NHA CCMA: General Patient Care

Thermometer

used to measure body temperature

Stethoscope

used to amplify sound in the body

Sphygmomenometer

used to measure blood pressure

Pulse oximetry

used to measure oxygen saturation in the blood

Reflex hammer

used for testing reflexes

Otoscope

used to examine the ears

Ophthalmoscope

used to examine the interior of the eye

Supine (horizontal recumbent position)

lies flat on their back with hands at the side

Prone

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

Dorsal recumbent

lying flat on the back with knees bent and feet flat on the examination table

Lithotomy

similar to dorsal recumbent, but feet are placed in stirrups attached to the end and sides of the table

Fowler’s

sits on the examination table with the head of the table raised to 90-degree angle

Semi-fowler’s

modified fowler’s position with the head of the table at a 45-degree angle

Left lateral (sims’ position)

placed on the left side with the right leg sharply bent upward and the left leg slightly bent (rectal exams)

Knee-chest

prone position and then asked to pull the knees up to a kneeling position with thighs at a 90-degree angle to the table and buttocks in the air

Parenteral

administered or occurring the body bypassing the gastrointestinal tract

Nonparenteral

given by mouth, delivered to the gastrointestinal tract

Otic

relating to the ear

Rights of medications

right patient, medication, form, dose, route, time, technique, education and documentation

Ophthalmic

relating to the eye and its diseases

Auricle (outer ear) for adult

outward and upward

Auricle (outer ear) for children and infants

outward and downward

Allergic

condition of sensitivity in which the immune system reacts abnormally to a foreign substance

Anaphylactic shock

systemic allergic reaction that can be life-threatening without immediate medical intervention

Sterilization

complete destruction of all micro-organisms through specific means

Ampule

sealed glass capsule containing a liquid

Food and drug administration (FDA)

organization responsible for protecting the public health by ensuring safety, efficacy, and security of human medications

Temperature storage medication

35 to 46 degrees F or 2 to 8 degrees C

Electronic medical record (EMR)

record in a medical practice or clinic to document the patient’s demographic information, care, progress, and treatment

Sterile technique

group of strategies used to reduce exposure to micro-organisms and keep the patient as safe as possible

Demographic

name, address, birthdate, sex, gender, SSN, phone number, employment information

Administrative data

notice of privacy practices form, advance directives, consent forms, medical records release forms

Correspondence

from patient’s insurance company, attorney, or patient themselves

Health history

chief complaints, present illness, past medical history, family history, social history, review of systems

Physician examination

assessment of each body part

Diagnostic procedures

electrocardiogram, holter monitor, spirometry, radiology, diagnostic imaging report

Continuity of care

consultation, home health care, therapeutic services documents, hospital documents

Computerized provider order entry (CPOE)

process in which providers enter and send treatment instructions (including medications, laboratory, and radiology orders) via a computer application rather than paper, fax or phone

Telehealth

includes non-patient and nonclinical services (teams meetings and professional development training for the health care team)

Surgical asepsis

techniques to eliminate pathogenic and other potentially harmful microbes related to invasive procedures

Biopsy

surgical removal of tissue for later microscopic examination

Endoscopy

procedure that uses an endoscope to view a hollow organ or body cavity (such as larynx, bladder, colon, sigmoid colon, stomach, abdomen and some joints)

Colposcopy

examination of the vagina and cervix performed using a colposcope, which is a specialized type of endoscope

Incision and drainage (I&D)

lancing a fluid of pressure buildup under the skin to allow it to drain and relieve pressure

Absorbable sutures

do not need to be removed and are digested by tissue enzymes and absorbed by the body tissue

Nonabsorbable sutures

used on skin surface where they can easily be removed after an incision heals

Stable

closure of wounds under high tension (such as trunk, extremities, and scalp)

Emergency medical services (EMS)

system that provides urgent pre-hospital treatment care

Severe hypoglycemia

low blood glucose levels

Hypovolemic shock

excessive loss of body fluid or blood

Heat exhaustion

body temperature varies too much over its normal range

Hypothermia

exposure to cold temperature

Syncope

fainting; brief episode of unconsciousness

Sprains

stretched or torn ligament

Strains

stretched or torn muscle or tendon

Dislocation

when a bone end slips out of the socket or when the capsule surrounding a joint is stretched or torn

Fractures

open (breaks through the skin and is exposed) or closed (does not penetrate the skin)

Abrasion

outer layers of skin are rubbed away because of scraping

Incision

smooth cut resulting from a surgical scalpel or sharp material

Laceration

edges are torn in an irregular shape

Puncture

made by a sharp, pointed instrument

Erythema

superficial reddening of the skin

Dehiscence

partial or total separation of a wound’s edges

Evisceration

separation of wound edges and protrusion of abdominal organs

Crash cart

portable cart stocked with emergency supplies

Myocardial infarction

flow of blood that brings oxygen to the heart muscle suddenly becomes blocked, and if not restored quickly, the heart muscles will begin to die and cardiac arrest can occur

Automated external defibrillator (AED)

device that provides electrical shock to restore a normal heartbeat

Durable medical equipment

medical devices and supplies that can be used repeatedly outside of a hospital

Inflammation

occurs at day 3 and is accompanied by pain, swelling, and loss of function

Proliferation

occurs between 3 and 21 days, with fibrin threads extending across the wound that starts pulling the edges together

Maturation

occurs between 21 days and 2 years, with tissue cells strengthening and tightening