NHA CCMA Exam

NHA CCMA EXAM Review 2022 Chief Complaint - the reason why the patient came to see the physician. History of Present Illness - explanation of the CC to determine the onset of the illness. Past,family,and social history - summary of personal and family health problems as well as social to include marital status, occupation, use of drugs, etc. Body Processes necessary for life: - Body Temperature, Respiration, Heart Function Vital Signs of body function: - temperature, pulse, respiration, blood pressure Febrile - presence of fever afebrile - absence of fever intermittent fever - fluctuating fever that returns to or below baseline remittent fever - fluctuating fever that remains elevated and does not return to baseline continuous fever - fever that remains constant; does not fluctuate axillary temperature - least accurate; taken under the arm tympanic temperature - useful for children; placed in the ear rectal temperature - per rectum; most effective normal adult pulse range - between 60-100 bpm apical pulse - taken over the apex of the heart by auscultation normal respiration rate - 12-20 per minute (Adults) apnea - temporary complete absence of breathing tachypnea - respiration rate greater than 40 per minute bradypnea - decrease in the numbers of respiration cheyne stokes - regular pattern of irregular breathing rate 1/10 orthopnea - decrease in numbers of respiration hypoventilation - reduced amount of air enters the lungs resulting in decreased oxygen level hyperpnea - abnormal increase in the depth and rate of breathing hyperventilation - increased amount of air entering the lungs Systole - the highest amount of pressure exerted during the cardiac cycle Diastole - the lowest amount of pressure exerted during the cardiac cycle Palpation - the sense of touch to determine the characteristics of an organ system Percussion - tapping or striking the body to determine the position, size and density of the underlying organ/tissue Auscultation - listening to sounds produced by internal organs Horizontal Recumbent Position - patient lies on back w/legs extended (used for most physical exams) Dorsal Recumbent Position - patient lies on back with knees flexed and soles of the feet flat on the bed Fowler's Position - semi/sitting position where back of the table is elevated. Dorsal Lithotomy Position - patient lies on back with knees flexed, legs seperated and thighs are acutely flexed. feet are usually in stirrups, Prone position - patients lies on abdomen with head turned to side Sim's position - patient lies on left side with right knee flexed against the abdomen and left knee slightly flexed knee-chest position - patient is on knees with chest resting on the bed and elbows resting on the bed above head OSHA - Occupational Safety and Health Administration external hemorrhage - controlling the bleeding is most effectively accomplished by elevating the affected part above heart level Shock - occurs when there is insufficient return of blood flow to the heart 2/10 CPR - Cardiopulmonary Resuscitation AMS - Agent, Modes of Transmission, Susceptible Hosts agents - infectious microorganisms that can be classified into groups; viruses, bacteria, fungi, and parasites Portal of Exit - the method by which an infectious agent leaves the reservoir 5 Modes of Transmission - Droplet, Airborne, Common Vehicle, Vectorborne, Contact (direct or indirect) Susceptible Host - Not Resistant or Immune Medical Asepsis - the destruction of pathogenic microorganisms after they leave the body disinfection - use of various chemicals that can be used to destroy many pathogenic microorganisms 1:10 Solution - most readily available and least expensive disenfectant surgical asepsis - all microbial life, pathogens and non pathogens are destroyed before an invasive procedure Gas Sterilization - often used for wheelchairs and hospital beds Dry Heat Sterilization - requires higher temperature than steam sterilization but longer exposure times Chemical Sterilization - use of the same chemical used for chemical disinfection Steam Sterilization (autoclave) - uses steam under pressure to obtain high temperature of 250-254F with exposure of 20-40 min Handwashing - the most important means of preventing the spread of infection Personal Protective Equipment - Masks, goggles, face shileds, respirators isolation precautions - method of infection control that assumes all human blood and body fluids were potentially infectious standard precautions - designed to prevent direct contact with blood and other body fluids u using PPE 3/10 transmission based precautions - the second tier of precautions are to be used when the patient is known or suspected of being contagious po - by mouth/orally pr - per rectum sl - sublingual (under the tongue) iv - intravenous im - intramuscular sq - subcutaneous qd - every day bid - twice a day tid - three times a day qid - four times a day pc - after meals / not on empty stomach qhs - each night prn - as needed heart location - in the thoracic cavity between the lungs just behind the sternum Upper chambers of the heart - right & left atria (atrium-singular) Lower chambers of the hear - Right & left ventricles Endocardium - innermost layer of the heart Myocardium - middle layer of the heart Epicardium - outermost layer of the heart pericardium - the sac in which the heart is contained right atrium - receives deoxygenated blood returning to the heart via the superior vena cava 4/10 right ventricle - receives deoxygenated blood from the right atrium which it pumps to the lungs for oxygenation through the pulmonary artery pulmonary arteries - the only arteries in the body that carry deoxygenated blood left atrium - receives deoxygenated blood returning from the lungs via the rught and left pulmonary veins pulmonary veins - the only beins in the body that carry oxygenated blood left ventricle - receives the oxygenated blood from the left atrium and pumps it to the body through the aorta aorta - the largest artery of the body Atrioventicular Valves (AV) - Tricuspid & Mitral Valve Tricuspid Valve - ;between the right atrium and the right ventricle Mitral Valve - between the left atrium and left ventricle Pulmonic Valve - between the right ventricle and pulmonary trunk Aortic Valve - between the left ventricle and aorta Murmurs - caused by diseases of the valves or other structural abnormalities S1 - first heart sound S2 - second heart sound Autonomic Nervous System (ANS) - subdivided into Sympathetic and Parasympathetic systems ANS - Automatic Nervous System sympathetic nervous system - affect both the atria and ventricles by increasing the heart rate parasympathetic nervous system - affects only the atria by decreasing the heart rate automaticity - the ability of the cardiac pacemaker cells to spontaneously initiate their own electrical impulse without being stimulated from another source excitability - the ability to respond to external stimulus: chemical,electrical, and mechanical 5/10 conductivity - the ability of all cardiac cells to receive an electrical stimulus and transmit the stimulus to other cardiac cells Contractility - the ability of the cardiac cells to shorten and cause cardiac muscle contraction in response to an electrical stimulus Depolarization - positive - contracting repolarization - negative - relaxation SA Node - primary pacemaker of the heart and has a normal firing rate of 60-100 bpm LEAD I - Left Arm is positive Right Arm is negative LEAD II - Left Leg is Positive Right Arm is negative LEAD III - Left Leg is positive Left Arm is negative Lead aVR - Right arm is positive and the other limbs are negative Lead aVL - Left arm is positive and the other limbs are negative Lead aVF - Left leg/foot is positive and the other limbs are negative V1 - 4th intercostal space, right sternal border V2 - 4th intercostal space, left sternal border V3 - between v2 and v4 V4 - 5th intercostal space, left midclavicular line V5 - 5th intercostal space, anterior axillary line V6 - 5th intercostal space, midaxillary line horizontal axis - represents time: 1mm vertical axis - measured in millivolts running speed - 25mm/sec 6/10 waveform - refers to movement away from the isoelectric line segment - line between two waveforms interval - waveform plus a segment complex - several waveforms P WAVE - deflection produced by atrial depolarization QRS COMPLEX - represents ventricular depolarization (activation) Q WAVE - initial negative deflection R WAVE - first positive deflection S WAVE - first negative deflection T WAVE - deflection produced by ventricular repolarizations Wandering Baseline - causes the baseline of the tracing to move up and down; due to interference with the signal stress test - noninvasive diagnostic procedure to determine the presence and severity of coronary artery disease ischemia - decrease in the amount of blood flow holter monitor - contains 5 electrodes attached to the patients trunk code of ethics - standards of right and wrong blood vessels: - aorta,arteries, capillaries, venules, veins, superior and inferior vena cava Tunica adventitia - outer connective tissue Tunica media - middle smooth layer Tunica Intima - inner endothelial layer Avg blood amount for adult - 5-6 liters Plasma - liquid portion of the blood Erythrocytes - red blood cells 7/10 Leukocytes - white blood cells 120 days - normal life span of an RBC Leukocyte function - protects against infection Thrombocytes-platelets - small irregularly shaped packets of cytoplams Hemostasis - process by which blood vessels are repaired after inkury Vascular Phase - stage 1 of hemostasis Platelet Phase - stage 2 of hemostasis Coagulation phase - stage 3 of hemostasis Fibrinolysis - stage 4 of hemostasis Antecubital fossa - preferred site for venipuncture median cubital vein - first choice vein for venipuncture cephalic vein - second choice vein for venipuncture basilic vein - third choice vein for venipuncture winged infusion sets - used for pediatric and elderly patients fasting specimen - require patient to abstain from eating for at least 12 hours edema - the accumulation of fluid in the tissues fistulla - the permanent surgical connection between an artery and vein Yellow Top Tube - Blood Cultures (1st) Light Blue Top Tube - Sodium (2nd) Red or Tiger Striped Tube - Serum / non additive tubes (3rd) Green Top Tube - Heparin (4th) Lavender Top Tube - EDTA(5th) Gray Top Tube - Glucose (6th) 8/10 Hematoma - blood accumulation in the tissue surrounding the vein Hemoconcentration - result of tourniquet being left on too long Phlebitis - inflammation of a vein Petechiae - tiny non-raised red spots due to the tourniquet being left on too long Thrombus - blood clot Thrombophlebitis - inflammation of a being with formation of clot two hour postprandial test - used to evaluate diabetes mellitus oral glucose tolerance test - used to diagnose diabetes mellitus PKU - test ordered for infants to detect phenylketonuria blood cultures - ordered to detect presence of microorganisms in the patients blood chilled specimens - ammonia, lactic acid, gastrin, acth light sensitive specimens - bilirubin, beta-carotene, vitamins a & b6 Dermal puncture site for infants - middle of the fourth and fifth toes to the heel Dermal puncture site for adults - third or fourth finger of the non dominant hand 1st draw for capillary - lavender tube 2nd draw for capillary - tubes with additives 3rd draw for capillary - tubes without additives Bacteriology - study of bacteria parasitology - study of parasites mycology - study of fungi virology - study of viruses meter - basic unit of length liter - basic unit of capacity or volume 9/10 gram - basic unit of weight or mass kilo - one-thousand deci - one-tenth centi - one-hundredth milli - one-thousandth micro - one millionth nano - one billionth components of the urinary system - two kidneys, two ureters, urinary bladder, and a urethra first morning sample - most commonly used for routine urinalysis mid stream specimen - collected not at the beginning or end of voiding but in the middle of urination clean catch specimen - requires special cleaning of the external genitalia urine output avg - 1200-1500ml every 24 hours examination of urine - physical, chemical and micrpscopic glucose - sugar typically found in urine Duty - duty of care Derelict - breach of duty of care Direct Cause - legally recognizable injury Damage - wrongful activity must have caused the injury tort - wrongful act that results in injury to one person by another good samaritan law - rendering of first aid by health care professionals at the scene of an accident or sudden injury 10/10