CCMA Review

Blood draw order

Blood culture

light blue

red

red and gray

green

lavender

gray

V1

4th intercostal space, right sternal border

V2

4th intercostal space, left sternal border

V3

equally between V2 and V4,

V4

5th intercostal space, left midclavicular line

V5

5th intercostal space, anterior axillary line

V6

5th intercostal space, mid axillary line

blood draw order pneumonic

BeCause Linda Ree Regularly Goes Loco Gogo

1st blood draw

blood culture

2nd blood draw

light blue

3rd blood draw

red

4th blood draw

red and gray

5th blood draw

green

6th blood draw

lavender

7th blood draw

gray

Light blue tube

sodium citrate, prevent clotting

red tube

no additives

Green top tube

heparin, prevent clotting

Lavender top tube

EDTA, anticoagulant additive

gray top tube

potassium oxalate and sodium fluoride, inhibit glycolysis

Use of serum separator

coagulation tests

use of red top tube

serum tests, iron panel, chemistry

use of green top tube

plasma determinations in chemistry studies

use of lavender top tubes

hematology tests, CBC, hemoglobin A1C levels

use of light blue top tube

PT/INR, PTT, D- dimer, Fibrinogen assay, coagulation studies

Use of gray top tube

blood glucose and lactate levels, blood alcohol

Reaction formation (defense mechanism)

patient expresses the opposite of what they actually feel

Denial (defense mechanism)

rejects info completely

Suppression (defense mechanisms)

consciously aware of their feelings but refuse to admit

Regression (defense mechanism)

reverts to expressively immature behavior

Venipuncture order

1. medial

2. cephalic

3. basilic

(reverse alphabetical)

5 rights of medication

right patient, drug, route, time, and dose

Venipuncture angle

15

subcutaneous injection angle

45

intramuscular injection angle

90

correct order donning PPE

gown, mask, goggles, glove

correct order doffing PPE

gloves, goggles, gown, mask

Sender creating the message

stage which sender communicates their message

Sender decoding feedback

feedback being decoded for accuracy and to ensure the communication is accurate

Receiver decoding the message

translating the received message with own subjective ideas

Receiver creating feedback

completed review of the perceived method

antineoplastics

medication that slow growth of cancer cells

antitussives

medication that suppresses coughs

Durable medical equipment

ambulatory aids, ex crutches, wheelchair, walker

when is body temperature lowest

in the morning

when is body temperature highest

in the late afternoon

Minimum temperature for autoclave for sterilization

250 F (121.1 C)

wandering baseline

poorly attached electrodes or patient movement, gradual shift of tracing away from center of paper

AC interference

electrical currents from nearby wiring or equipment, series of even small, spikes in the tracing

Interrupted baseline

electrical disconnection or detached electrode, results in tracing moving into margins of the paper

somatic tremor

muscle movement, irregular jagged peaks with shifting baseline

scratch test characteristics

spacing of 1.5 - 2 in between test sites

reactions w/in 10-30 min

can identify 70 or more allergies at one time

reactions are noted from numerical values 2 - 4

patients wait 30 min after to ensure not adverse reactions

Medical records release

signed by patient to authorize release of records to the assigned persons on release

advance beneficiary notice (APN)

notifies patient of services that may not meet medicare’s medical necessity requirement

Release of information

provide authorization for the practice to discuss confidential account info w/a third party payer

5 Stages of Grief

denial

anger → “why me”

bargaining → give something up

depression → expressing regret

acceptance → coming to terms

auditing

checking claims for completeness

reviewing

checking the diagnosis and procedure codes so provider correctly reimbursed

unbundling

codes are separated out to bill for procedures separately

abstracting

reviewing a patient’s medical record to determine what diagnosis and procedure codes should be used for billing

When should bone density screening occur

every 2 years for females 65 years and older

When should lung cancer screening occur

patients who meet specific criteria and between 55 - 80 years old

When should colonoscopy screening occur

every 3 years for 45 - 75 years old

When should prostate cancer screening occur

male patients 50 years and older

cryoprobe

removes skin lesions, skin cancer, lung biopsies

senn retractor

retract small incisions and assist with suturing

Adson forceps

grasp delicate tissue

cytobrush

obtain specimen during pap smear

Supine position

also known as the horizontal recumbent position, patients lie flat on their back with hands at the sides

prone position

lie face down, flat on the stomach, with the head turned to one side. and arms either alongside the body or crossed under the head, used to provide access to back

dorsal recumbent position

lying flat on the back with knees bent and feet flat on the examination table, used when giving female catheter

lithotomy

lying flat on the back with knees bent and feet in stirrups attached to the end of and sides of the table, used for gynecologic exams (colposcopy)

fowler’s position

patient sits on the examination table with the head of the table raised to a 90 degree angle, used when patient is experiencing dyspnea

lateral semi-prone recumbent

patient placed on the left side with the right leg sharply bent upward and and the left leg slightly bent, used for rectal procedures

reference range for hemoglobin

12-17.5

reference range for hematocrit

36%-53%

reference range for fasting glucose

70 to 100 mg/dL

reference range for total cholesterol

130 to 300 mg/dL

lead colors for extremities

white: right arm

black: left arm

red: left leg

green : right leg

suggested screening for breast cancer is at

age 40

normal adult BP

120/80

elevated adult BP

120-129/80

hypertension stage 1 adult BP

130-139/80-89

hypertension stage 2 adult BP

>140/>90

hypertension crisis

>180/>120

First dose Hep B

at birth

First dose Varicella and MMR

at 12 months

First doseTdap

at 7 years

pharmacodynamics

study of drug’s effects on the body

pharmacokinetics

study of how the body absorbs, distributes, metabolizes, and excretes drugs

expected prediabetic fast glucose

100 - 125 mg/dL

expected diabetic fasting glucose

>126 mg/dL

Proper way to remove a suture

grasp the knot, lift knot away from the skin, slide scissors up under the suture and cut the suture, not the knot, at skin level

appropriate diagnostic statement in outpatient setting

fever of unknown origin

Part A Medicare Coverage

hospital care → inpatient care

Part B Medicare Coverage

medical care → Dr visit, outpatient care, DME, mental health

Part C Medicare Coverage

expanded A and B → vision, dental

Part D Medicare Coverage

prescription drugs

Directed exchange

form of health information exchanged (HIE) that supports provider ability to send and receive info securely utilizing electronic measures

Query-based exchange

form of health information exchanged (HIE) that supports provider’s ability to find or request info from other health care providers