NWCA Study Guide

Who establishes the scope of practice guidelines for CCMA’s?

Your State, Texas

True or False: When preforming visual acuity test, both eyes should be open, even the one that is covered.

True

What layer of the heart that is damaged during a heart attack?

The myocardium

What is another word for a heart attack?

Myocardial infarction

What delivers deoxygenated blood from the body to the right atrium of the heart?

The superior & inferior vena cava

What delivers oxygenated blood from the lungs to the left atrium of the heart?

Pulmonary veins

A “p-wave” means what about the pacemaker?

The pacemaker site is the SA Node & that means it’s a normal sinus rhythm

What is a normal sinus rhythym?

When the heart rate is between 60-100 bpm and the rhythm is regular

Ex: 88 is a normal sinus rhythm

What must a heart rhythm have to make it a normal sinus rhythm?

A “P wave”

What is considered a normal PR interval for a rhythm?

between (.12 - .20)

Ex: .18 is a normal PR interval

What is considered to be a normal range for a QRS complex?

less than .12

Ex: .04 is a normal QR complex

How much time is in the light pink, tiny box on the EKG?

0.04 seconds

How much time is in the dark pink, large box on the EKG?

0.20 seconds

How would you calculate a patient’s heart rate from a 6 second EKG strip?

Count the number of R waves in a 6 second strip & then multiply that number by 10

If you join leads I, II and III in a triangle, what is it called?

Einthoven’s Triangle

Where is the V1 electrode located?

At the fourth intercoastal space just right of the sternum

What signs and sx tell you it is time to stop a physical stress test?

Chest pain, slow heart rate, very high blood pressure, or an elevated ST segment

Elevated ST indicates potential heart attack, Slow HR or high BP indicates possible blockage

An elevated _____ during a stress test indicates a patient’s heart is not getting enough oxygen & may be having a heart attack?

ST segment

Rhythms that originate or begin beating in the Atrioventricular Junction (AV Node) are called?

Junctional Rhythms

What is the rate of the rhythm if a heartbeat starts in the AV Node?

40-60 bpm

What is the purpose of HIPAA?

Requires facilities maintain confidentiality of patient information

True or False: Needle sticks cause transmission of blood borne pathogens

True

What is the additive in a royal blue tube?

A clot activator

What color of tube is used for blood bank collections?

Pink

What is the average skin puncture depth for capillary blood collection?

2-3 mm

What specimens require chilling?

Gastrin, ammonia, and lactic acid

What is Hemoglobin? Where is it found?

It is found in Red blood cells or erythrocytes and carries oxygen

What is another name for red blood cells?

Erythrocytes

How do you determine Hemoglobin levels?

RBC’s or erythrocytes are tested

What tubes are used to preform blood cultures?

Yellow top tubes and culture bottles

What is the additive in the light blue tube?

Sodium citrate

What tube is used to test for coagulation?

the light blue tube

If a patient is not fasting, what is affected the most in blood work?

Triglycerides

What happens if Red blood cells are destroyed or hemolyzed during a blood draw?

The hemoglobin count will be falsely low

What is critical to a patient’s care?

Medical records

What instrument is used to examine the following: ears, eyes, lungs, BP.

Ears: otoscope

Eyes: ophthalmoscope

Lungs: stethoscope

Blood pressure: sphygmomanometer

What are the three layers of the heart?

Epicardium, myocardium, endocardium

What is the name of the sac surrounding the heart?

Pericardium

What is the difference between type 1 & type 2 diabetes?

Type 1: insulin dependent, autoimmune, body does not produce insulin

Type 2: non insulin dependent, metabolic, body makes insulin but resists it

Normal range for the following: body temp, pulse, bp, and respiration.

Body temp: 97-99 F

Pulse: 60-100 bpm

BP:120/80 mmHg

RR: 12-20 RR

Define the following terms: Tachy, pnea, Brady, tachypnea.

Tachy: fast or rapid

Pnea: breath or respiration

Brady: slow

Tachypnea: abnormally fast breath rate

How do you fold and discard exam table paper and how often?

Roll or fold the dirty side inward & between each patient

What is triage and why is it important?

Process of evaluating, and prioritizing patients based on urgency of condition. They are sorted to where patients with more severity of condition get care first.

How does an autoimmune disease affect the body? What do the body cells do?

The body’s immune system mistakes health cells for harmful invaders and attacks them.

What do you do when a patient has chest pain or difficulty breathing?

alert the provider & call 911 for emergency care

What is the difference between general and local anesthetic?

General anesthetic: entire body is unconscious & unresponsive

Local anesthetic: numbs a specific area while conscious

What is the name for the highest point and lowest point of blood pressure?

Systolic/Diastolic

Why is a swaged needle most often used to sew up lacerations?

It is atraumatic - causes minimal tissue trauma

What is the difference between a dressing and a bandage?

Dressing: goes directly on the wound to protect it

Bandage: used on the outside to hold dressing in place

What is an angiogram?

X-ray exam of the blood vessels

What is a cholecystography?

X-ray exam of gallbladder

How do you perform an eye irrigation? How is the patient positioned? What direction do you irrigate the eye?

The patient is positioned on their side (same side as affected eye), flush outward & away from bridge of nose (inside out).

Name the two heart valves that open to allow the ventricles to fill.

Tricuspid & mitral

Inherent rate of the pacemaker site in: SA Node, AV Node & Ventricles.

SA Node: 60-100 bpm

AV Node: 40-60 bpm

Ventricles: 20-40 bpm

What are the two cardiac cycles?

Systole & Diastole

Depolarization is an electrical event that occurs in cardiac cells and should result in ________

Heart muscle contraction

The P wave represents ________ depolarization

The QRS wave represents _______ depolarization

P wave: Atrial depolarization

QRS wave: Ventricular depolarization

If the PR interval in the EKG complex takes up 3 tiny boxes, what is you PR interval? Is it considered normal?

.12 seconds

Yes, normal range is between .12 and .20 seconds

Lead I

Positive pole

right arm & left arm; right arm

What is a holter monitor?

Portable device that you can move around in, measures heart activity

You enter the exam room and find your patient on the floor unconscious. You can assume they would want medical treatment. What kind of consent is this?

Implied consent

What is a patient’s bill of rights?

Patients’ rights to respectful, considerate medical care

What does a face shield protect you from?

Sprays & splashes

What does a mask protect you from?

airborne droplets

What is the difference between advanced medical directive & durable power of attorney?

Advanced medical directive is done before and states preferences in writing

Durable power of attorney names a trusted person to make decisions

What is the difference between medical asepsis and surgical asepsis?

Medical Asepsis: reduces number of microorganisms

Surgical Asepsis: completely eliminates all microorganisms, sterilization

What is the difference between extension, abduction and adduction?

Extension: increasing angle of joint

Abduction: away from midline

Adduction: towards midline

What vein is used most of the time to draw blood?

Median cubital vein

What is the additive in the yellow top tube?

Sodium polyanethole-sulfonate (SPS)

How long can blood remain in the yellow top tube before needing to be transferred to a blood culture bottle?

2-4 hours

Color of tube for CBC & DIFF

Purple

What is a syringe transfer device for?

Collecting specimens by inserting tube in device and allowing blood to flow freely

What equipment is helpful for a patient who is likely to faint while giving blood?

Reclining chair

What does “chain of custody” mean when dealing with specimens like drug and alcohol levels?

The unbroken, documentation trail that tracks all steps from collection to final result reports.

What is the sequence for taking off the following PPE? Gloves, gown, goggles

Gloves, goggles, gown

What happens to the blood specimen if you shake the tube too hard?

Hemolysis - breaking apart of red blood cells

Why is using a butterfly needle to collect blood cultures directly from the vein to the blood culture bottle ideal?

Minimize risk of contamination & decreases the time of the blood to reach culture

What is the purpose of standard precautions or universal precautions?

Reduce the transmission of infectious agents between patients & healthcare workers

What is the abbreviation for cerebrospinal fluid? Where is it found?

CSF, found in Spinal column

When would you use the butterfly system to draw blood?

Patient has small, or hard to access veins

Needle packaging is color coded by ___

Gauge

What is the anticoagulant that’s is in a green top bottle?

Sodium heparin

What anticoagulant is used in blood donations?

CPD (Citrate-Phosphate-Dextrose)

How long does it take for blood to clot in a plain red top tube?

30-60 min

What is thrombosis?

Blood clot

How many hours without food or drinks is considered fasting?

8-12 hours

What is edema?

Swelling caused by fluid build up in intracellular spaces

How might you realize you stick an artery by accident and not a vein?

Bright red blood that pulses with heartbeat

What else can be used as a tourniquet for obese patients?

Blood pressure cuff

What actions can you take to improve your success with a patient with very difficult veins?

Warming, rotate arm, gravity, palpitating the entire site

When do you release the tourniquet?

Halfway through procedure or when blood begins to flow

How do you do a 3 way match when verifying patient information before drawing blood?

Patient verbal statement, patient ID or wrist band, lab form