wire or don't have a heart beat.
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Stress Test
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A noninvasive diagnostic procedure to determine the prescence and severity of coronary artery disease.
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Normal Sinus Rate
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60 - 100 beats per minute
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Ischemia
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Decreased amount of blood flow.
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Angina
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Chest pain and discomfort (give nitroglycerin).
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Myocardial Infarction
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Area of dead (necrotic) tissue in the heart muscle; heart attack.
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Holter Monitor
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Has 5 electrodes.
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Liters of Blood
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The average adult has 5 - 6 liters.
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3 Major Veins Located in the Antecubital Fossa
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Median Cubital Vein / Cephalic Vein / Basilic Vein
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Median Cubital Vein
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The first choice - large vein in the middle of the upper arm; most commonly used for venipuncture and doesn't tend to move.
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Cephalic Vein
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The second choice - usually more difficult to locate and has a tendency to move, however it is often the only one that can be palpated in the obese patient.
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Basilic Vein
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The third choice - it is the least firmly anchored and located near the brachial artery.
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Activated Partial Thromboplastin Time (APTT)
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A test used to evaluate the intrinisic pathway; also used to monitor heparin therapy.
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Prothrombin Time (PT)
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A test used to evaluate the extrinisic pathway; also used to monitor coumadin therapy.
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Antecubial Fossa
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The preferred site for venipuncture.
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25 Gauge Needle
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The smallest needle.
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Winged Infusion Sets
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Used for venipuncture in the elderly and pediatric patients.
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Tourniquets
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Prevents the venous outflow of blood from the arm causing the veins to buldge thereby making it easier to locate the veins.
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Gloves
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Must be worn when collecting blood specimens.
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Hemolysis
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When the tournique is left on the arm too long.
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Edema
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Is the accumulation of fluid in the tissues.
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Bevel Facing Upward
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Insertion of the needle at an angle of 15 - 30 degrees.
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Order of Draw
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Blood Cultures (yellow) / Sodium Citrate (light blue) / Serum (red or tiger strip) / Heparin (green) / EDTA (lavendar) / Glucose (gray)
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Hematoma
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The collection of blood that has escaped from the blood vessels into tissue.
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Hemoconcentration
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The increase in proportion of formed elements to plasma caused by the tourniquet being left on too long.
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Phlebitis
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Inflammation of a vein as a result of repeated venipuncture in that vein.
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Petechiae
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These are tiny non-raised red spots that appear on the skin from rupturing of the capillaries due to the tourniquet being left on too long or too tight.
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Thrombus
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This is a blood clot usually a consequence of insufficient pressure applied after the withdrawal of a needle.
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Thrombophlebitis
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Inflammation of a vein with formation of a clot.
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Fasting Specimens
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This require collection while the patient is is the basal state,(patient has fasted and refrained from strenuous exercise for 12 hours prior to the drawing).
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Timed Specimens
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Blood is drwan at specific times for different reasons.
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PKU
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This test is orderedfor infants to detect phenylketonuria, a genetic disease that causes mental retardation; peformed doing the heel stick.
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Lavendar Top-tube
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Ethylenediaminetetraacetic Acid (EDTA) / Anticoagulant
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Light Blue Top-tube
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Sodium Citrate / Anticoagulant
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Red / Gray Tiger Strip Top-tube
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Serum / Non-Additive
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Green Top-tube
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Heparin
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Gray Top-tube
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Glucose / Additives
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Yellow Top-tube
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Blood Cultures / Sterile
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Culture & Sensitivity
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Is the primary test done to detect the prescence and identify the microorganisms in body fluids and issues.
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Urinalysis
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Performs physical, chemical, and microscopic examination of urine.
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Urinalysis Physical Exam
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Assesses the color, clarity, and specific gravity of the specimen.
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Urinalysis Chemical Exam
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Is done using chemical reagent strips to screen for substances such as sugar and protein.
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Urinalysis MIcroscopic Exam
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Is done to detect prescence of blood cells, bacteria, and other substances.
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Bateriology
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The study of bacteria.
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Parasitology
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The study of parasites.
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Mycology
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The study of fungi.
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Virology
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The study of viruses.
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Serology (Immunology)
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Uses serum to analyze prescence of antibodies to bacteria, viruses, fungi, and parasites.
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Meter
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The basic unit of length.
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Liter
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The basic unit of capacity or volume.
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Gram
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The basic unit of weight or mass.
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Kilo
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1000.00 (One-thousand)
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Deci
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0.1 (one-tenth)
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Centi
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0.01 (one-hundredth)
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Milli
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0.001 (one-thousandth)
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Micro
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0.000,001 (one millionth)
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Nano
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0.000,000,001 (one billionth)
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Gram Stain
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Is used to classify bacteria on the basis of their form, size, cellular morphology and gram stain reaction.
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1st Morning Sample
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Is the type of specimen most commonly used for routine urinalysis.
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HCG
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Human Chorionic Gonadotropin--hormone produced by placenta. This is what is tested for in urine pregnancy tests since the only time it is present is during pregnancy.
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Anuria
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The absence of urine.
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Hematuria
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The prescence of blood in urine.
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Polyuria
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The passage of large volume of urine.
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Proteinuria
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The prescence of excessproteins in urine.
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Components of the Urinary System
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Consists of two kidneys, two uterers, urinary bladder, urethra.
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Mid-Stream Specimen
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Is one that is collected not at the beginnng or end of voiding, but in the middle of urination.
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Clean-Catch Specimen
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In collecting this specimen it requires special cleaning of the external genitalia.
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Urine Output
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Normally averages 1200 - 1500ml every 24 hours.
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Examination of Urine
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Physical, chemical, microscopic
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Sputum Specimen
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A specimen of expectorant material from the mouth - forcefully expelled from the lungs and placed in a sterile container.
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Informed Consent
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This is a consent given by the patient who is made aware of any procedure to be performed, its risks, expected outcomes, and alternatives.
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Patient Confidentiality
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The key concept is HIPAA; patients rights to privacy and all information should remain personal.
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4 Elements of Negligence (4 D's)
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Duty / Derelict / Direct Cause / Damage
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Duty
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Duty of care.
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Derelict
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Breach of duty of care.
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Direct Cause
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Legally recognizable injury occurs as a result of breach of duty of care.
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Damage
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Wrongful activity must have caused the injury or harm that occured.
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Good Samaritan Law
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This law deals with the rendering of first aid by health care professionals at the scene of an accident or sudden injury.
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Throat Cultures
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Are used to detect a baterial, fungal, or viral infection in the throat.
