Medical Assisting Chap.22, 25-28

What are 5 guidelines to maintain a sterile field?

Don't let sterile packages get wet, always face the sterile field, hold sterile items about waist level, place sterile items incenter if sterile field, don't spill liquids onto sterile field, don't cough sneeze or talk over sterile field, don't reach over sterile field, don't pass soiled supplies over sterile field

What are sterile forceps used for?

to move or manipulate sterile items

How can you add items to the sterile field?

with sterile forceps, a sterile gloved hand, or by flipping them onto the field

what are the 3 phases of healing?

Healing by primary intention, healing by secondary intention, and healing by tertiary intention

healing by primary intention

simplest form of healing, edges are closely approximated, and scarring is usually minimal

healing by secondary intention

granulation present, edges are not closely approximated, and scarring is usually more severe.

healing by tertiary intention

wound initially left open due to possible contamination of wound, wound left open to fill in with granular tissue, and considerable scar formation

what are the 3 phases of wound healing?

Phase 1 (inflammatory), Phase 2 (proliferative), and Phase 3 (remodeling)

Phase 1 of wound healing

inflammatory, lasts 1 - 4 days, body attempts to heal itself, increased circulation, and scab forms

what are the signs that the phase 1 is working?

edema, warmth, redness, and pain

Phase 2 wound healing

proliferative, lasts several days to several weeks, vessels continue to repair, and scab from phase 1 continues to dry

Phase 3 wound healing

remodeling, takes from weeks to years, fibroblasts build scar tissue to guard area

what are the most common office surgeries?

excision of skin lesions (moles, skin tags) and Incision and Drainage of wound (I&D, abscesses like boils, furuncles)

X-rays

high-energy waves that cannot be seen, heard, felt, tasted, or smells and that can penetrate fairly dense objects such as the human body

mammography

examination of breasts used as screening tool for breast cancer, where the breast is compressed in a specialized device

contrast medium examinations

used to visualize abdominal structures, radiopaque material swallowed or injected.

fluoroscopy

used to observe movement, guidance of medical devices

computed tomography (CT)

used to create detailed three-dimensional images of organs, pt must remain inside a tube.

sonography

used to create still or moving cross sectional images, high frequency sound waves, used for heart function, pelvic structures, and developing fetus

magnetic resonance imaging (MRI)

used to create detailed cross-sectional images, typically used for central nervous system and joint structures

nuclear medicine

used to study organs, early detection of abnormalities in thyroid, brain, lungs, liver, spleen, kidney, bone, breast

what is a PET scan?

positron emission tomography

what is a SPECT scan?

single photon emission computed tomography

what are the types of interventional radiologic procedures?

PTCA, Laser angioplasties, vascular stents, and embolizations

PTCA

percutaneous transluminal coronary angioplasty (balloon angioplasty)

Laser angioplasty

removes deposits in blood vessels

Vascular stents

plastic or wire tubes inserted into stenosed or constricted area of vessel

embolization

stops active bleeding from a blood vessel

What are the 5 types of shock?

hypovolemic, cardiogenic, neurogenic, anaphylactic, and septic shock

what are the symptoms of shock?

low BP, restlessness or signs of fear, thirst and nausea, cool clammy skin, pale skin with cyanosis at lips and earlobes, rapid and weak pulse.

hypovolemic shock

shock cause by loss of blood or other body fluids

cardiogenic shock

types of shock in which the left ventricle fails to pump enough blood for the body to function

neruogenic shock

shock that results from dysfunction of nervous system following spinal cord injury

anaphylactic shock

severe allergic reaction within minutes to hours after exposure to a foreign substance

septic shock

shock that results from general infection in the bloodstream

what are the 4 major sources of burns

thermal, electrical, chemical, and radiation burns

thermal burns

liquid/solid, gas, flame (ex: touching the hot autoclave and getting burned)

electrical burns

electrocution, lightening (ex: lightening bolt burning your skin)

chemical burn

corrosive substances (ex: paint thinners or gasoline)

radiation burn

sunburn, radioactivity (ex: sunburn)

classifications of burns

superficial (burn limited to epidermis), partial-thickness (burn involving epidermis and varying levels of dermis), and full-thickness burn (burn that has destroy all skin layers)

rule of 9 in adults

head & arms 9%, front and back trunk 18%, each lower extremity 18%, genitals 1%

rule of 9 in children

head 18%, arms 9%, front and back trunk 18%, each lower extremity 13.5%, genitals 1%

ischemia

decrease in oxygen to tissues

splint

device used to immobilize a sprain, strain, fracture, or dislocation of limb

infraction

death of tissues due to lack of oxygen

myocardial infraction

heart attack

what is included in the primary assessment?

responsiveness, circulation, airway, breathing

what is in the secondary assesment?

general appearance, level of consciousness (AVPU), vital signs, and skin

AVPU

awake and alert, responds to voice, responds only to pain, unresponsive or unconscious

disaster

a sudden and unplanned event that has the potential to cause damage to property or life

what are examples of natural disasters?

drought, earthquake, epidemics, floods, hurricane, tornado, etc.

man made disasters

vehicle accidents, plane crashes, train derailments, biohazards materials

epidemic

when a disease affects numerous people in a local area

pandemic

when disease affects numerous people in many areas around the world at the same time

bioterrorism

intentional release of a biologic agent with the intent to harm individuals

what are the 4 types of skin infections?

bacterial, viral, fungal, and parasitic

what is an example of bacterial skin infections

impetigo, folliculitis, furuncle, carbuncle, cellulitis

what are examples of viral infections?

herpes simplex, herpes zoster, verruca

what are examples of fungal infections?

ring worm, athletes foot, jock itch

what are examples of parasitic infections?

scabies, pediculosis (lice)

what are types of inflammatory reactions?

eczema, acne vulgaris, psoriasis, seborrheic dermatitis

what are types of disorders caused by pressure

callus and corn, decubitus ulcers, intertrigo

what are types of skin cancers?

basal cell carcinoma, squamous cell carcinoma, malignant melanoma

what are the 9 bandage guidelines?

observe the principles of medical asepsis, keep area and bandage dry and clean, never apply bandage to open wound, never allow skin surfaces of two bodily parts to touch each other, pad joints and any bony prominence, bandage affected part in normal position, apply bandages at the distal part first, always talk to patient during the bandage, when bandaging hands and feet leave the fingers and toes exposed

bulla

vesicle or large blister larger than 1 cm

macule

small, flat discoloration of the skin

vesicle

skin lesion that appears as a small sac containing fluid (a blister)

pustule

lesion containing pus

furuncle

acute inflammation deep within hair follicle(boil)

carbuncle

infection involving subcutaneous tissues around several hair follicles

impetigo

highly infectious skin infection causing erythema and progressing to honey-colored crusts

erythema

redness of the skin

folliculitis

inflammation of hair follicles

cellulitis

inflammation or infection of the skin and deeper tissues that may result in tissue destruction

herpes simplex

infection caused by the herpes simplex virus (HSV)

herpes zoster

infection caused by reactivation of varicella zoster virus (shingles)

verruca

wart

dernatiphytosis

fungal infection of the skin

alopecia

baldness

pediculosos

infestation of lice

eczema

superficial dermatitis; redness, vesicles, itching, and crusting

pruritis

itching

seborrhea

overproduction of sebum by sebaceous glands

urticaria

hives

psoriasis

chronic skin disorder that appears as red patches covered by thick, dry, silvery scales

intertrigo

rash of the body fold

vitiligo

depigmentation of patches of the skin

neoplasm

abnormal growth of new tissues, tumor

shock

lack of oxygen to individual cells of the body

contusion

collection of blood in tissues after an injury, a bruise

hematoma

blood clot that forms at an injury site

ecchymosis

characteristics black and blue mark that results from blood as it accumulates under the skin

laceration

open wound

allergen

any substance that causes manifestation of an allergy

hyperthermia

general condition of excessive body heat

heat cramps

type of hyperthermia that causes muscle cramping

heat exhaustion

a type of hyperthermia that causes an altered mental status

heat stroke

most serious type of hyperthermia

hypothermia

below normal body temp