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Patient Care_Skill


Describe infection cycle 5 elements 1.Reservoir/host-where they grow) 2.Exit(nose,mouth,ear,GI,urinary trct,body fluids) 3.Transmission(via air/droplets/direct cont.) 4.Infection (break in reciever's body-open wound/mucous membrane,mouth) 5.Susception (immune syst cant ward off)
Describe control of disease the caregiver is responsible for interrupting or establishing barriers to the infection cycle at any stage of the process. some barriers to infection are the use PPE, hand washing, isolation techniques.
what's a nosocomial infection? what is a another name for it? pertaining to only infections originating in the hospital. more commonly known as a "Health care associated infection"
Asepsis? absence of microorganisms that produce disease; the prevention of infection by maintaing a sterile condition.
Medical Asepsis practices that help reduce the number and spread of microogransims
what's a spore hard, thick walled capsule formed by some bateria that contains only the essential parts of the proptoplasm of the bacterial cell.
exact definition of "wound" a bodily injury caused by physical means, with disruption of the normal continuity of sturctures.
what's "disinfection" the removal off? the destruction or removal of pathogenci organisms, but not necessarily their spores.
list the steps in the cross-contamination cycle A draining wound leaks staph infection- onto soiled dressing- transfered to abrasion on new host from dressing - new host has a suppressed immunse system - an infection develops and grows in the new host- new person now has staph.
what's the difference btwn medical and surgical asepsis? medical asepsis are practices that reduce the number and spread of microgranisms. surgical asepsis are practices that render and keep objects/areas FREE of ALL micorganisms.
explain the proper handwashing tecnhiques -med aspesis (4 medical aspesis) remove jewelry (do not touch sink, soap/towel dispenser). turn on WARM h2o, wet hands DOWNWARD, apply soap, wash 30 secs (longer if u know u are contaminated)-rinse down, dry, use towel to turn off faucet + open door.
describe the detailed technique for the hand washing proption (where to srub, what order). - med asepsis. palms together, interlace fingers, betwn around each, webspace, dorsum, fingertips, knuckels, encircle thumb+wrist
infection control PART 1- dif btwn CDC's two tiered approach to infection control: stardard precautions vs transmission based precautions? (-describe only standard on this card) these protect the caregivers +pts, regardless of their diagnosis (via barriers, hand hygiene, sharps handling/disposal procedures, soiled disposal, cough hyigene (spatail seperation >3ft or mask), immed assist. if direct blood2blood contact.
infection control PART 2- dif btwn CDC's two tiered approach to infection control: stardard precautions vs transmission based precautions? (-describe only transmission based precautions these are designed to protect the CAREGIVER from specialezed pts w/highly transmissible pathogens.
what are isolation precautions isolation of pts, in private room (or w/like disease). these are they same as TRANMISSION BASED PRECAUTIONS. the disease-specific precautions are divided into 3 designations of precautions based on the route of transimission- contact, droplet, airborne
occasionally, the term ____ _____ may be used to designate a pt whose condition or disease causes a high eisk of becoming infected through contact w/ another person (they have a compromised immune sytem- ex. burn victim, Low WBC) protective isolation
proper application (DONNING) for protective isolation? wash hands, cap, mask, wash hands, gown glove.
removal (DOFFING) for contaminated PPE untie waist, take off 1 glove. untie neck w/clean hand. remove gown w/gloved hand, using clean hand on inside. remove glove from inside out. wash hands. untie mask, remove cap. wash hands.
explain the requirements for HIGH level disinfeciton and what its used for. high- destroys LL microbial life except high # of spores (use hot water pasteurization 80-100C for 30 mins or EPA chemical 10-45mins). this can be used for reusable instruments or items that come in contact w/mucous membrances (eg-endotracheal tubes)
explain the requirements for INTERMIDIATE lvl disinfection and what its used for. intermediate-EPA approved germicides (or atleast 500ppm free available Cl) (or 1/4C bleach + 1 Gal water). used to destroy MOST viruses, most fungi, vegetative bacteria, and TB. DOES NOT KILL BACTERIAL SPORES.
explain the requirements for LOW lvl disinfection and what its used for. routine housekeeping cleaners or EPA approved hosipital disenfectants W/OUT a label claim for tuberculocidal activity. this destroys MOST bacteria, some fungi, some viruses. does NOT KILL TB bacteria or BACTERIAL SPORES.
Whats the role of OSHA? establishes regualations for health care facililities and are designed to protect empolyees.
whats apnea absence of breathing
whats arrhythmia variation from normal rhytm
bradycardia slow HB <60bpm
whats diaphoresis profuse perspiration
dyspnea difficultiy breathing
dysrhythmia distubrance of rhytm.
whats ectopic arising or produced abnormally
intubation insertion of a tube into the LARYNX to maintain an open airway.
whats SOB? shortness of breath
orthopnea a condition in which breathing is easier when the person is seated or standing.
syncope temporary supsension of consciouness casued by cerebral anemia; FAINTING
stridor? a shirll, harsh sound, especially the respiratiory sound heard during insipration in a person w/ a laryngeal obstruction
what factors are including w/vital signs. significance? BP, HR, temp, RR, and LEVEL OF PAIN. they tell general health and can be used to establish goals of tx/treatment plan, and assess a pts response to tx.
what are some signs of anoxia? mental confusion, fatigue, exhaution, slow reactions/response to commands, nausea, syncope, vertigo, diaphoresis, change in appearance (pallor/erythema), decrease in BP, pupil constriction or dialation.
list some factors that affect body temp time of day (lower in am), age(slight decrease w/age,increase in young),enviro, infection, physical activity, emotional status(increase during stress),site of measurement (higher4rectal,lower 4axilla-compared 2 oral), PMS, warm/cold food w/in 14-30min
normal range for Body temp mouth- 96.8-99.3. rectal- 97.8-100.3
what's hyperpyrexic temp greater than 106F
when measuring temp in the ear (infants, toddlers, older), how long should you wait if they've been laying on their ear? 2-3 mins so the ear canal temp can become stable. NOTE- TEMP IS DIF BTWN EARS. DOCUMENT WHICH EAR.
when measuring temp orally, make sure your probe is placed.... must be under tongue + hold w/lips for 30-90secs. dont touch teeth and breat with nose
list some factors that affect pulse age (decrease w/age, adolescents higher), gender (M are lower), enviro, infection, physical activity (but should return w/in 3-5 mins after cessation), emotions, medications, cadiopulmonary (pts w/hypertension may have LOWER HR +vice versa). conditioning.
how can you describe a pulse rate, rhytm, volume. "strong and regular" "weak and regular" "irregular- indicates both strong and weak beats occur)
whats thready? weak force to each beat and irregular beats
limits of tachycardia? HR > 100 bpm
BP for adults- normal, high normal, elderly normal <120/<80. high normal 130-139/85-89. elderly 120-140/80-90.
what are the stages of hypertension (in BP #s) prehypertension= 120-139/80-89. stage 1=140-159/90-99. stage 2= 160-179/100-109. stage 3= 180-209/110-119. stage 4= >210/>120
what are some factors that contribute to hypertension obesity, physical inactivyt, excessive use of nicotine, alcohol, salt. ateriosclerosis, diabetes, oral contraceptives, advance age, kidney disease, diet, race (great incidence in african descent)
what are the 2 most common sites for pulse radial and carotid.
what should u use if radial is resticited temporal or carotid
what should u use (HR) if extremities are restricted or difficult to palpate apical
where should you measure HR if pts have periperal vascular disease or a disorder affecting peripheral blood flow inguinal, popliteal, tibial, pedal arterial.
explain how the size and conditions of arteries will affect the BP if reduced lumen, increase BP. areteries w/decreased elasticity increased systolic and decreased diastolic. (this accounts for change in elderly (higher systolic and lower diastolic).
where should the cuff be placed left arm, forearm maintaned at level of 4th intercostal space and elbow extended. no change if person is supine. BP may increase if arm is lower and decrease if arm is raised.
T/F BP measurements should be same in all body parts false. BP higher in L UE. if measured in thigh- systolic is usually higher than arm bc wider baldder in cuff.
what are the characteristics of breath? rate (#/min), rhythm (regularity of pattern), depth (amot of air exchanged), character (diviation from normal, resting, quiet respiration).
T/F some noise should be heard during normal respiration false- no sound should be heard during normal resting respiration. abnormal sounds include wheezing, rales, stridor.
how much should BP increase duirng exercise? systolic should gradually rise and plateau as exercise plateaus. diastolic should only rise 10-15mmHgs.
when should BP return to reg after exercise stops with 3-5 mins.
name some factors that affect RR? age (young pts, less than 3yrs, and elderly pts tend to have higher RR), physical activity, emotions, air quality, altitude, disease.
T/F- its okay for respiration pattern to become irregular during exercise false. thats an abnormal response
what pulse should you expect in newborns? 100-130
what pulse should you expect in childern 1yr-7yrs? 80-120
!!!!what should you always remember for lab?!!!! WASH your hands, INTRODUCE yourself, obtain CONSENT, SMOOTH SHEETS, cover!
whats a normal RR for infants? 30-50
what's the 5th vital sign? PAIN!
Id three sources where medical diagnosis and pahology pertaining to pt can be obtained? med record, pt, doctor?
what topics must be covered in systems review? NICE + CCALM- Nueromuscular, Integumentary, Cardio/pulm, Educational needs, Cogntive, Communication, Affect, Learning, Musculoskeletal
what do you note in Cardio/pulm? whole system as impaired/not impaired. HR, BP, RR, edema/inflamation
what do you note in Neuromuscular? each subcategory as impaired or not. Gait, locomotion, balance, motor function.
what do you note in Integumentary? system as a whole as impaired or not. skin color, continuity, disruption, pliability or texture.
what do you note in Muscolskeletal? each subcategory as impaired or not. gross symmetry, gross ROM, gross strength, pts height + weight.
what do you note in communication? specific abilities as impaired or not. is their communication age appropriate and their style "i.e. age appropriate + unimpaired."
what do you note in educational needs? everything they need to learn- always disease process. can also address safety, use of devices/equip, ADL, HEP, recovery/healing process
what do you note in cognition? each ability as impaired or not. if pt is orietneted to person, place, time (ex. oriented x 3).
whad do you note in affect? specific abilities as impaired or not. emotional and behaviora responses. ex'"emotiontal/behavioral responses unimpaired.".
what do you note in learning Barriers? if pt has hearing or visual problems, inablility to read or understand what is read, need for an intrepreter. USE OF GLASSES/HEARING AIDS SHOULD BE IN HISTORY SECTION, under LIVING ENVIRO.
Created by: tpostrel