






Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Community
Ask the community for help and clear up your study doubts
Discover the best universities in your country according to Docsity users
Free resources
Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors
A comprehensive overview of clinical examination procedures, encompassing asepsis techniques, vital signs measurement, various examination methods (inspection, palpation, etc.), and specimen collection and processing. it details different patient positions used during examinations and includes definitions of key medical terms. The content is suitable for students in healthcare programs.
Typology: Exams
1 / 12
This page cannot be seen from the preview
Don't miss anything!
Asepsis - Free from infection or infectious material medical asepsis - Defined as the destruction of disease-causing organisms surgical asepsis - Destruction of all organisms sued for surgery or injections sterile field - A work area free of all pathogens and non-pathogens (including spores) resident flora - microorganisms that normally reside on the skin, mucous membranes, and inside the respiratory and gastrointestinal tracts transient flora - microbes that reside on the skin surface and are easily removed by hand hygiene hand hygiene - washing hands with either plain or antiseptic soap and water and using alcohol-based hand rubs How long should you wash your hands for? - 1 minute and 15 seconds How long should you rub hand sanitizer? - 20 - 30 seconds Sanitization - cleaning process that REDUCES pathogen leavels to produce a healthy, clean environment Disinfection - A process that eliminates many or all microorganisms, with the exception of bacteria spores, from inanimate objects Sterilization - The process that completely destroys all microbial life, including spores. Autoclave - Piece of equipment used to sterilize articles by way of steam under pressure and/or dry heat The recommended temperature for effective sterilization in an autoclave is: - 250 - 255 Autoclave tape indicator - Used to show that the instruments have been properly steralized by changing colors. sterile technique - Techniques of creating a sterile field and performing within the sterile field to keep microbes at an irreducible minimum
surgical instruments - Cutting Dissecting Grasping and Clamping Dilating and Probing Visualizing surgical sutures - thread or wire used to hold tissue and skin together Vital sings - human indicators of internal homeostasis Temperature - A measure of how hot or cold something is. Normal temperature range - 98.6 (97.7-99.5) tympanic temperature - Temperature taken in the ear axillary temperature - Temperature taken at the armpit rectal temperature - temperature taken in the rectum Temporal Artery Temperature - Temperature taken by forehead. oral temperature - temperature taken in the mouth pulse - Beat of the heart as felt through the walls of the arteries. temporal pulse - side of forehead carotid pulse - side of neck apical pulse - pulse taken with a stethoscope and near the apex of the heart brachial pulse - the pulse felt in the upper arm (used for blood pressures) radial pulse - the pulse felt at the wrist femoral pulse - groin popliteal pulse - behind the knee dorsalis pedis pulse - top of foot pulse rate - the number of heartbeats or pulses felt in 1 minute pulse rythm - The time interval between heartbeats
manipulation - Passive moment of a joint to determine the range of extension or flexion of a part of the body. Examination Sequence - check body from outside to inside and from head to toe opthalmoscope - Instrument used to examine the eyes tongue depressor - a thin depressor used to press the tongue down during an examination of the mouth and throat otoscope - instrument used for visual examination of the ear tuning fork - a two-pronged, fork-like instrument that vibrates when struck; used to test hearing, especially bone conduction tape measure - used to take body measurements stethoscope - a medical instrument for listening to the sounds generated inside the body reflex hammer - instrument used to test patient reflexes gloves - personal protective equipment used to protect skin on hands from harmful germs Fowler position - The sitting position, which is used for cranial, facial, and some reconstructive breast procedures, drape placement varies. Semi-Fowler's Position - Modification of Fowler's position with the table elevated 45 degrees. Used for postoperative exams such as breathing disorders, head trauma, or pain. Drape should cover the entire patient from the nipple line and down. suspine position - lying on back, facing upward, used for heart, breast, and abdominal exams. Drape should be open down in front and be placed over any exposed area not being examined. dorsal recumbent position - Lying on the back, with the knees flexed, used for rectal, vagina, and perineal digital exams. Patient should be completely draped with the drape in a diamond shape. (not used if a speculum internment is needed) lithotomy position - lying on back with legs raised and feet in stirrups, used for pap exams. Diagonal Drape should go over the abdomen and knees. Sims position - lying on left side with right knee drawn up and with left arm drawn behind, parallel to the back. Used for rectal exams for rectal medication and some parental and pelvic exams. Drape extends diagonally from under the arm and below the knees.
prone position - lying face down, used for back exams. Drape should cover from the middle of the back to below the knees with the gown opening in the back. knee-chest position - patient is lying face down with the hips bent so that the knees and chest rest on the table and butt is in the air. Used for proctologic, sigmoid, and rectal exams. A gown should open in the back and an opening drape or a single sheet should be dropped diagonally over the patient's back at the sacral area. Trendelenburg position - lying on back with body tilted so that the head is lower than the feet Patient identifiers - any demographic information that can identify the patient, such as name, address, phone number, Social Security number, or medical identification number Specimen Collection and Processing - Chemistry tests are performed on either serum or plasma. urinalysis - the examination of urine to determine the presence of abnormal elements dipstick urinalysis - involves dipping a type of chemical analysis strip into a sample or urine and reading the colors of the squares that measure the specific gravity, acidity (pH), glucose, ketones, blood, leukocytes, nitrites, bilirubin, and urobilinogen levels in the sample chain of custody - the documented and unbroken transfer of evidence reagent strips - most widely used technique to chemically analyze urine. Clinitest - popular test for urine glucose or other substances hematology - study of blood Qualitative testing - Focus on characteristics or components of cells Quantitive data - numbers obtained by counting or measuring Hematocrit (Hct) - - percentage of erythrocytes in a volume of blood Female: 36-46% Male: 42 - 52% Increased = dehydrated Decrease = over hydrated, anemia, blood loss ***Should be 3 times the Hgb Hemoglobin - An iron-containing protein in red blood cells that reversibly binds oxygen.
past history - information that includes any childhood or adult diseases, surgical procedures, accidents, pregnancies, deliveries, and allergies usual childhood diseases - used here to record that the patient had all the "usual" or commonly contracted illnesses during childhood. family history - the record of a disease's presence and impact within a family Social History - a record of habits like smoking, drinking, drug abuse, and sexual practices that can impact health objective findings - health provider's findings (the physical exam) subjective findings - what the patient says Uses of drugs - Prevention, Treatment, Diagnosis, Cure, Contraceptive, Palliative, Replacement Drug classification - A method of grouping drugs; may be based on structure or therapeutic use. prescription - a piece of paper written by a doctor that lets you get medicine at the pharmacy Drug Forms - The physical characteristics of medication side effects - reactions to medicine other than the one intended Adverse Reactions - a list of possible unpleasant or dangerous secondary effects other than the desired effect Controlled Substances Act - The federal law giving authority to the Drug Enforcement Administration to regulate the sale and use of drugs. FDA (Food and Drug Administration) - an agency in charge of ensuring the safety of all foods sold except meat, poultry, and seafood Forms of medication - Tablets, capsules, elixirs, suppositories, ointment, aerosol, syrup, transdermal disk or patch, powder drug dosage - measure of the quantity of drug consumed Influencing Factors - Age and physical condition Systems of Measurement - Household and Metric System
gtt, gtts - drop, drops tsp - teaspoon Tbs - tablespoon fl oz - fluid ounce oz - ounce qt - quart pt - pint lb - pound 2.2 lbs - 1 kg 3 tsp - 1 tbsp 1 tbsp - 15 mL 16 oz - 1 lb 1 oz - 30 mL, 2 Tbs, or 6tsp 1 tsp - 5 mL Absorption - The process by which nutrient molecules pass through the wall of the digestive system into the blood Methods of administration - oral- mouth via swallowing or smoking; Nasally- snorting or inhaling; IM- injection into a muscle; IV- Injecting into a vein; Subcutanious- injecting beneith the skin; Topical- applyed on top of the skin; Sublingually- dissolving under the touge; rectally- inserted into the anus; Vagionally- inserted into the vagional opening Rules of Medication Administration - Right Medication, Right Dose, Right Route, Right Time, Right Patient, Right Education, Right to Refuse, Right Technique, and Right Documentation. hub, hilt, shaft, lumen, point, and bevel - Needles consist of: Gauge and length of needle - The lumen size is indicated by the gauge. ampule medication - a single does of medication.
Review of Systems (ROS) - A systematic approach for collecting the patient's self- reported data on all body systems. Usually taken by the physician when interviewing a patient to obtain their medical history the first step would be to ensure - privacy in a separate room. When laboratory procedures are performed in a medical office, there must be a strict adherence to - CLIA and OSHA standards CLIA - Clinical Laboratory Improvement Amendment-the law that regulates human testing OSHA - Occupational Safety and Health Administration Random specimen - A single urine specimen taken at any time First morning specimen - urine specimen taken when the patient first awakens; most concentrated specimen Two-Hour Postprandial urine specimen - called 2 hours after a meal, used in diabetes screening and for home diabetes testing programs 24 hour urine specimen - a urine specimen consisting of all urine voided in a 24-hour period second voided specimen - collected to determine glucose levels, first void of the morning is discarded and the second void of the day is collected clean catch midstream - is a method of collecting a urine sample for various tests, including urinalysis and urine culture capillary puncture - Is the technique used when only a small amount of blood is needed as a specimen for a blood test capillary puncture site - middle finger Records of dispensing/administration of controlled drugs must be kept for a minimum of