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CNT |! Part |! 1 |! Exam |! with |! precise |!|!
solutions
What |! are |! the |! possible |! adverse |! effects |! of |! acupuncture? |! - |! Correct |! answer |! ✔Common:
- |! needle |! site |! pain |! or |! discomfort
- |! bleeding/bruising
- |! superficial |! hematoma
- |! fatigue
- |! headache
- |! pain |! and |! pain |! at |! site |! of |! needle |! insertion
- |! aggravation |! of |! symptoms. |! Rare: |!
- |! risk |! of |! infection |! transmission |! - |! introducing |! pathogenic |! organisms
- |! broken |! needles
- |! untoward |! reactions
- |! inadvertent |! injury |! to |! important |! organs. |!
- |! organ, |! tissue, |! and |! nerve |! injury
- |! cutaneous |! disorders
- |! hypotension
- |! fainting -vomiting
- |! stuck |! needle
- |! forgotten |! needle Identify |! critical |! and |! highly |! recommended |! procedures |! to |! reduce |! AE |! for |! acupuncture. |! - |! Correct |! answer |! ✔Bruising |! and |! Bleeding:
- |! be |! aware |! of |! vascular |! anatomy
- |! avoid |! arteries |! and |! larger |! veins
- |! apply |! mild |! pressure |! after |! needle |! removal -* |! know |! acu |! points |! over |! major |! vessels: |! LU9, |! HT7, |! ST9, |! ST12, |! ST13, |! ST42, |! SP11, |! HT1, |! LV12, |! BL40.* |!
- |! apply |! caution |! in |! patients |! on |! medications |! or |! supplements |! that |! thin |! the |! blood, |! especially |! elderly |! patients Needle |! site |! pain/sensation: |!
- |! allow |! alcohol |! to |! dry |! before |! needling |!
- |! visualize |! anatomical |! structure
- |! palpate |! subcutaneous |! structures |! before |! needle |! insertion Fainting: |!
- |! prevent |! first-time |! patient |! in |! the |! supine |! position |! with |! knees |! slightly |! elevated |! for |! the |! first |! acupuncture |! treatment
Organ |! and |! Central |! Nervous |! System |! Injury/Traumatic |! Tissue |! Injury:
- |! use |! oblique |! angles
- |! shallow |! needling
- |! Needling |! Du |! 22 |! on |! an |! infant |! is |! prohibited Infections: |!
- |! follow |! CNT
- |! follow |! Standard |! Precautions
- |! hand |! sanitation
- |! maintain |! a |! Clean |! Field
- |! prep |! skin |! accordingly
- |! use |! only |! single |! use |! needles |! and |! lancets
- |! *imme What |! are |! the |! possible |! adverse |! effects |! of |! moxibustion? |! - |! Correct |! answer |! ✔- Rubefaction |! (causing |! redness)
- |! blistering
- |! itching |! sensations
- |! discomfort |! due |! to |! smoke
- |! general |! fatigue
- |! stomach |! upsets
- |! flare-ups |!
- |! headaches
- |! burns
- |! bruising
- |! cellulitis
- |! allergic |! reactions
- |! infections How |! to |! reduce |! AEs |! for |! moxibustion? |! - |! Correct |! answer |! ✔Burns:
- |! make |! sure |! to |! take |! a |! detailed |! patient |! history |! and |! identify |! conditions |! such |! as |! neuropathy |! that |! would |! limit |! a |! patients |! response |! to |! pain
- |! remain |! in |! room |! at |! all |! times
- |! avoid |! direct |! moxibustion |! on |! the |! face, |! within |! the |! hairline, |! or |! in |! other |! highly |! sensitive |! areas
- |! anticipate |! falling |! ash |! and |! provide |! a |! shield
- |! do |! not |! multi-task |! while |! providing |! moxibustion
- |! monitor |! skin |! temperature
- |! keep |! water |! and |! fire |! extinguisher |! in |! the |! room Secondary |! Infection |! from |! Moxa |! Burns: -LOL |! prevent |! burns |! in |! the |! first |! place
- |! wash |! all |! burns |! that |! do |! occur |! with |! cool |! running |! water |! immediately
- |! hand |! sanitize |! properly |! before |! and |! after |! treating |! any |! burns
- |! assess |! damage |! and |! refer |! to |! western |! medical |! practitioner |! if |! needed. |! Nausea |! or |! other |! Adverse |! Reactions |! to |! Moxa |! Smoke:
- |! properly |! vent |! rooms |! in |! which |! moxibustion |! occurs
- |! risk |! of |! exposure |! to |! and |! transfer |! of |! bloodborne |! pathogens Other: -acu |! needles |! getting |! sucked |! in |! further, |! increasing |! risk |! of |! pneumo |! or |! organ |! puncture How |! to |! reduce |! AEs |! for |! cupping? |! - |! Correct |! answer |! ✔Fire |! Cupping:
- |! take |! a |! careful |! patient |! history |! to |! identify |! diabetes, |! neuropathies, |! or |! other |! conditions |! that |! might |! limit |! a |! patients |! response |! to |! pain |! or |! the |! ability |! to |! sense |! heat.
- |! put |! burning |! material |! must |! be |! placed |! in |! the |! deepest |! part |! of |! the |! cup, |! not |! near |! the |! rim
- |! remove |! the |! burning |! material |! before |! applying |! cup |! to |! patients |! skin Infections:
- |! follow |! standard |! precautions
- |! follow |! clean |! field |! guides
- |! follow |! proper |! hand |! sanitation
- |! apply |! cups |! on |! clear |! skin |! only
- |! use |! PPE |! gloves |! for |! wet |! cupping Preventing |! Skin |! Lesions:
- |! screen |! patients |! for |! bleeding |! disorders
- |! screen |! patients |! for |! potential |! lesions |! such |! as |! keloids
- |! limit |! retention |! time |! of |! cups |!
Unintended |! Deep |! Penetration |! of |! the |! Needle:
- |! apply |! over |! needles |! that |! are |! inserted |! obliquely |! in |! the |! thoracic |! region |! to |! avoid |! pneumothorax General:
- |! *cupping |! should |! not |! be |! applied |! 48 |! hours |! before |! or |! 24 |! hours |! after |! chemotherapy |! treatment What |! are |! the |! AEs |! of |! heat |! lamps? |! - |! Correct |! answer |! ✔- |! burns
- |! mechanical |! failure |! of |! the |! heat |! lamp How |! to |! reduce |! AEs |! for |! heat |! lamps? |! - |! Correct |! answer |! ✔- |! heat |! lamps |! should |! not |! be |! used |! on |! infants, |! children, |! incapacitated |! persons, |! or |! sleeping |! or |! unconscious |! persons -prevent |! water, |! moisture, |! liquids, |! or |! metal |! objects |! from |! coming |! in |! contact |! with |! the |! lamp, |! don't |! use |! lamp |! in |! wet |! or |! moist |! environments
- |! do |! not |! use |! if |! any |! part |! of |! the |! lamp |! is |! cracked
- |! monitor |! heat |! at |! all |! times
- |! don't |! use |! heat |! lamp |! in |! proximity |! to |! combustible |! materials
- |! take |! careful |! patient |! history How |! to |! reduce |! AEs |! of |! electro-acupuncture? |! - |! Correct |! answer |! ✔Excessive |! Current:
- |! Standard |! precautions.
- |! The |! use |! of |! sterile |! single-use |! needles |! and |! other |! instruments |! that |! may |! break |! the |! skin, |! such |! as |! seven-star |! hammers, |! press |! tacks/intradermal |! needles, |! and |! lancets. What |! are |! the |! components |! of |! a |! clean |! field? |! - |! Correct |! answer |! ✔A |! clean |! field |! is |! the |! area |! that |! has |! been |! prepared |! to |! contain |! the |! equipment |! necessary |! for |! acupuncture |! in |! such |! a |! way |! as |! to |! reduce |! the |! possible |! contamination |! of |! sterile |! needles |! and |! other |! clean |! or |! sterile |! equipment. Steps: Follow |! Safety |! Guidelines |! for |! Hand |! Sanitation.
- |! Select |! a |! clean, |! dry, |! flat |! surface |! to |! serve |! as |! the |! setting |! for |! the |! clean |! field. |! A |! treatment |! table |! is |! not |! suitable.
- |! Establish |! a |! new |! clean |! field |! for |! each |! patient. |!
- |! Place |! materials |! such |! as |! acupuncture |! needles |! in |! blister |! packs |! on |! the |! clean |! field. |!
- |! Place |! clean |! cotton |! balls |! or |! unopened |! swabs |! on |! the |! field. |! If |! desired, |! these |! items |! may |! be |! kept |! in |! a |! clean |! jar |! near |! the |! clean |! field.
- |! Clean |! the |! surface |! used |! for |! the |! clean |! field |! with |! a |! low-level |! disinfectant |! at |! least |! once |! daily. Strongly |! Recommended
- |! Place |! clean |! cotton |! balls |! or |! unopened |! swabs |! on |! the |! clean |! field. |! If |!
desired, |! these |! items |! may |! be |! kept |! in |! a |! clean |! jar |! near |! the |! clean |! field.
- |! Keep |! sterile |! items |! near |! the |! center |! of |! the |! clean |! field |! with |! clean |! items |! nearer |! the |! edges.
- |! Clean |! blister |! packs |! of |! sterile |! needles |! may |! be |! handled |! and |! replaced |! back |! onto |! the |! clean |! field.
- |! Clean |! previously |! sterilized |! guide |! tubes |! may |! be |! handled |! and |! replaced |! back |! onto |! the |! clean |! field What |! are |! the |! proper |! practitioner |! hand |! hygiene |! requirements |! on |! the |! treatment |! setting? |! - |! Correct |! answer |! ✔- |! Wet |! your |! hands |! with |! clean, |! running |! water |! (neutral |! or |! warm) |! and |! apply |! soap
- |! Lather |! your |! hands |! by |! rubbing |! them |! together |! with |! the |! soap. |! Be |! sure |! to |! lather |! the |! backs |! of |! your |! hands, |! between |! your |! fingers, |! and |! under |! your |! nails.
- |! Scrub |! your |! hands |! for |! 10-20 |! seconds.
- |! Rinse |! your |! hands |! well |! under |! clean, |! running |! water, |! with |! your |! hands |! lower |! than |! your |! elbows.
- |! Dry |! your |! hands |! using |! a |! clean |! paper |! towel.
- |! Turn |! off |! the |! faucet |! using |! a |! paper |! towel.
- |! Open |! any |! doors |! between |! you |! and |! your |! patients |! using |! a |! paper |! towel, |! or |! reclean |! hands |! upon |! entering |! the |! patient's |! room. What |! are |! the |! requirements |! for |! skin |! preparation |! prior |! to |! needling? |! - |! Correct |! answer |! ✔- |! Follow |! Safety |! Guidelines |! for |! Hand |! Sanitation.
What |! are |! the |! steps |! for |! safe |! needle |! withdrawal? |! - |! Correct |! answer |! ✔Apply |! pressure |! to |! the |! acupuncture |! point |! with |! clean |! cotton |! or |! gauze. How |! to |! manage |! used |! sharps |! and |! other |! used |! equipment? |! - |! Correct |! answer |! ✔Instruments |! that |! have |! penetrated |! the |! skin |! must |! be |! isolated |! immediately |! in |! an |! appropriate |! sharps |! container. What |! safety |! practices |! should |! be |! implemented |! to |! prevent |! needles |! being |! left |! in |! a |! patient? |! - |! Correct |! answer |! ✔Counting |! needles. What |! is |! the |! variation |! of |! CNT |! protocol |! for |! an |! office |! setting? |! - |! Correct |! answer |! ✔Treatment |! Protocol |! in |! an |! Office |! Setting
- |! Select |! a |! clean, |! dry, |! flat |! surface |! to |! serve |! as |! the |! setting |! for |! the |! clean |! field. |! (Note: |! The |! selected |! location |! CANNOT |! be |! the |! treatment |! table |! as |! the |! patient |! may |! move |! his |! or |! her body!) |! [critical] |!
- |! Wash |! hands |! for |! at |! least |! 10 |! - |! 15 |! seconds |! under |! running |! water, |! lathering |! well |! with |! soap. |! Liquid |! soap |! is |! recommended |! rather |! than |! bar |! soap, |! which |! may |! become |! contaminated. |! Or, |! if |! soap |! and |! water |! are |! unavailable, |! clean |! hands |! with |! the |! alcohol-based |! hand |! sanitizer. |! [critical]
- |! Place |! a |! clean |! paper |! towel, |! clean |! table |! paper |! or |! other |! barrier |! that |! will |! serve |! as |! a |! clean |!
field |! on |! the |! work |! surface |! in |! a |! way |! that |! does |! not |! compromise |! the |! cleanliness |! of |! the |! surface |! that |! will |! serve |! as |! the |! clean |! field. |! [strongly |! recommended]
- |! Set |! out |! the |! materials |! needed |! for |! a |! treatment. |! Sterile |! items |! such |! as |! acupuncture |! needles |! in |! blister |! packs |! (in |! their |! original |! packaging) |! should |! be |! placed |! on |! the |! center |! of |! the |! clean |! field |! first. |! It |! is |! acceptable |! to |! utilize |! either |! individually |! wrapped |! needles |! or |! needles |! in |! multi-packs |! as |! long |! as |! they |! are |! sterile, |! single-use |! needles. |! [recommended]
- |! Clean |! items |! such |! as |! cotton |! balls |! and |! unopened |! swabs |! may |! either |! be |! placed |! on |! the |! clean |! field |! or |! kept |! in |! jars |! or |! containers |! near |! the |! clean |! field |! so |! as |! to |! be |! at |! hand |! for |! the |! practitioner. |! [recommended]
- |! Ensure |! the |! skin |! at |! the |! acupuncture |! points |! to |! be |! used |! is |! clean. |! If |! 70% |! alcohol |! swabs |! are |! used, |! allow |! the |! alcohol |! to |! dry. |! [strongly |! recommended]
- |! If |! a |! practitioner |! must |! place |! the |! needle |! inside |! a |! guide |! tube, |! the |! needle |! should |! be |! dropped |! into |! the |! tube, |! handle |! first, |! to |! minimize |! the |! risk |! of |! contaminating |! the |! point |! of |! the |! needle. |! [strongly |! recommended]
- |! Insert, |! manipulate, |! and |! withdraw |! the |! needle |! without |! touching |! the |! shaft |! of |! the |! needle |! that |! enters |! the |! patient's |! skin |! at |! any |! time. |! [critical] |! If |! a |! guide |! tube |! is |! to |! be |! reused, |! it |!
surface |! that |! will |! serve |! as |! the |! clean |! field. |! [strongly |! recommended]
- |! Set |! out |! the |! materials |! needed |! for |! all |! the |! treatments |! to |! be |! performed |! in |! a |! single |! session. |! Sterile |! items |! such |! as |! acupuncture |! needles |! in |! blister |! packs |! should |! be |! placed |! on |! the |! center |! of |! the |! clean |! field |! first. |! [strongly |! recommended] |! Cotton |! balls, |! gauze, |! and |! other |! materials |! should |! be |! placed |! closer |! to |! the |! edges |! of |! the |! field. |! [recommended]
- |! Clean |! items |! such |! as |! cotton |! balls |! and |! unopened |! swabs |! may |! either |! be |! placed |! on |! the |! clean |! field |! or |! kept |! in |! jars |! or |! containers |! near |! the |! clean |! field |! so |! as |! to |! be |! at |! hand |! for |! the |! practitioner. |! [recommended] 90
- |! Ensure |! the |! skin |! at |! the |! acupuncture |! points |! to |! be |! used |! is |! clean. |! If |! 70% |! alcohol |! swabs |! are |! used, |! allow |! the |! alcohol |! to |! dry. |! [strongly |! recommended] |!
- |! If |! a |! practitioner |! must |! place |! the |! needle |! inside |! a |! guide |! tube, |! the |! needle |! should |! be What |! is |! the |! variation |! of |! CNT |! protocol |! for |! a |! public |! health |! setting? |! - |! Correct |! answer |! ✔-make |! sure |! to |! wash |! hands |! properly -make |! sure |! patient |! is |! sitting |! properly -make |! sure |! there's |! a |! sharps |! container |! in |! the |! immediate |! vicinity
What |! is |! the |! variation |! of |! CNT |! protocol |! for |! a |! travel |! setting? |! - |! Correct |! answer |! ✔Same |! as |! office |! setting. What |! are |! the |! best |! practice |! protocols |! for |! acupuncture |! needling? |! - |! Correct |! answer |! ✔1. |! Follow |! CNT |! Protocol
- |! Hand |! sanitation.
- |! Establishing |! and |! maintaining |! a |! clean |! field.
- |! Skin |! preparation.
- |! Isolation |! of |! contaminated |! sharps.
- |! Standard |! precautions.
- |! The |! use |! of |! sterile |! single-use |! needles |! and |! other |! instruments |! that |! may |! break |! the |! skin, |! such |! as |! seven-star |! hammers, |! press |! tacks/intradermal |! needles, |! and |! lancets. What |! are |! the |! best |! practice |! protocols |! for |! moxibustion? |! - |! Correct |! answer |! ✔Critical: |! Practitioners |! must |! wash |! hands |! thoroughly |! before |! starting |! moxibustion, |! and |! before |! and |! after |! treating |! any |! burns |! as |! OPIM |! may |! be |! present.
- |! Critical: |! Prevent |! second |! degree |! burns |! from |! moxa |! by |! paying |! close |! attention |! to |! a |! patient's comfort |! and |! skin |! reactions |! during |! all |! treatments.
- |! Critical: |! Take |! a |! careful |! patient |! history |! to |! identify |! neuropathies |! or |! other |! conditions |! that |! might |! limit |! a |! patient's |! response |! to |! pain |! or |! the |! ability |! to |! sense |! heat.
- |! Critical: |! During |! moxa |! therapy |! the |! practitioner |! must |! remain |! in |! the |! room |! at |! all |! times.
significant |! asthma |! or |! other |! reactions |! to |! smoke. What |! are |! the |! best |! practice |! protocols |! for |! cupping? |! - |! Correct |! answer |! ✔Critical: |! Follow |! Standard |! Precautions.
- |! Critical: |! Follow |! Safety |! Guidelines |! for |! Establishing |! and |! Maintaining |! a |! Clean |! Field.
- |! Critical: |! Follow |! Safety |! Guidelines |! for |! Hand |! Sanitation.
- |! Critical: |! Cupping |! should |! not |! be |! applied |! 48 |! hours |! before |! or |! 24 |! hours |! after |! chemotherapy |! treatment.
- |! Critical: |! Cup |! over |! clear |! skin |! only. |! Do |! not |! cup |! over |! an |! active |! skin |! lesion, |! moles, |! swelling, |! trauma, |! inflammation, |! infection, |! or |! burns |! (including |! sunburn).
- |! Critical: |! Practitioners |! must |! take |! a |! thorough |! history, |! including |! bleeding |! disorders |! and |! medication |! history, |! before |! applying |! cups.
- |! Critical: |! Practitioners |! must |! take |! a |! thorough |! history |! to |! identify |! diabetes, |! neuropathies |! or |! other |! conditions |! that |! might |! limit |! a |! patient's |! response |! to |! pain |! when |! planning |! to |! utilize |! fire |! cupping.
- |! Critical: |! Screen |! patients |! for |! history |! of |! reactive |! skin |! lesions |! such |! as |! keloid |! scarring |! or |! Köebner |! phenomenon.
- |! Critical: |! Assess |! carefully |! the |! use |! of |! fire |! cupping |! on |! patients |! who |! have |! a |! decreased |!
response |! to |! pain |! (e.g., |! those |! with |! diabetes |! or |! neuropathies).
- |! Critical: |! Practitioners |! must |! wash |! hands |! before |! starting |! the |! procedure |! and |! again |! after |! removing |! gloves |! (if |! used).
- |! Critical: |! Personal |! protective |! equipment |! (PPE) |! - |! wear |! gloves |! and |! eye |! protection |! at |! all |! times |! when |! blood |! or |! OPIM |! may |! be |! present |! (wet |! cupping, |! cupping |! after |! needling).
- |! Critical: |! Each |! area |! to |! be |! wet |! cupped |! must |! be |! cleaned |! immediately |! before |! cupping |! by |! the |! practitioner.
- |! Critical: |! Lancets |! used |! for |! wet |! cupping |! should |! be |! sterile, |! used |! only |! once, |! then |! discarded |! in |! a |! proper |! sharps |! container. 115
- |! Critical: |! If |! blood |! or |! other |! OPIM |! are |! present, |! collect |! with |! cotton |! swab, |! gauze, |! paper |! towel, |! or |! cloth |! and |! dispose |! in |! biohazard |! trash.
- |! Critical: |! When |! blood |! or |! other |! OPIM |! are |! present, |! allow |! the |! vacuum |! to |! be |! compromised |! slowly, |! and |! then |! remove |! the |! cup.
- |! Critical: |! If |! lubricants |! are |! used |! for |! gliding |! cu What |! are |! the |! best |! practice |! protocols |! for |! bleeding? |! - |! Correct |! answer |! ✔Critical: |! Personal |! protective |! equipment |! (PPE) |! - |! wear |! gloves |! at |! all |! times |! as |! blood |! and |!
