NHA 2023 EKG certification test --- Other Resource: https://www.studystack.com/flashcard-951100
HIPPA
Health Insurance Portability and Accountability Act of 1966
PHI
Personal Health Information
Examples of PHI
Name, DOB, SSN, Phone #, marital status, employment, address
Discussion of PHI should be _______.
limited
PHI can be used educationally if patient information is ________.
redacted
OSHA
Occupational Safety and Health Administration; ensures safe work environment
CDC
Centers for Disease Control and Prevention; provides recommendations to keep patients and workers safe according to established best practices
HAI
Healthcare associated infection
Universal precautions include….
Standard precautions, medical asepsis, breaking chain of infection, hand washing(follow proper technique), sanitization and sterilization of materials, disinfection - limits microbial activity
Medical asepsis (clean technique)
Used daily in every clinical setting; consists of the removal or REDUCTION of microorganisms after they leave the body and breaking the chain of infection
Examples of asepsis
washing hands before and after each patient encounter, making sure the workspace is clean, properly cleaning and disinfecting equipment
Standard precautions for EKG
wear gloves if there are open areas on the skin because these increase the possibility of being exposed to body fluids
_____ is a body fluid that is NOT considered harmful to others.
Sweat
MOST IMPORTANT thing that stops the cycle of infection
Good Hand Hygiene
Accessories that can harbor pathogens
jewelry, rings, and artificial nails
Sanitization
first step; reduces number of microbes so the equipment is ready for sterilization or disinfection; gloves must be worn
Disinfection
the process of destroying pathogens on a surface; does not destroy all microbial spores
Chemical disinfections CANNOT be used on _________.
patients
The EKG machine leads and exam table should be disinfected after __ ___.
each use
SDS
Safety data sheets; used in conjunction with PPE to maintain safe work environment
Only put items with body fluid into a _________ container.
biohazard
Dispose of any needs or other sharp supplies used during a stress test injection in the appropriate ______ container.
sharps
EKG technicians are responsible for:
delivering safe patient care, maintaining confidentiality, and ensuring privacy
Scope of practice is defined by the individual ____ and in compliance with institutional policies and procedures.
state
EKG technicians must stay up to date on current ___ and ___.
research, technology
_____ consent is needed for more extensive cardiac testing.
Written
___ consent is most common for EKGs (i.e. changing into gown, lying down, etc.)
Implied
Patients should be fully ______ and provided a private and safe environment that limits physical exposure of the patient
informed
NHA
National HealthCareer Association
NHA expects professionals to use their best efforts to:
better society and exhibit honesty and professionalism while treating all individuals with respect
Protecting the privacy and rights of individuals are both ethical considerations and _____ obligations.
legal
What should an EKG technician let a patient know if thy ask about the results of a test?
Only disclose a confirmation that the EKG was successfully completed and will be interpreted by the provider
To facilitate communication, maintain a _________ attitude and demonstrate good listening behaviors.
non judgemental
Good listening behaviors
make eye contact, face the patient, repeat or clarify what the patient says to show understanding, assess the patient’s knowledge to determine health literacy and ability to understand new information
Therapeutic communication technique
Ask “Can you please state your name and DOB?” rather than asking the patient to confirm the stated information
Communication cycle
a message is sent by the sender, which is decoded and interpreted by the receiver, who then sends a response back to the original sender
Analytical patients
do not show emotion; hard to interpret if anxious or not; still provide information
Intuitive communicator
might not want details but would like to see the big picture
Prior to explaining the procedure, introduce yourself, including your ____ within the organization and state what will be done.
position
Display professionalism
physical appearance, eye contact, display understanding and knowledge of situation; can increase patient’s confidence in their care
Active listening skills
recognize verbal and nonverbal messages (facial expressions, body language)
Use skilled interviewing techniques
open-ended questions (What medications do you usually take?)
Provide empathy
do not jump to conclusions or pass judgement
Practice collaboration
make patient part of healthcare team
Embrace technology
select no more than 3 communication channels
A ________ can be warranted when an EKG tech is performing an EKG on a teenage patient, or on a patient who has cognitive deficits or dementia
chaperone
Make sure the person who is providing assistance to the patient has been authorized by the patient or the court system in the form of ____________________.
durable power of attorney
People who have ______ impairments can require additional audio, visual media such as written materials, pictures, or audio files
sensory
Avoid using _____ as interpreters, they might not communicate information accurately.
family members
Factors that affect communication with patients
Culture, language, religion, developmental level, gender, disability
EMR
electronic medical record
The Joint Commission mandates using two of the following identifiers to verify each patient’s identity before performing any procedure:
full name, DOB, address, phone #, SSN - ASK PATIENT TO STATE THESE THEMSELF
Prior surgical procedures and medications can all affect the EKG tracing and should be _____.
documented
OPQRST
onset, provocation, quality, severity, time - to get a description of patient symptoms
Emergencies related to cardiac testing
Syncope, chest pain, abnormal vitals, hypotension, arrhythmias, myocardial infarction
Patients who have chronic lung conditions and poor oxygen saturation often cannot assume full ______ position; arrange to complete the EKG in a semi-fowlers or other upright position
supine
Factors that can affect vital signs
stress, food or liquid intake, medical conditions, age and physical activity
Equipment used to measure blood pressure
sphygmomanometer, blood pressure cuff, stethoscope
Blood pressure is measured in…
millimeters of mercury (mmHg)
________ pressure is recorded when the first sharp tapping sound is heard, which is when the blood begins to surge into the artery that has been occluded by the inflation of the blood pressure cuff (phase 1)
systolic
_______ pressure is recorded when the last sound disappears completely and the blood is flowing freely (phase 5)
diastolic
Korotkoff sounds (5 phases)
distinct sounds that are heard throughout the cardiac cycle
Phase 2 Korotkoff
swishing sound as blood flows through the artery
Phase 3 Korotkoff
sharp tapping sounds
Phase 4 Korotkoff
sound changes to a soft tapping sound which begins to muffle
Electronic equipment can interpret blood pressure without _________.
auscultation
Heart rate pulse is measured by _________.
palpation
Radial pulse
thumb side of wrist; most common site for measuring adult pulse
Brachial pulse
inside upper arm; most common sight for measuring pulse in children
carotid pulse
located in the neck just below the jawbone; most common sight for use in emergency procedures
Femoral pulse
strong pulse at this sight demonstrates circulation being sent to the lower extremity
Pedal pulse
if absent, circulation to the toes is affected
Apical pulse
is counted by listening to the heartbeat at the apex of the heart
Pulse is evaluated on…
rate, rhythm (regularity), and volume (strength)
Thready
a pulse that is faint or difficult to detect
Bounding
a very strong pulse
Rate can be affected by
age, activity level, fitness level, motions, body position, body size, medications, environmental temperature, illness, medical conditions
Measure pulse and blood pressure while the patient is sitting in a resting position with their ____ flat on the ground.
feet
Average heart rate tends to ____ with age.
slow
Respirations are evaluated on….
rate, rhythm, depth
Depth
how much air is inhaled
Respiratory rates _____ with age and are affected by health conditions or environmental factors.
decrease
Tachypneic
respiratory rate greater than 20 breaths per minute; are anxious or experiencing respiratory distress
Bradypnea
respiratory rate less than 10 breaths per minute; side effect of some medications
Respiratory rates outside the expected rage are serious and can result in…
acid-base imbalance, hypoxia, brain injury, organ failure
Temperature is an indicator of…
infection, hydration, metabolism
An oral temp that is over __ degrees F or __ degrees C is considered febrile
99.5, 37.5
Pulse oximetry
determines the percentage of oxygen saturation in the body
Patients displaying symptoms of the following are often assessed with a pulse oximeter
pneumonia, asthma, bronchitis
Finger probe uses infrared light to obtain peripheral capillary oxygen saturation (____) reading
SPO2
Pulse oximeter is unreliable if the patient has….
Nail polish, cold hands, acrylic nails, edema, or carbon monoxide poisoning
Pulse oximeter probe can be attached to an ____ instead of the finger.
earlobe
Patients who have chronic respiratory ailments can function normally with SPO2 levels less than ___.
95%
Adequate perfusion
warm skin, pink mucous membranes, strong peripheral pulses, capillary refills less than 2 secs
Patients who have hypoxia or low SPO2 can experience…
anxiety, confusion, increased respiratory rate
Expected reference range for respiratory rate in newborn
30-50 breaths per minute
Expected reference range for respiratory rate in adult
12-20 breaths per minute
Older adults have a slightly ____ body temperature due to loss of body fat and muscle mass
lower
95% + pulse oximeter reading
normal pulse ox result
Expected reference range for blood pressure
<120/<80