Chapter 9: general patient care

At the end of each day, the MA should

disinfect the work area and stick the exam rooms

Upon arriving to work the next day, the MA should

recheck the rooms for cleanliness and adequacy of supplies

Identifiers on daily schedule

patient’s name and the reason for the visit

Sodium hypochlorite solution

1:10 dilution of household bleach to water; common solution to disinfect surfaces

In relation to medical facility safety, the MA is responsible for reporting

sidewalk cracks, loose handrails, snow, or ice to their immediate supervisor

Restatement

repeating or paraphrasing information relayed by the sender to confirm the accuracy

Reflection

when the receiver focuses on the main idea of the message but incorporates feelings the sender might be exhibiting or possibly feeling

Clarification

summarizing the information relayed by the sender to clear up any confusion

Chief complaint

subjective information from the PT on the reason for the visit

Medical reconciliation

comparing the patient’s list of medication to the medical record’s list of medication

Anaphylaxis

life-threatening allergic reaction that leads to circulatory collapse, shock, and death if left untreated

Anthropometric measurements

screening tests that include height and weight and head circumference for infants)

Denver developmental screening test

a series of activities used to determine the developmental stage of children

Vital signs are key indicators of

homeostasis

Metabolism

relationship between heat produced and heat loss

Oral temperature uses

digital thermometer

Aurally temperature uses

tympanic thermometer

Temporally temperature uses

temporal artery scanner

Normal oral, tympanic, and temporal temperatures are

98.6°F (37°C)

Axillary temperatures are 1°F \___ than 98.6°F

cooler (less)

Rectal temperatures are 1°F \___ than 98.6°F

higher

What fingers should you use to palpate the pulse

second and third fingers (index nd middle fingers)

What side of the wrist is the radial pulse located on

the thumb side

Where is the brachial pulse located

inside the upper arm

Where is the carotid pulse located

the neck, below the jaw bone

Who do you use the brachial pulse on

children

When do you check the carotid artery

in emergency procedures

Thready

pulse is faint/difficult to detect

Bounding

pulse is very strong

Average heart rate of adult (15+)

60 to 100/min

Average heart rate of newborn

120 to 160/min

Minimum heart rate for infants, toddlers, and preschoolers is

80/min

Maximum heart rate for infants

140/min

Normal respiratory rate of newborn

30 to 50/min

Normal respiratory rate of adult

12 to 20/min

Rales

choking or crackling sounds heard on inspiration that can sound moist or dry

Rhonchi

common rattling snoring sounds often associated with chronic lung disease

Systolic pressure

first sharp tapping sound; when blood begins to surge into the artery

Diastolic pressure

the last sound heard; when blood is flowing freely

The readings of systolic and diastolic pressure are phases

I and V of the Korotoff sounds

Korotoff sounds

the five phases of articular relaxation that are audible while obtaining a manual blood pressure

Blood pressure tends to

rise with age

Average blood pressure of infants and children

between 60/30 to 100/80

Normal blood pressure for adults

lower than 120/80 mm Hg

For adults, what systolic readings are considered elevated?

systolic readings between 120 and 120

Stage 1 hypertension

130 to 130/80 to 89

Stage 2 hypertension

readings greater than 140/90

Patients experiencing symptoms associated with \____ are candidates for pulse oximetry

pneumonia, asthma, or bronchitis

If necessary, the pulse oximetry can be placed on the

earlobe

First information recorded from patient

chief complaint and weight

Normal BMI range

18.5 to 24.9

For infants, weight is more accurate if the infant

lies down or sits on the scale

Infant scales measure in

pounds and ounces

Sims’

laying on the left side with legs flexed at a 90-degree angle

When is sims’ position used?

exams involving the rectum, enemas

Supine position

lying on back

Knee-chest

prone (lying on the stomach) and bent at the waist, resting on the knees with the arms above the head

When is the knee-chest position used

gynecological or rectal exams. Treatments of spinal adjustments

Trendelenburg

lying with the head lower than the legs (forced circulation to vital organs)

When is Trendelenburg used?

shock

Dorsal recumbent

lying on the back with knees up and feet flat on the table

When is dorsal recumbent used?

catheterizations, genital examination of younger children and adolescents

Fowler’s

sitting position, 90 degrees

When is Fowler’s used?

Exams involving the eyes, ears, nose, throat, and chest

Semi-fowlers

sitting position, 45 degrees

When is semi-fowler’s used

exams involving the chest. When the patient cannot lay flat and for patients experiencing SOB

Lithotomy

lying flat on the table with buttocks at the end of the table and feet resting in stirrups

When is lithotomy used?

Female pelvic exams

Sphygmomanometer is used on the

arm (blood pressure)

Ophthalmoscope is used on the

eyes

Tuning fork is used on the

head

Temporal thermometer is used on the

forehead

Speculum is used on the

nose

What information should the MA check when preparing medication

name of the medication, dosage, time and route of administration

First check of medication

comparing the administration order to the medication

Second check

after the medication is prepared for administration

Third check

completed immediately prior to administering the medication to the patient

Why are alcohol swabs used on a vial stopper?

prevent the introduction of germs into the solution and keep the needle sterile

The lower the gauge number

the wider the lumen

Guage 14 is the

largest

Gauge 31 is the

smallest

Needle gauge for Intradermal (ID)

27 to 28

Needle gauge for subcutaneous (SC)

25 to 26

Needle gauge for intramuscular (IM)

20 to 23

Needle length of ID

⅜ inch

Needle length of SC

½ inch, ⅝ inch

Needle length for IM

1 to 3 inches

Common IM injection sites

deltoid muscle, ventrogluteal muscle, vastus lateralis muscle

Angle for IM injection

90

Common SC injection sites

upper outer arm, abdomen, thigh

Angle for SC injection

45

Heparin and insulin are examples of

SC injections

Common site for ID injections

mid forearm (TB), back (allergy testing)

Angle for ID injections

10 to 15

When administering an ID injection, do not

massage or apply pressure to the site

Irrigation solutions should be

tepid or room temperature

If the irrigation solution is too cold, it can lead to

dizziness or discomfort

Abrasion

scrape or rub

Contusion

bruise

Strain

overstretching of a muscle or tendon