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Cnt exam 3

QuestionAnswer
What is the method of transmission for HEV? Fecal/oral transmission
What is the expected incubation & onset for HEV 15-60 days & onset is abrupt
What are the symptoms for HEV Fever, malaise, nausea, por appetite, jaundice
Does HEV become chronic NO
Where is HEV most common and how is it prevented Most common in developing countries, best prevented with cleanliness
How is HIV transmitted (AIDS virus) Blood borne pathogen, transmitted by blood, semen, baginal secretions, mucus
What are considered non risk behaviors for HIV Handshake, touching, hugging, holding hands, casual contact.
What precautions should you take with HIV infected patients First, you can’t tell, so treat all patients the same, specifically, avoid touching exposed wounds, mucus, blood.
Who is most at risk at this point for HIV infection IV drug users, sex workers, transfusion recipients, gay males, anyone who participate in unsafe sex, transplant transmission, health care workers
Which has the greater risk: HBV or HIV HBV
What is the incubation for HIV Up to 15 yrs
Can an asymptomatic patient transmit the virus Yes
What are the initial infection symptoms? Though many patients show no initial symptoms, one can have 2-4 weeks of a flu-like symptoms, like mono. Resolution is spontaneous
What are the later infection symptoms of HIV Fever malaise, body aches, wasting, night sweating, weight loss, diarrhea
What kind of complications can accompany HIV HIV encephalopathy, myelopathy, peripheral neuropathy, dementia with memory loss, apathy, depression, motor dysfunction, opportunistic infections, neoplastic disorders, TB, herpes, staph, hepatitis, pneumonia, which is a frequent cause of death.
Are there any extra precautions you should take with known HIV patients? Mask, gloves both for yhour safety and the Px as they are prone to opportunistic infection
What particular skin dangers should acupuncturists be aware of? Any broken skin on hands: rashes, hangnails, non-intact fingers/cuticles/skin
What is the rule about blood, body fluids, used needles and gloves Treat them as if they are infected
Define sterilization Procedures to destroy all microbial including viruses. Applies to instruments and surfaces that might come into contact with sterile instruments.
How does a sterilant differ from an antiseptic A sterilant is a product which destroys all microbial life and is designed for non-living surfaces. And antiseptic is a product designed to reduce the density of microbial life of living tissue
What is the transmission method for HAV Fecal and oral
What is the incubation period for HAV and what kind of onset can you expect 15-50 days with an abrupt onset
What are the symptoms for HAV Mostly digestive: abdominal discomfort, low appetite, nausea, jaundice, fatigue
Which of the hepatitis viruses has a vaccine Hep A&B
Which of the hepatitis viruses go chronic Hep B&C
Is there a vaccine for hep c No
What is the transmission method fro HBV Blood borne
How long can HBV survive outside of the host? Can survive for 1 week even in dried blood
What is the incubation period for HBV & what kind of onset can you expect Incubation is 50-180 days onset is insidious
What kind of symptoms does one experience with HBV Mild flu-like symptoms at first, gradually poor appetite or appetite loss, abdominal pain, joint pain or rash, chills, diarrhea, *all lasting 2-6 weeks-extreme fatigue, depression. *all lasting several months-Liver cancer. *not a guarantee, but common aft
What percentage of people with HBV are symptom free 30%
What percentage of people with HBV get a chronic infection 50%
What percentage of people with HBV make a full recovery 70%
What is the rule for treating people with HBV You often cannot tell who has it and who does not since 30% are symptom free, you therefore treat all patients as if they are infected
How long is one contagious even after recovery 3+ months
What form of treatment is best for HBV Acupuncture to reduce stress, induce relaxation, and improve energy. Herbs to treat Liver and infection
What is the transmission method for HCV HCV is a blood borne pathogen
What is the incubation period and expected onset of HCV infection 20-90 day incubation with insidious onset
What percentage of Liver patients have HCV 40-60%
What percentage of HCV patients get a chronic infection of HCV 50%
What are the symptoms of HCV infection Anorexia, nausea, vomiting, jaundice
What vaccine is available for HCV There isn’t one
Which of the hep viruses is found concurrent with HBV HDV
What is the incubation and transmission method for HDV Unknown
What type of onset can one expect in a HDV infection Unknown since it is concurrent with HBV
How does an antiseptic differ from a disinfectant An ANTISEPTIC reduces the density of microbials on living tissue. A DISINFECTANT reduces or destroys the density of microbials on non-living surfaces
Define aseptic technique Techniques for preventing infections during invasive procedures such as acupuncture. Aseptic technique differs for different kinds of procedures
What is disinfection Use of chemicals and procedures to destroy or reduce number of pathogens on INANIMATE OBJECTS
What is clean technique Techniques which reduce the risk of infection of Px and staff members by killing or reducing the strength of pathogens. This reduces the chances of pathogens transmitting to people.
Define Clean Field Area prepared to contain acupuncture equipment so sterility of needles is preserved. Applies both to the working area, surfaces, patient’s skin, and anything touching patient’s skin
Which kind of soap is best: liquid or solid Liquid. Solid soap sits in water after you use it which renders it contaminated
How often should you clean working surfaces and with what At least once per day (or whenever visibly contaminated) with disinfectant
A supine placement of the patient is suitable for what kinds of acupuncture Facial, frontal, chest, and abdomen, anterior & lateral aspects of lower extremities
For what kinds of treatment should you place your patient prone For treatments of the occipital, neck, lumbodorsal, & posterior aspects of lower extremities.
When should you place your patient on their side When treating the lateral side of the body only
When is it a good idea to treat your patient sitting up For head, back and upper extremities, can also be really good for people that are over weight or have heavily developed shoulders. When these people lay down prone the backs of their necks disappear.
What is the single most important procedure for preventing infection in a health care situation Hand washing
When do you wash your hands when dealing with patients Before a treatment, immediately before an acu procedure. After contact with blood body fluids, obvious environmental contaminants. Whenever your hands get contaminated during treatment between patients. At the end of the treatment after removing PPE
List the procedure for hand washing Wash surface of hands between fingers, around/under fingernails, above wrist. Lower hands so soap/.water drains off finger tips during rinse. Soap/wash for at least 10 sec. Turn off tap with towel or elbow.
How should you keep fingernails for best hygiene Short and clean
How do you clean hands if there is no sink available Alcohol based hand disinfectants, antiseptic hand cleaners, antiseptic towelette
What do yo do if your hands are contaminated after washing Clean fingers with alcohol or alcohol based rub, germicidal scrub or antiseptic towelette
What do you do in addition to washing hands for immunocompromised patients Germicidal soap or alcohol based hand disinfectant
What percentage alcohol do you use to prep needle site for insertion 70% alcohol (any more dries to fast)
What do you use for insertion site prep when you have an immunocompromised patient 1. Lodophor (i.e. Betadyne) followed by 2. Alcohol swab or Benzylconium Chloride.
What are the proper ways to swab an insertion site In such a way that you only touch the area once. You can either. Wipe once in one direction. Wipe in a spiral from in to out
Do you have to use a new swab for each insertion point Not necessarily, you can use the same swab for points in the same general area
Why do you let the alcohol dry on the insertion site rather than artificially drying it Reduce discomfort on needling. Reduce possibility of injecting minute contaminants suspended in alcohol. Alcohol is more effective as an antiseptic if it has a longer drying period
Can you palpate an insertion site once you have cleaned it. Yes but only if your hands have not been contaminated since your prepped the site. If they have, rewash/clean them again before palpating or. Picking up a needle.
What precautions must you take with the needle shaft The shaft must remain sterile. 1 don't let the needle shaft touch the part of a packet you touched when you open it. 2 don't touch the shaft when you are inserting or manipulating the needle. 3 if you must support the shaft during manipulate/insert, use t
Can you re-use a guide tube Yes. They must be sterile at the beginning of the treatment for each patient. One guide tube per patient is acceptable.
Where do you put a used guide tube if you’re using it more than once for a single patient. You can place it on the clean field between uses as long as it remains clean.
If you are using multiple sterile needles with a single guide tube how do you insert the needle into the tube. Drop the needle into the tube handle first.
When do you use gloves during acupuncture procedures During procedures like bleeding where there is greater risk of blood/fluid conduct. Working w/Px with open lesions or weeping exudates. When practitioner has cuts, abrasions, chapped hands etc and they are located where they pose a hazard. When palpating/
Is it always necessary to use gloves during acupuncture procedures. No not in the absence of significant bleeding
Do gloves prevent needle sticks. No. Only proper handling procedures prevent sticks
When do you replace disposable gloves As soon as practical when they are contaminated. As soon as possible if torn, punctured, compromised.
What do you do with used needles Isolate them until you can either dispose of them or sterilize them
When should you replace a sharps container When it is 3/4 full
What do you do in the event of a needle spills or dropped needles 5 steps. 1pick up with gloves & hemostats/tweezers. 2 clean spill with soap&water 3 wipe exposed surfaces with germicide (like bleach) 4 discard all clean up materials 5 wash hands.
What do you do in the event of bleeding during cupping 1 gather gloves/cleaning materials. 2put on gloves. 3 remove cups in such a way that blood or fluids do not spread or splash. 4stop bleeding w/pressure. 5 clean up bleeding that has occurred. 6 isolate cups immediately. 7 handle&dispose of any materials u
What is the rule for disposable and/or non-sterilizable plastic or rubber cupping equipment Only use these on one patient.
How do you clean up a spill of blood or body fluids 1wear disposable, waterproof gloves. 2 clean the spill once with soap and water. 3wipe all exposed surfaces with germicide. 4 dispose of all materials used in clean up by double wrapping. 5 wash hands.
What is the definition of “biohazardous waste” Any solid or liquid waste that may prevent a threat of infection to humans
How do you package biohazardous waste for disposal? What differs from this rule? Needles differ. They go in their own sharps container. Package everything else ion red, impermeable, polyethylene or polypropylene bags & seal it.
Do you disposed of used needles 1 separate from all other waste. 2 place in leak resistant, puncture resistant, rigid container. Seal & label properly
What are teh CNT protocols for working in public health clinics. 1 wash hands before/after work shift with soap & water. 2 wash with soap/water or alcohol based germicidal rub prior to puncturing. 3 wash with soap/water between treatments or as often as possible. (You can use alcohol based hand rub, antiseptic towelett
What kind of needles are recommended in public health settings. Disposable.
What are the rules for removing needles in public health settings. 1 carry the sharps container so you can dispose of them immediately. 2 count the needles used. 3 check chairs/surrounding areas for fallen needles before during after each session. 4 instruct clients not to handle needles if they fall out or after you rem
Name 4 acceptable procedures for sterilizing needles 1 auto clave 2 dry heat 3 chemical sporicides sterilant 4 chemical sporicides sterilant 4 ethylene oxide
Name 3 things that don’t sterilize 1 Alcohol, 2 pressure cookers 3 boiling water
Give degrees, time & pound of pressure necessary for sterilization in an autoclave. Time 30 min. Degrees 250*. Pounds of pressure 15
What is the critical step that makes autoclaving effective The sudden drop of pressure at the end. Breaks down cell walls of resistant spores.
Is it acceptable to submerge equipment in water during autoclaving No
Give time degree fro dry heat sterilization Time 2 hours. Degree 338*F
Give the 3 classifications of disinfectants per the CDCP 1 high level disinfectants. 2 intermediate disinfectants. 3 low level disinfectants.
Give the 4 classifications of disinfectants per EPA 1 sporicides. 2 general disinfectants. 3 hospital disinfectants. 4 sanitizers.
Name 3 types of disinfectant solutions used in clinics 1 dilutions of sodium hypochlorite. 2 lysol (int to low level). 3 70% alcohol (int level)
What should the labels on disinfectants contain What the solution is. What the concentration is. What date was it mixed.
There are 3 steps to the double disinfectant method. What are they in general. 1 primary disinfection. Chemical disinfection soaked, not cleaned. 2 cleaning & inspection. 3 final sterilization dry heat or autoclave.
Created by: Jkellycal