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CCMA Certification study guide
Chief complaint CC The reason a patient called for help. Also, the patient's response to questions such as "What's wrong?" or "What happened?" History of present illness HPI Explains the chief complaint. A chronological description of the development of the patient's present illness from the first sign or symptom or from the previous encounter to the present. Vital Signs Temperature, pulse, respiration, and Blood pressure are all ___________ ___________. Normal oral temperature 97.6F - 99.6F intermittent fever Fever that alternates between elevated and normal or subnormal body temperatures. Remittent fever fever in which temperature fluctuates greatly but never falls to the normal level. Continuous fever A fever that remains constant above the baseline, does not fluctuate. 60-100 BPM Normal pulse rate Respirations Rate, rhythm, and depth are taken into account when measuring what? Systole contraction of the heart Diastole relaxation of the heart Anthropometric measurements Measurement of height, (length rather than height is used in infants because they cannot stand.), weight, BMI, head circumference in infants, waist to hip, % of body fat. Inspection General appearance, state of nutrition, body habits, symmetry, pasture and gait, speech. palpation to examine by touch Percussion physical examination method of tapping over the body to elicit vibrations and sounds to estimate the size, border, or fluid content of a cavity such as the chest. Ausculation
the act of listening to sounds arising within organs (as the lungs or heart) as an aid to diagnosis and treatment. OSHA a government agency in the Department of Labor to maintain a safe and healthy work environment cardiopulmonary resuscitation an emergency procedure for life support consisting of artificial respiration and manual external cardiac compression SHOCK This is caused by inadequate blood flow to the heart and in turn to the rest of the body. Symptoms of shock Pale, cold, clammy skin rapid, weak pulse increased shallow breathing expressionless face or staring eyes are all ____________ ___ _________. First aid for Shock maintain open airway for the victim, call for assistance, keep victim lying down w/ head lower than rest of body; attempt to control bleeding or other cause of shock if known; keep victim warm until help arrives Portal of exit Method in which a infectious agent leaves the reservoir. Ex: contact with body fluids such as blood or saliva. mode of transmission contact, droplet, air, vehicles, or vectorborne Portal of entry A pathway by which the causative agent enters the host. The area in which a microorganism enters the body. They may be cuts, lesions, injection sites, or natural body orifices. Susceptible host An individual who has little resistance to an infectious agent. Disinfection Process used to destroy microorganisms; destroys all pathogenic organisms except spores, can only be used on inanimate objects. Will not be used for invasive procedures, and will not be inserted into body orifices nor be used in sterile procedure. Chemical sterilization Uses the same chemical used for disinfection, but exposure time is longer. Steam sterilization (Autoclave) uses steam under pressure to obtain higher temperature (250-254F) with exposure time of 20-40 minutes depending on item being sterilized. hand washing What is the most important means of preventing the spread of infection? hand antisepsis the removal & destruction of transient microorganisms using antimicrobial soaps. PPE Personal protective equipment mask, goggle, face shield, respirator
AV node Located at the posterior septal wall at the right atrium just above the tricuspid valve. There is a 1/10 second delay of electrical activity at this level to allow blood to flow from the atria to the ventricles. Lead I Left arm is positive and right arm is negative (LA-RA) Lead II Left leg is positive and right arm is negative (LL-RA) Lead III Left leg is positive and left arm is negative (LL-LA) aVR The right arm is positive and the other limbs are negative aVL The left arm is positive and the other limbs are negative aVF The left leg (or foot) is positive and the other limbs are negative V 4th intercostal space, right sternal border V 4th intercostal space, left sternal border V equidistant between v2 and v V 5th intercostal space, on the left midclavicular line V 5th intercostal space at the anterior axillary line V 5th intercostal space, midaxillary line 1mm 1 small square on eKG grid is equal to 5mm 1 large square on EKG grid is equal to 1mv 2 large squares on EKG grid is equal to .04 seconds or 40m seconds 1 small square on eKG grid is equal to how much time? .2 seconds or 200m seconds 1 large square on eKG grid is equal to how much time? 1 second or 1000 m seconds 5 large squares on eKG grid is equal to how much time? 25mm per second The running speed of an EKG is? Horizontal axis What represents time on an EKG? Vertical axis
What represents amplitude on an EKG? P Wave Deflection produced by Atrial depolarization. Normal range does not exceed 0.11s in duration or 2.55mm in height. T wave Deflection produced by ventricular repolarization QRS complex Ventricular depolarization Somatic tremors Patients tremors or shaking the wires can produce jittery patterns on the EKG tracing. Wandering baseline sweat or lotion on the patients skin or tension on the electrode wires can interfere with the signal going to the EKG apparatus causing the baseline of the tracing to move up and down on the EKG paper. 60-cycle interference can produce deflections occurring at rapid rate that may mimic atrial flutter. this is caused by electrical appliances or apparatus being used nearby while the tracing is taken. broken recording the stylus goes up and down trying to find the signal. tis can be caused by loose electrode or cables, or by frayed or broken wires arrhythmia abnormal heart rhythms Ischemia decreased blood flow to tissue caused by constriction or occlusion of a blood vessel can cause chest pain or angina Myocardial infarction Death of myocardial cells PR segment .16 mm/s; line from the end of the P wave to the onset of the QRS complex ST segment From J point to the onset of the T wave; if elevated above base line could indicate myocardial infarction (STEMI) Beta Blockers Reduce heart rate, blood pressure, myocardial oxygen consumption, effectively treat angina pectoris and hypertension. Contraindicated for cardiac stress test. 5-6 liters The average adult has __ - ___ _______ of blood. 55% How much of our blood is plasma? 45% How much of our blood is made up of formed elements? RBC, WBC, Platelets 99% ____ Of formed elements are Red Blood cells Erythrocytes
The vein of choice because is it large and does not tend to move the the needle is inserted. Cephalic vein The second choice for venipuncture. It is usually more difficult to locate and has a tendency to move, however, it is often the only vein that can be palpated in the obese patients. Basilic Vein The third choice for venipunctures. It is the least firmly anchored and located near the brachial artery. If the needle is inserted too deep, this artery may be punctured. 3-4 inches above the venipuncture site Where should the tourniquet be placed when performing venipuncture?
- Blood cultures,
- light blue top tubes
- Serum (red or gray tubes)
- green top tubes
- lavender top tubes
- Gray top tubes. What is the correct order of Draw? Fasting specimens Glucose Tolerance Test; Patient must have fasted and refrained from strenuous exercise for 12 hours prior tot he drawing. 2 hour postprandial This test is used to evaluate diabetes melitus. Fasting glucose level is compared with the level 2 hours after eating a full meal of ingesting a measured amount of glucose. Blood cultures 8-10 mL; Are measured to detect the presence of microorganisms in the patient's blood. Tests for septicemia. PKU To test for mental retardation or brain damage. Cold Agglutinins Red topper tubes, and must be kept warm. Chilled specimens Arterial blood gases ammonia lactic acid pyruvate, acth gastrin parathyroid Light sensitive specimens Bilirubin beta-carotene Vitamins A&B porphyrins Infant dermal puncture
Use the lateral aspect of the heel (dorsal pedis lateralis), do not exceed more than 2.0mm. Older children & adult dermal puncture Use the distal segment of the third and fourth finger of the non dominant hand. Go perpendicular to the lines of the fingerprint. Lavender Tubes Contains EDTA. The tubes are used for CBC, RBC count, WBC & platelet count, WBC differential count, Hemoglobin and hemoaocrit determinations, ESR (erythrocyte sedimentation rater), Sickle Cell screening. Light blue tubes Contains sodium citrate, which prevents coagulation, tube must be completely filled. Test for coagulation studies. Green top tubes Chemistry tests. Heparin. tube should be inverted 8 times. Gray top tube Fasting blood sugar, Glucose tolerance test, blood alcohol levels, lactic acid measurement. Potassium Oxalate/Sodium Fluoride Red/gray speckled or gold top tube Serum Seperator Gel; Chemistry tests. Contain clot activators, glass particles, silica and celite. Must invert tubes 5 times. Red top tube Serum chemistry test, serology tests, blood bank. This is a plain vacuum tube that contains no additives Yellow top tube Sterile; Contains SUP sodium polyanetholesulfatonate; blood cultures; invert 8 times/ At least once a day How often should tests be checked for accuracy? Toxicology Analyzes poison levels of drugs and poisons Blood type AB+ is Universal Recipient Blood type O+ Universal Donor ABGs analysis of aterial blood to determine the adequacy of lung function in the exchange of gases; transport on ice Anuria The absence of urine Hematuria The presence of blood in the urine Polyuria The passage of large volumes of urine First morning urine sample The type of specimen that is most commonly used for routine analysis and HCG (pregnancy) test
sterilization free of all microorganisms diaphoresis profuse sweating Nosocomial infections Infections derived from the patient staying in the hospital V codes identify conditions other than a disease or injury, but are not necessarily a primary diagnosis
