NHA CCMA 2025 SmarterMA Flashcards

Schedule I Class Drugs

No Acceptable Medical Use, High Potential Abuse. EX: Heroin, LSD, Marijuana

Schedule II Class Drugs

Yes Acceptable Medical Use, High Potential Abuse. EX: Fentanyl, Oxycodone, Morphine, Meth

Schedule III Class Drugs

Yes Acceptable Medical Use, Low Potential Abuse: Codeine

Schedule IV Class Drugs

Yes Acceptable Medical Use, Lower Potential Abuse. x: Xanax, valium and ambien

Schedule V Class Drugs

Yes Acceptable Medical Use, Lowest Potential Abuse. Cough medicine with Codeine

Intradermal (ID) angle, needle gauge and length

5-15 degrees

25-27 gauge

1.25-1.5 in

ex: TB and allergy testing and flu vaccine

Intravenous (IV) angle, needle gauge and length

15-30 degrees

21-23 gauge

1-1.5in

ex: iv fluids

Subcutaneous (subQ)

45 degrees

23-25 gauge

5/8 in

ex: insulin

Intramuscular (IM)

90 degrees

22-25 gauge

1-1.5in

ex: epipen

Hemoglobin ranges for male and females

male: 13.5-17.5 g/dL and female: 10.5-13.5 g/dL

Steps for a venipuncture

1. Requisition and ordered tests

2. Verify patients identity and introduce yourself

3. Explain the process to the patient and consent

4. Gather Equipment

5. Wash hands and globe

6. Tie the tourniquet 3-4in above site and ask pt to make a fist

7. Clean area with back and forth strokes, 2.5in diameter

8. Prepare needle and tube holder while alcohol dries. Inspect needle for defects

9. Anchor vein with the thumb below site

10. Insert needle at 15-30 degrees angle, bevel up

11. Push the collection tube into the holder to puncture the tube stopper with the needle

12. Release tourniquet once blood flows, it should be on only for 1min less to avoid hemoconcentration

13. Fill tubes in order

14. Place gauze over site, withdraw needle and apply pressure to stop bleeding

15. Discard needle into biohazard sharp container

16. Label specimen with patients name, ID, time, date of collection and initials

17. Place tubes in biohazard transport bag

18. Check site before leaving. Apply pressure in increments, if bleeding is not stopping after 8 mins, seek help

19. Apply bandaid/tape gauze, and tell patient to remove after 1 hour

20. Clean up and dispose waste

21. remove gloves, wash hands, say bye to patient and inform that the provider will let them know of the results

EKG lead placement

R/L arm/L leg

clouds over grass

coal over fire

V1: 4th ICS RSB

V2: 4th ICS LSB

V4: 5th ICS MCL

V3: BTWN V2 and V4

V6: 5th ICS Mid-axillary line

V5: 5th ICS Anterior axillary line

EKG Artifacts: AC interference

Electrical interference (cell phone or AC power lines) or no proper grounding on right electrode

EKG Artifacts: Somatic tremor

Patient muscle movement voluntarily or involuntarily

EKG Artifacts: Wandering Baseline

Poorly attached electrodes

EKG Artifacts: Interrupted Baseline

Electrode Disconnection due to poor contact between the electrodes and the skin

Scratch Test

Steps:

Prick the skin to introduce the allergen

drop the allergen

distance between each allergen is 1.5-2in apart

Hematocrit ranges

Adult men: 41%-53%

Adult women: 36%-46%

Hemoglobin ranges

Male: 13.5-17.5 g/dL

Female: 12-16 g/dL

Potassium Range

3.5-5.1 mEq/L

Blood Glucose range

70-110 mg/dL

EKG paper grid measuring

Each small square: 1 mm or 0.04 seconds

Each big square: 5mm, or 0.2 seconds

Weber vs Rinne Test

Weber: tuning fork on midline and ask what ear hearing in

Rinne: put tuning for on mastoid (behind ear canal) and ask when no longer hearing it then move near canal

Preanalytical, analytical and postanalytical phases in clinical lab testing process

Preanalytical: procedures from time a lab test is order to specimen collection and prep (lab req, drawing blood, labeling, identifying pt)

Analytical: testing phase where the specimen is analyzed in lab (processing the blood)

Postanalytical: interpreting results, reporting and archiving data (relaying results to pt)

Bipolar vs Unipolar leads

Bipolar leads: measure voltage between 2 points, have both positive and negative electrode, direct view of hearts electrical activity

I, II, III (limb leads)

Unipolar: measure voltage between single pt of reference, have only + electrode, give indirect view, comparing electrical activity to common reference

AVR, AVL, AVF limb leads

V1-6 precordial leads

12 lead ECG consists of 3 bipolar leads and 9 unipolar leads

Yellow test tube

Additive: sodium polyanetholsulfonate (SPS)

Specimen type: whole blood

Tests: blood culture (paternity/DNA)

Inversions: 8

Special instructions: sterile (aseptic technique)-clean site with iodine rather than 70% alcohol swab

Young (young lady bell rarely getsto greet lucy gray)

Yellow pee goes Spssss

Light Blue Tube

Contains Sodium Citrate. Used in Coagulation testing. Tests for PT, PTT, Fibrinogen, clotting factors, D dimer

Lucy Bell

Light blue SauCer

Red tube

Contains Silica (glass) or Plastic (clot activator) which activates clotting.

Plastic: chemistry panels

Glass: routine blood donor screening, diagnostic for infectious diseases, CMP, drug test

Rarely

Red glass or plastic cup

Gold or tiger top (red-grey)

Additive:

Serum separator tube (SST)

Clot Activator

Thixotropic gel

Test: serum determinations, may be used for routine blood donor screening and diagnostic testing for serum for infectious diseases

GetTo

Gold Tiger Clot SST

Orange Tube

Contains: Thrombin, RST

Effects on Specimen: Quickly clots blood

Uses: STAT serum chemistries

Green tube

Contains Sodium or Lithium Heparin.

Plasma Used in Chemistry: STAT routine chem test, ammonia, troponin, electrolytes, ABG

Sodium heparin: chromosome analysis

GReets

Green Audrey Heparin

Lavender tube

EDTA, whole blood hematology (CBC, RBC, WBC, platelet, HBA1c, Hct, SED Rate,

immunohematology testing, blood donor screening4

EDTA: preserves shape, size of cells

Lucy

Lavender EDTA

Pink tube

EDTA, blood bank

Gray tube

potassium oxalate and sodium fluoride

Blood Glucose testing (GTT, FBS), blood alcohol concentration test, drug test, lactic acid/lactate test

Gray

Gray OXlate

Light Yellow tube

Contain acid citrate dextrose (ACD) and are used for blood bank studies and DNA paternity testing

Dark Blue tube

Contains different additives, free of element contamination

Toxicology or nutritional chem determinations

Serum Separate Tube Inversion Times

"Yellow, Lavender, Green, and gray, flip them 8-10 today!"

"Serum tubes, flip them 5, this makes sure your serum survive"

Red, Gold, Tiger, SST

"For light blue, its 3 to 4, then you don't flip anymore"

Appearance of EKG artifacts

Somatic tremor artifact: jagged peaks with irregular height and spacing

Interrupted baseline: sudden disruption of tracing

AC interference: consistent thick and fuzzy tracing

Wanderline baseline: tracing that wanders away from the center of the paper

ABG procedure

1) prepare and position, use a pre-heparinized syringe

2) Choose an artery, near the radial wrist

3) Insert 30-45 degree angle

4) collect blood

5) Store and level, place in ice

Screening tests and age range

Colonoscopy: 45-75 years old, every 3 years

Mammogram: Female 45-54 old annually, females above 55 years old+ annually or every other year

PSA: males 55-69, annually or every other year

PAP: Females 21-29 y/o, every 3 years, females 30-65 years old every 3 years, but every 5 years if having HPV

Bone density test: females 65 y/o+, every 2 years

Order of draw for capillary puncture

Gasp Lucy GreetS Ozzy's Son

Blood Gases (lithium heparin), Lavender, Green (sodium heparin), Other additives, Serum tubes

Capillary blood tests cannot be used for:

ESR (erythrocyte sediment rate)

Blood cultures

Coagulation studies

ABG (needs artery)

HCPCS vs Level I vs Level II codes

HCPCS codes: alphanumeric billing codes used to identify medical services and procedures

Level I: CPT codes, maintained by the AMA, cover physician services and procedures

Level II: National codes, used for non physician services like DME, ambulance services and lab tests

HCPCS codes

A codes: ambulance and transportation

B codes: enteral and parenteral therapy

C does: outpatient prospective payments

D: dental

E: DME

G: PQRI physician quality reporting

H: Alc and drug abuse treatment

J: Drug adminstered other than oral

L: orthotics and prosthetics

M: Other medical services

P: Pathology and lab

Q: temporary and miscellaneous codes

R: Diagnostic radiology

S: Temporary National codes (not covered by medicare )

T: medicaid codes

V: Vision, hearing and speech pathology services, for ear, eye, and speech treatment

CLIA Waived Tests

Pregnancy tests

Nasal swab for flu A and B

H. Pylori

HbA1c

Hemoglobin

Spun Hct

Rapid Step test

Blood glucose

Cholesterol testing

Dipstick, tablet or multi stick urinanalysis

Fecal occult

Drug testing

Medicare part A, B, C, D, and Plan G or K

A: hospital insurance: inpatient and healthcare facilities

B:Medical insurance: services from healthcare providers, outpatient care, and DME

C: Medicare advantage: alt way to get A and B thru private insurance palns

D: Drug coverage

Plan G or K: Medicare supplemental insurance (Medigap), thru private insurance

Types of scheduling

*Wave booking: 5 patients booked at the beggining of the hour

*Modified-wave booking: 3 patients booked in the beginning of the hour and 2 patients are booked at 30 mins later, each hour

*Double-booking: 2 patients scheduled at 9:15

*Stream time-specific scheduling: patient A at 9:30, patient B booked at 10, patient C booked at 10:30

*Open booking: no patient appt, see pt in order which they arrive

*Cluster, categorization booking: all vaccines booked on Wednesday