The Advanced eClinical Training Final Exam

Patient-Centered Medical Home (PCMH)

care delivery model in which a PCP coordinates treatment to ensure patients receive the required care when and where they need it and in a way rhey can understand

Home Health

specific type of care provided to those who cannot leave their home easily and end once the specified goals are reached

Hospice

end-of-life care focused on comfort rather than curative efforts

Fee for Service

a system under which doctors and hospitals receive a payment for each service they provide

Value-Based Plans

insurance coverage that changes the amount of reimbursement based on health outcomes of patients and the quality of the service they received

Managed Care

plans that provide health care in return for preset scheduled payments and coordinated care through a defined network

Capitation

payment rates ties to expected usage and assigned a per-member, per-month payment based on age, race, sex, lifestyle, medical history, and benefit design

Health Maintence Organization (HMO)

provides wide range of services by a group of primary-care physicians, specialists, and other healthcare professionals in a prepaid system

Preferred Provider Organization (PPO)

group of healthcare providers that provide services to a specific group, often at a reduced rate

Point of Service Plan (POS)

a network of selected contracted, participating providers

Analgesics

relieve pain (acetaminophen, hydrocodone, codeine)

Antacids/Anti-Ulcer

gastroesophageal reflux disease (eesomeprozole, calcium carbonate, famotidine)

Antibiotics

bacterial infections (amoxicillin, ciprofloxacin, sulfamethoxazole)

Anticholingerics

smooth muscle spasms (ipratropium, dicyclomine, hyoscyamine)

Anticoagulants

delay blood clotting (warfarin, apixaban, heparin)

Anticonvulsants

prevent or control seizures (clonazepam, phenytoin, gabapentin)

Antidepressants

relieve depression (doxepin, fluoxetine, duloxetine, selegiline)

Antidiarrheals

reduce diarrhea (bismuth subsalicylate, loperamide, dipenhnoxylate/atropine)

Antiemetics

reduce nausea, vomiting (metoclopramide, ondansetron)

Antifungals

fungal infections (fluconazole, nystatin, miconazole)

Antihistamines

relieve allergies (diphenhydramine, cetirizine, loratadine)

Antihypertensives

lower blood pressure (metoprolol, lisinopril, valsartan, clonidine)

Anti-Inflammatories

reduce inflammation (ibuprofen, celecoxib, naproxen)

Antilipemics

lower cholesterol (atorvastatin, fenofibrate, cholestyramine)

Antimigraine Agents

relieve migraine headaches (topiramate, sumatriptan, rizatriptan, zolmitriptan)

Anti-Osteoporosis Agents

improve bone density (alendronate, ibandronate, calcitonin)

Antipsychotics

psychosis (quetiapine, haloperidol, risperidone)

Antipyretics

reduce fever (acetaminophen, ibuprofen, aspirin)s

Skeletal/Muscle Relaxants

reduce or prevent muscle spasms (cyclobenzaprine, methocarbamol, carisoprodol)

Antitussives/Expectorants

control cough, promote elimination of mucus (dextromethorphan, coedine, guaifenesin)

Antivirals

viral infections (acyclovir, interferon, oseltamivir)

Antiolytics (Antianxiety)

reduce anxiety (clonazepam, diazepam, lorazepam)

Bronchodilators

relax airway muscles (albuterol, isoproterenol, theophylline)

Central Nervous System Stimulants

reduce hyperactivity (methylphenidate, dextroamphetamine, lisdexamfetamine)

Contraceptives

prevent pregnancy (medroxyprogesterone acetate, ethinyl estradiol, drospirenone)

Decongestants

relieve nasal congestion (pseudoephedrine, mometasone, exymetazoline)

Diuretics

eliminate excess fluid (furosemide, hydrochlorothiazide, bumetanide)

Hormone Replacement

stabilize hormone deficiencies (levothyroxine, insulin, desmopressin, estrogen)

Laxatives/Stool Softeners

promote bowel movements (magnesium hydroxide, bisacodyl, docusate sodium)

Oral Hypoglycemics

reduce blood glucose (metformin, acarbose, glyburide)

Sedative-Hypnotics

induce sleep/relaxation (zolpidem, temazepam, eszopiclone)

What angle do you inject an ID injection?

15 degrees

What areas are suitable for an ID injection?

skin of the mid forearm

What areas are suitable for an IM injection?

deltoid, vastus lateralis, and ventrogluteal muscles

What areas are suitable for an SQ injection?

upper arms, abdomen, buttocks, and upper outer thighs

What angle do you inject an SQ injection?

45 degrees

What angle do you inject an IM injection?

90 degrees

What is a normal range for adult blood pressure reading?

systolic: less than 120

diastolic: less than 80

What is an abnormal range for adult blood pressure reading?

systolic: 120-179

diastolic: 80-110

What is an emergent range for adult blood pressure reading?

systolic: greater than 180

diastolic: greater than 110

What is a normal range for adult pulse reading?

60-100

What is an abnormal range for adult pulse reading?

bradycardia: below 60

tachycardia: above 100

What is an emergent range for adult pulse reading?

varies based on many factors

What is a normal range for adult temperature reading?

97.6-99.6

What is an abnormal range for adult temperature reading?

99.6-104.0

What is an emergent range for adult temperature reading?

dangerous: 104-105

fatal: 106 or higher

What is a normal range for adult respiratory rate reading?

12-20

What is an abnormal range for adult respiratory rate reading?

bradypnea: less than 12

tachypnea: greater than 20

What is an emergent range for adult respiratory rate reading?

varies based on many factors

Supine Position (Horizontal Recumbent Position)

patient lies flat on their back with hands at the sides

What is the supine position used for?

used to examine anything on the anterior/ventral surface of the body (head, chest, stomach) and for certain types of x-rays

Prone Position

the patient lies face down, flat on the stomach, with the head turned to one side, and arms either alongside the body or crossed under the head

What is the prone position used for?

used for back exams and certain types of surgery

Dorsal Recumbent Position

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

What is the dorsal recumbent position used for?

used to inspect the head, chest, vaginal, rectal, and perineal areas

relieves strain on the lower back and relaxes abdominal muscles

Lithotomy Position

similar to the dorsal recumbent position, except the patient's feet are placed in stirrups attached to the end and sides of the table

What is the lithotomy position used for?

used for vaginal examinations and for obtaining cell samples of the cervix

Fowler's Position

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

What is the fowler's position used for?

used for examinations of the head, neck, and upper body

Semi-Fowler's Position

modified fowler's position with the head of the table at a 45-degree angle instead of a 90-degree angle

What is the semi-fowler's position used for?

used for post-surgical exams and patient with difficulty breathing or lower-back injuries

Left Lateral Position (Semi-Prone Recumbent Position)

requires the patient to be placed on the left side with the right leg sharply bent upward and the left leg slightly bent

What is the left lateral position used for?

used for rectal exams, taking rectal temperatures, enemas, and perineal and pelvic exams

Knee-Chest Position

patient is placed in the 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

What is the knee-chest position used for?

used for proctologic exams, sigmoidoscopy procedures, and rectal and vaginal exams

What is the additive in a yellow top tube?

Sodium polyanethol sulfonate (prevents blood from lotting and stabilizes bacterial growth)

What is the laboratory use for a yellow top tube?

blood or body fluid cultures

How many inversions are needed for a yellow top tube?

0

What is the additive in a light blue top tube?

sodium citrate (removes calcium to prevent blood from clotting)

What is the laboratory use for a light blue top tube?

coagulation testing

How many inversions are needed for a light blue top tube?

3-4

What is the additive in a red top tube?

none

What is the laboratory use for a red top tube?

serum test, chemistry studies, blood bank, and immunology

How many inversions are needed for a red top tube?

5

What is the additive in a red/gray marbled top tube?

no anticoagulants but contains silica particles (enhance clot formation; use for serum separation)

What is the laboratory use for a red/gray marbled top tube?

serum tests, chemistry studies, and immunology

How many inversions are needed for a red/gray marbled top tube?

5

What is the additive in a green top tube?

heparin (inhibits thrombin formation to prevent clotting)

What is the laboratory use for a green top tube?

chemistry test

How many inversions are needed for a green top tube?

8

What is the additive in a green/gray marbled top tube?

lithium heparin and gel (plasma separation)

What is the laboratory use for a green/gray marbled top tube?

plasma determinations in chemistry studies

How many inversions are needed for a green/gray marbled top tube?

8

What is the additive in a lavender top tube?

ethylenediaminetetraacetic acid (EDTA) (removes calcium to prevent blood from clotting)

What is the laboratory use for a lavender top tube?

hematology test

How many inversions are needed for a lavender top tube?

8

What is the additive in a gray top tube?

potassium oxalate and sodium fluoride (removes calcium to prevent blood from clotting and inhibits glycolysis)

What is the laboratory use for a gray top tube?

chemistry testing, especially glucose and alcohol levels

How many inversions are needed for a gray top tube?

8-10

List the correct order for the order of draw.

yellow, light blue, red, red/gray marbled, green, green/gray marbled, lavender, and gray