NHA EKG Board Study Guide

HIPPA

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