MA Course Studying

What is an EKG

electrocardiogram - measures electrical activity of the heart

What is a P-wave

atrial depolarization (contract)

What is QRS Complex

ventricular depolarization (contract)

T-Wave

Ventricular repolarization (relax)

U-wave

Further repolarization of the ventricle

Explain Each Part of SOAP

S - subjective (chief complaint, patient history)

O - objective (vital signs, diagnostic tests)

A - assessment (diagnosis)

P - Plan (next steps)

What is wave scheduling

5 patients admitted at the beginning of every hour

What is Streaming / Time Specified Scheduling

Patient A - 9:30

Patient B - 10:00

Patient C - 10:30

What is Cluster Scheduling

schedule by the type of appointment and time

Open Hour

first come first serve

Modified Wave Scheduling

more patients scheduled at the beginning of the wave than towards the end

How to Open Flaps in Sterile Field

• Open flap most away from you outwards

• Open side flaps

• Open the one closest to you towards you last

What are the Symptoms of Congestive Heart Failure

• feet, abdomen swelling (edema)

• Fatigue

• Shortness of breath

Where is the V1 electrode

• 4th intercostal space on the patients right sternal edge

Where is V2

5th intercostal space on patients left sternal edge

Where is V4

5th intercostal space on patients mid-clavicular line

Where is V3

In-between V2 and V4

Where is V5

5th intercostal space on the anterior axillary line

Where is V6

5th intercostal space on the midaxillary line

What is Syncope

• fainting or a temporary loss of blood flow to the brain

Precursors of Syncope

• paleness

• sweating

• dizziness

• blood draws

What position should patients at risk for syncope be in

• trendelenburg

• supine

What is considered a normal HR

60-100

What is Anemia

• Low RBC

Symptoms of Anemia

• shortness of breath

• fatigue

Cause of hypoglycemia

• Not enough carb ingestion

• Too much insulin

Order of Draw for Venipuncture

Yellow, Light Blue, Red, Gold, Tiger, Green, Lavender, Grey

Young Lady Bell Rarely Gets To Greet Lady Grey

What does “ac” abbreviation mean

• before meals

What does “pc” abbreviation mean

• after meals

What does “po” abbreviation mean

Taken by mouth

What does “prn” abbreiviation mean

as needed

Anorexia

• no eating, self starvation

Bulimia

• binge eating and then purging (getting rid of calories)

Evidence of Bulimia

• erosion of tooth enamel

• swollen cheeks

What is AC Interference

• electrical interference

• produces jaggy/spiky EKG

What does Loose Lead show on EKG

• wandering baseline

Somatic Tremor Interference

• involuntary muscle movement

• Jagged spikes

Disconnected Electrode

• gaps in baseline

Therapeutic Communication

• helps patients feel heard

• Listener wants to resolve patients problems

Sanitization

reduces organic material from items, gets rid of visible debris

Disinfection

kills most harmful micro-organisms

What are some common disinfectants

• 1:10 bleach

• Glutaraldehyde

• Alcohol

Sterilization

• kills all micro-organisms including spores

Types of Sterilization

• UV Radiaiton

• Autoclave

Allergy Test - What type of injection, what angle, what skin layer is penetrated

• Intradermal

• 15-30 degrees

• epidermis

Allergy Test - How far apart is each test

• 1-2 inches

Is bevel faced up or down

up

How far above the venipuncture site is a tourniquet tied

• 3-4 inches

How long should you keep the tourniquet on

1 min to prevent hemoconcentration

What is the chain of infection

1. Infectious Agent

2. Resevoir

3. Portal of Exit

4. Transmission

5. Portal of Entry

6. Susceptible Host

Blood Pressure Ranges - Hypotension

• systolic below 90 or diastolic below 60

Blood Pressure Ranges - Normal

• systolic 90-120 and diastolic 60-80

Blood Pressure Ranges - Elevated

• systolic 120 -129 or diastolic below 80

S1 Hypertension

• Systolic 130-139 or diastolic 80-89

S2 Hypertension

• Systolic 140+ or diastolic 90+

Hypertensive Crisis

• Systolic 180

• + or diastolic 120+

When teaching should you document the discussion

Yes

Advance Directive

• living will in case patient can’t make decisions for themselves

• contains instructions about what the person does/doesn’t want

Notarized Will

will after death

Healthcare Proxy

someone who makes decisions for you (power of attorney)

How to measure respiratory rate

• measure for 30 sec and multiply by 2

What does -emesis mean

• vomiting/nausea

How to perform a capillary puncture

• perpendicular to finger lines - allows blood to form drop

• off center on middle or right finger

• wipe off first drop because it contains tissue fluid

What does -uria mean

urine

What is epitaxis

nose bleed

What is hematoehezia

blood in stool

What causes artificially low measurements on a pulse ox

• cold hands/fingers

What are the Steps for Urine Drug testing

1. Check BR before patient enters

2. Ensure patient does not flush

3. Assess temp within 4 min

4. Volume = 30-45 mL

5. Temp = 32-38 degrees

6. Seal lid in the presence of patient

What volume of Urine is required for Urinalysis

• 10 mL

Ischemia

loss of blood flow

What can Ischemia cause

• stroke

• heart attack

What is myopia

near-sightedness

What is Continuous fever

persistently high

What is a remittent fever

• fluctuation above normal but no sign of return to normal

What is Intermittent fever

• comes and goes with periods of normalcy

What is spiking fever

• spikes quickly to a high temp and falls again

BMI range - Underweight

• less than 18.5

BMI range - Normal

18-25

BMI range - Overweight

25-30

BMI range - Obese

30+

How to Take a BP Measurement

• cuffs lower edge is 1 in above anticubital fossa

• hand level with heart

• listen to brachial artery

Customary Charge

• what multiple providers usually charge

Usual Charge

• what one provider charges

Reasonable Charge

• if provider puts in extra investment of time and effort

• if its a complex procedure

Accepted Charge

• patients and payers think of it as fair

Subcutaneous - type of injection, absorption rate

• fatty layer

• slow/mod absorption

• insulin

Transdermal - type of injection, absorption rate

• patch on skin

• slow/steady

Intra-muscular - type of injection, absorption rate

• into muscle

• moderate/fast

Intravenous - type of injection, absorption rate

• into vein

• immediate

Buccal - type of injection, absorption rate

• between check and gum

• mod/fast

Oral - type of injection, absorption rate

• by mouth

• slow/mdo

Inhalation - type of injection, absorption rate

• inhaled

• fast

Topical - type of injection, absorption rate

• applied to surface of skin

• slow/mod

Rectal - type of injection, absorption rate

• into rectum

• mod/fast

Paranteral Meaning

anything that bypasses the GI system

Category 1 Codes

• describe medical procedures/services

• billing and reimbursement

Category 2 Codes

• extra info

Category 3 codes

emerging tech

normally insulin injections are 45 degrees but with obese patients it’s 90 degrees

What degree is intramuscular injection

90