Clinical Skills Exam

Bacteria

Single-celled organisms that multiply quickly and can be treated with antibiotics.

Virus

Microscopic organisms that require a host cell to replicate and are not treatable but managed by treating symptoms.

Transmission Route

The method by which an infection is spread, including surface/contact, droplet, and airborne.

Infection Control

Strategies to prevent the spread of infections, including cleaning, disinfecting, and sterilizing surfaces.

Body Substance Isolation (BSI)

A system of precautions to reduce the transmission of infectious agents among patients.

Personal Protective Equipment (PPE)

Clothing and gear such as gloves, gowns, and masks used to prevent the spread of infections.

Hepatitis B

A viral infection that affects the liver, has a vaccine, and can be spread through blood and bodily fluids. Symptoms: jaundice, fever, feel like shit

1982- high risk groups

1991- HBV national childhood vaccination program

2013- 1.4 million w chronic HBV

Hepatitis C

A liver infection caused by the Hepatitis C virus, primarily transmitted through blood; no vaccine available.- AVG risk for infected is 1.8%

Cardiac Auscultation

The practice of listening to heart sounds to assess heart rhythm and identify abnormalities.

Systolic Pressure

The top number in a blood pressure reading, indicating the pressure during heart's contraction.

Diastolic Pressure

The bottom number in a blood pressure reading, indicating the pressure during the heart's rest interval.

Vital Signs

Measurements of the body's basic functions, including temperature, pulse, respiration, and blood pressure.

Auscultation Techniques

Methods used to listen to body sounds, such as heart, lung, and bowel sounds, using a stethoscope.

OPQRST

A mnemonic used to assess a patient's pain: Onset, Provocation/Palliation, Quality, Radiation/Region, Severity, Time.

HIPAA

Health Insurance Portability and Accountability Act, legislation that protects patient privacy and health information.

SAMPLE

A mnemonic for gathering patient history: Signs/Symptoms, Allergies, Medications, Past medical history, Last intake, Events leading up.

PPE Disposal

The process of safely removing and discarding personal protective equipment to minimize contamination risks.

Fine Crackles/Rales

Abnormal lung sounds caused by fluid in the lungs, typically heard at the bases- end of inhalation, resembling velcro.- Causes- CHF, chronic bronchitis

Wheezing

High-pitched sounds caused by bronchial constriction, often observed in asthma and immune response patients.- starts on exhalation,

Stridor

A high-pitched wheezing sound indicating upper airway obstruction, often heard in cases of choking or anaphylaxis., heard in trachea

Patient Interaction Zones

Different physical proximity levels during patient interaction; includes public, social, personal, and intimate spaces.

S4 Heart Sound

Indicates aortic stenosis; occurs before S1 and is best heard with the bell of the stethoscope.-stiff ventricles

Normal Respiratory Rate

The typical range of breaths per minute for a healthy adult, which is 12-20.

Normal Pulse Rate

The standard heartbeats per minute for an adult, typically 60-100.

Bradycardia

A pulse rate of less than 60 beats per minute.

Tachycardia

A pulse rate of more than 100 beats per minute.

Temperature Measurement

Method of determining body heat, most accurately taken rectally.

Patient Assessment Acronyms

Mnemonics like A&O, SAMPLE, and OPQRST used to guide patient evaluations.

Tachypnea

An abnormally rapid breathing rate, typically defined as more than 20 breaths per minute in adults.

Bradypnea

An abnormally slow breathing rate, typically defined as fewer than 12 breaths per minute in adults.

S1 Heart Sound

The first heart sound, produced by the closure of the mitral and tricuspid valves, signaling the start of ventricular contraction.- loudest at the apex of heart

S2 Heart Sound

The second heart sound, produced by the closure of the aortic and pulmonary valves, marking the end of ventricular contraction.- loudest at base of heart, occurs at start of diastole, split ocurrs during inhalation

Aortic Valve

A heart valve that controls blood flow from the left ventricle into the aorta, preventing backflow into the ventricle.

Tricuspid Valve

A heart valve situated between the right atrium and right ventricle, regulating blood flow in the heart.

Pulmonary Valve

The valve allowing blood to flow from the right ventricle to the pulmonary arteries and preventing backflow into the ventricle.

Mitral Valve

A heart valve located between the left atrium and left ventricle, facilitating blood flow into the ventricle.

S3 Heart Sound

An abnormal heart sound that may suggest heart failure; it occurs shortly after S2 and is best heard with the bell of the stethoscope.

Stridor

A high-pitched wheezing sound indicating upper airway obstruction, often heard in cases of choking or anaphylaxis.

Rhonchi

Low-pitched, rattling junky lung sounds that resemble snoring, often indicating airway obstruction due to mucus.- causes- lung infection, severe asthma

Wheezing

High-pitched sounds caused by bronchial constriction, often observed in asthma patients.

Supine Position

A patient position where the individual lies flat on their back.

Prone Position

A patient position where the individual lies flat on their stomach.

High Fowler's Position

A sitting position where the patient's torso is elevated to about 60-90 degrees, often used for patients with respiratory distress.

Semi-Fowler's Position

A sitting position where the patient's torso is elevated to about 30-45 degrees, offering comfort and aiding breathing.

Trendelenburg Position

A position where the patient lies flat on their back with legs elevated above the head, used in specific medical emergencies.

Reverse Trendelenburg Position

A position where the patient lies flat on their back with the head elevated above the legs, often used post-surgery.

Left Lateral Recumbent Position

A side-lying position with the patient on their left side, often used in recovery to maintain airway patency.

Patient Interaction Stages

The phases involved in interacting with a patient, which typically include introduction, assessment, intervention, and feedback.

Introduction Stage

The initial phase where the healthcare provider introduces themselves, establishes rapport, and explains the purpose of the interaction.

Assessment Stage

The phase where the healthcare provider gathers pertinent patient information, including history and current condition.

Intervention Stage

The phase where specific actions are taken to address the patient's needs, including treatment or support.

Feedback Stage

The final phase where the provider reviews the interaction, discusses outcomes, and addresses any questions or concerns from the patient.

Public Interaction Zone

The space where interactions occur in a public setting, typically more than 12 feet away, allowing for limited personal interaction.

Social Interaction Zone

The space where interactions are typically between 4 to 12 feet apart, allowing for conversation but with some personal space.

Personal Interaction Zone

The space where interactions happen within 1.5 to 4 feet, allowing for closer communication and personal engagement.

Intimate Interaction Zone

The space for interactions within 0 to 1.5 feet, used for close relationships or while providing personal care, requiring careful management.

A&O

Alert and Oriented; assesses a patient's awareness of themselves and their surroundings, often the first step in cognitive evaluation.

AVPU

A mnemonic used to assess a patient's level of consciousness: Alert, Verbal response, Painful response, Unresponsive.

SOAP

A documentation method used in medical records: Subjective, Objective, Assessment, Plan.

SAMPLE (Expanded)

A detailed mnemonics for patient history: Signs/Symptoms, Allergies, Medications, Past medical history, Last intake, Events leading up to the current issue.

What does HIPAA stand for?

HIPAA stands for Health Insurance Portability and Accountability Act, a law designed to protect patient health information and privacy.

Importance of HIPAA Compliance

HIPAA compliance ensures the safeguarding of patient data, promotes trust in healthcare, and prevents legal consequences.

Consequences of HIPAA Violations

Violations of HIPAA can result in fines, legal action, and damage to the healthcare provider's reputation.

Methods of Protecting Patient Information (HIPAA)

Includes use of secure communication, employee training, access controls, and regular audits to ensure patient data confidentiality.

Patient Consent under HIPAA

Patients must provide consent for sharing their health information, ensuring their right to privacy is respected.

What is the purpose of the SAMPLE mnemonic?

The SAMPLE mnemonic helps healthcare providers quickly collect essential information about a patient's condition.

Limitations of SAMPLE

While SAMPLE is comprehensive, it may not cover every aspect of a patient's medical history; additional questions may be needed.

Coarse: Rales/Crackles

fluid in the lungs, heard throughout lungs, Early Inhalation, Souds like bubbling, causes: Pulmonary edema

Covid 19

System infected- respiratory, ROT: breathing (airborne), Signs and symptoms: no taste, Testing- Viral (nasal swab/saliva antigen, PCR/nucleic amplification test, ALSO serology/antibody- determines if youve previously had the virus, via blood sample

Tubercolosis

System infected: Respiratory, ROT- same room as someone infected, Signs and Symptoms- coughing, sweating, red, cold sweats

Influenza

System infected: respiratory and upper airway, ROT: droplet (coughing, sneezing), Sign and symptoms: everything, affected- Old, young, immunocompromised,

HIV/ AIDS

attack immune system leaving patient unable to fight off infection

• AIDS- set of conditons that result when the immune system has been attacked by HIV

lower risk for healthcare workers than hepatitis or TB, contact with blood usual route of infection

OSHA

Occuppational Safety and Hazard Association- covers and creates safety regulations for ALL American workers- aka anyone who has a job in America “x amounts of fire exits”

Apical

felt at the apex (bottom) of the heart

Carotid-

side of neck below the jaw

Brachial

near bicep/ inner elbow

Radial

wrist

Pedal

thigh

Korotkoff sound

thudding and whooshing sound caused by turbulent blood flow when auscultating a BP

Murmurs

Turbulent blood flow through damaged heart valves, can occur during systole and diastole can vary in location based on valve involved

Grading System

Grade 1- barely audible

Grade 2- audible, but soft

Grade 3- moderately loud w/o thrust or thrill

Grade 4- loud with a thrill

Grade 5- very loud with thrill

Grade 6- loud enough to be heard before stethoscope comes into contact with chest