MA 201 Common POL

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Shutrbug20
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MA 201 Common POL
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2011-03-20 23:49:53
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  1. Hemoglobin (Hgb or Hb)
    Allosteric PROTEIN found in every erythrocyte (RBC) that carry O2 and CO2
  2. Normal Hemoglobin ranges
    Males: 14-18g/dl

    Females: 12-16g/dl
  3. Hemoglobin Low Count
    Enemia
  4. Hemoglobin Below 10g/dl
    • Shortness of breath
    • Tiredness
    • Pale skin
    • PANIC VALUE
  5. Hemoglobin Below 5g/dl
    No LIFE
  6. Hemoglobin TOO High
    • Polycythemia - bone marrow makes too many RBC
    • Weakness and fatigue results
  7. Hemoglobin Test
    • 1. Lancet finger, place large drop blood on reagent card
    • 2. Place card in machine, read / record results
  8. Hematocrit (Htc)
    Measures PERCENTAGE sample of blood (RBC)
  9. Normal Hematocrit Range
    • Males: 40-54%
    • Females: 37-47%
  10. Hematocrit Collection and Process
    • 1. Use lancet to draw blood out
    • 2. Micro tubes placed at blood sight to draw into capillary tube (no bubbles)
    • 3. Plug with clay card
    • 4. Draw 2 tubes, place in machine, spin
    • 5. Use machine scale to read/record results
  11. Hematocrit Tube Contents
    • 1. Bottom Layer RBC (heaviest)
    • 2. Buffy Coat (Leukocytes / Platelets)
    • 3. Plasma top layer
  12. Hemoglobin / Hematocrit Conversion
    • Hgb to Hc = Hgb x3 +- 3 estimate
    • Hc to Hgb = Hc /3 +- 3 estimate
  13. Erythrocyte Sedimentation Rate (Sed-Rate) (ESR)
    Measures rate RBC settle in calibrated tube in given time (1-2hrs)
  14. Erythrocyte Sedimentation Rate (Sed-Rate) Tests For
    • 1. Acute Inflammatory Infection
    • 2. Autoimmune Dissorders
    • 3. Arthritis / Polymialgia
    • 4. Acute / Chronic Infection
    • 5. Lupis
  15. Normal Erythrocyte Sedimentation Rate (Sed-Rate) Range
    • Males: 0-10mm/hr
    • Females: 0-20mm/hr
  16. Erythrocyte Sedimentation Rate (Sed-Rate) Can't Detect
    • Sickle Cell
    • Polycythemia Vera
  17. Erythrocyte Sedimentation Rate (Sed-Rate) Test Comprimise
    • Reading before time can yield false negative
    • Reading after time can yield false positive
  18. Blood Glucose Test
    Uses capillary blood to screen glucos levels for Diabetes
  19. Normal Fasting Gluclose Level
    • 70-120mg/dl
    • Fasting Blood Sugar (FBS)
  20. Glucose Tolerance Testing (GTT)
    Used to diagnose diabetes, gestational diabetes, and hypoglycemia
  21. Glucose Tolerance Testing (GTT) Procedure
    • 1. Patient drinks a glucose concentrated drink
    • 2. Urine and blood collected at 30min, 30min, 1hr, 2hr incriments
    • If FBS is over 150mg/dl, DO NOT TEST!
  22. Symptoms to cause Glucose Tolerance Testing (GTT)
    • 1. extreme thirst, dehydration
    • 2. fatigue
    • 3. weight loss
    • 4. visual difficulties
    • 5. high glucose reading
  23. Glucose Tolerance Testing (GTT) Adverse Reactions
    • 1. Weakness
    • 2. Fainting (Syncopy)
    • 3.Excessive sweating
    • 4. Vomitting
    • 5. Pancrease failure to metabilize sugar
  24. Hemoglobin A1C (HbA1c)
    Glycohemoglobin
    • Modified form of hemoglobin elevated when glucose remains too high
    • Used to determine how much control patient has with glucose diet
  25. Cholesterol
    Too much can cause atherosclerosis / arteriosclerosis, hardening of the arteries
  26. Normal Cholesterol Range
    130-200mg/dl
  27. Phenylketonuria (PKU)
    • tested on newborns for congenital disease caused by inability to metabolize certain amino acids (Phenylalanine)
    • Prevents brain from developing (MR)
    • Required in all 50 states and Canada
  28. Urinalysis - 3 Major Catagories
    • 1. Physical, Chemical, Microscopic
    • 2. Must test within 1hr or refrigerate for later testing
  29. Urinalysis - Physical
    • Cloudy - cloudy, hazy, turbid
    • Volume - how much
    • Odor - acrid
    • Specific Gravity - waste particles 1.005-1.030 most fall 1.010-1.025
  30. Urinalysis - Chemical
    • Measures variety of chemicals on reagent strip
    • 1. Blood
    • 2. pH
    • 3. Ketones
    • 4. Glucose
    • 5. Leukocytes
    • 6. Bilirubin
  31. Urinalysis - Microscopic
    We only prep for specimen
  32. Urinalysis - Midstream (Sterile)
    • 1. Clean meatus (front to back)
    • 2. Urinate small amount into toilet, stop
    • 3. Catch in jar without touching inside, stop
    • 4. Continue urination into toilet
  33. Urinalysis - First Morning Pee
    • 1. Best to catch
    • 2. Been in bladder over night
  34. Urinalysis - 24hr
    • 1. Collect for 24hr from first urination
    • 2. Keep in same jar in refridgerator
    • 3. Annotate time of first pee on jar
  35. Substance Abuse Analysis
    Used to detect presence of illigal / illicit drugs or chemical substances
  36. Substance Abuse Analysis Requirements
    • 1. Patient must sign Chain-of-Custody form to concent for collection
    • 2. Tape lid closed after collection, patient signs
    • 3. Patient signs Lab request form to verify test complete and agrees
  37. Fecal (stool) Sample
    Used to provide diagnostic insight
  38. Fecal (stool) Sample Can Detect
    • 1. Occult (hidden) blood
    • 2. Ova / parasites (O&P)
    • 3. Bacterial / Viral infections
    • 4. Fat content (lipids)
  39. Fecal (stool) Sample
    Guaiac Test
    • Tests for blood in stool
    • Early detection for Colon Cancer Px 50+
    • Turns BLUE if positive
  40. Fecal (stool) Sample
    Patient Education before sample
    • 1. Increase fluids
    • 2. Avoid laxatives
    • 3. Avoid straining during collection
  41. Sputum
    Detect serious infections of lower respiratory tract
  42. Sputum Facts
    • 1. First morning is best
    • 2. Lower respiratory tract is sterile
  43. Sputem Diagnosis
    • 1. Cancer
    • 2. Bacterial / Viral Infection
    • 3. Fungal Infection
    • 4. Tuberculosis
    • 5. Meningitis
  44. Bacteria Collection (24-48hr Growth)
    • 1. Wound / Skin collection
    • 2. Blood cultures
  45. Bacteria Culture Sensitivity
    Culture bacteria while using different types antibiotics (which ones work)
  46. Bacteria Culture Media
    • 1. Primary Agar (most common) encourages growth of all microorganisms
    • 2. Selective Agar lets some grow but not others
    • 3. Enrichment Agar has nutrients added
    • 4. Place Ager plates (dishes) in incubator upside down (lid down)
  47. Parenteral
    • Meds given outside digestive system
    • Injections, Topical, Transdermal (slowest)
  48. Parenteral Characteristics
    • Fast acting
    • Used for vomiting of unconscious patients
    • Can cause immediate allergic reactions
    • Pain / infection from poor techniques
  49. 7 Rights
    • 1. Patient - watch same sounding names
    • 2. Drug - watch same sounding name
    • 3. Dose - too much can kill
    • 4. Time - too close = overdose
    • 5. Route - how in
    • 6. Technique - cause pain
    • 7. Documentation - didn't chart, didn't happen
  50. 7 Rights Checked 3x
    • 1. When locate meds on shelf
    • 2. When remove meds from container
    • 3. When replace meds back on shelf
  51. Methods of Administration
    • 1. Oral - by mouth
    • 2. Sublingual - under tongue
    • 3. Buccul - between cheek and gum
    • 4. Inhaler
    • 5. Topical - skin
    • 6. Sprays - throat
    • 7. Transdermal - through skin
    • 8. Suppository
  52. Pharmacology
    Study of use, preperation, handling, storage, and actions of drugs
  53. Medication Ordered
    • 1. Administered - given in office, take now
    • 2. Prescribed - written order, to be filled later
    • 3. Dispensed - given in office, take later (samples)
  54. Assissting with Medication
    • To be able to dispense/administer meds, must have understanding of what meds will do to patients
    • Everyone reacts differently
  55. Physician's Desk Reference (PDR)
    Acurate, reliable, and current info about medications
  56. PDR Sections
    • 1. Manufacturer's Index (White)
    • 2. Brand / Generic Name (Pink) most used
    • 3. Product Category (Blue)
    • 4. Product ID (Grey)
    • 5. Product Info (White)
  57. Immunizations / Vaccines
    Drugs that prevent disease
  58. Analgesics
    Drugs that have a particular action
  59. Cardiac Drugs
    Drugs that have a target effect
  60. Drug Actions
    • Directly affects one or more body tissues
    • Effect on microorganisms
    • Replacement body chemicals
  61. Drug Action Classifications
    • 1. Local - area where meds administered
    • 2. Remote - away from admin site
    • 3. Systemic - throughout
    • 4. Synergistic - works with / against another drug
  62. Drug Forms (special)
    • Ocular - drug between to thin membrane layers placed under lower eye lid
    • Implantable - beneath the skin
  63. Prescription
    • A written order for medication / treatment
    • Legal document
    • Narcotics are always hand written
    • Record all meds in Px chart
  64. Precription Requirements
    • 1. Full Name Px
    • 2. Name Medication
    • 3. Dosage & Route
    • 4. How often to take
    • 5. Date / Time ordered
    • 6. Directions & Signature of Prescriber
  65. Who can Prescribe
    • 1. MD - Doctor
    • 2. DO - Doctor of Osteopathy
    • 3. DDS - Dentist
    • 4. PA - Physician Assisstant
    • 5. NP - Nurse Practisioner
    • 6. CNM - Midwife
  66. Narcotics - Prescribers Must
    Register with DOJ and DEA under the Controlled Substances Act 1970
  67. Medication Schedule
    • 1. No use, prescription prohibited (heroin, LSD, Marijuana)
    • 2. May not be refilled, High abuse (cocain, percocet, demerol)
    • 3. May refill 5x, Moderate abuse (vicodin, T3)
    • 4. May refill 5x, Mild abuse (valium, xanax)
    • 5. Subject to state / local laws, Limited abuse (cough syrup with codine)
  68. Medication Charting
    Must Have:
    • 1. Who ordered
    • 2. What ordered (strength/dose)
    • 3. What date given
    • 4. How taken
  69. Quality Control (QC)
    Assesses testing procedures, reagents, machines, and techniques
  70. Quality Assurance (QA)
    Program evaluates quality and effectiveness according to acceptable standards
  71. Drug Action Considerations
    • 1. Patient age (old/young need less)
    • 2. Patient weight
    • 3. Body surface area
    • 4. Drug interactions (when mixed with others)
    • 5. Allergies
    • 6. Tolerance to the meds
    • 7. Time
  72. Theraputic
    • Pertaning to results obtained from treatment
    • Application of remedies and treatment of disease
  73. Diagnostic
    • Pertaining to a diagnosis
    • Finding what is wrong
  74. O2 Ordered
    • In liters per minute
    • Via nasal cannula / mask / etc...
  75. Placebo
    • Non-medication treatment for comfort
    • Usually used in clinical study
  76. Antitoxin
    An antibody produced in response to and capable of neutralizing specific biologic toxin
  77. Emultion
    • Mixture of two liquids not mutually soluable
    • The lipid is broken into small globules
  78. Digoxin
    Antiarrhythmic and cardiotonic up force and contractility of heart muscle (treats CHF)
  79. Analgesic
    Relieves pain, no loss consciousness (motrin, tylenol)
  80. Anasthetic
    Produces lack of feeling (lidocaine, novocaine)
  81. Antianxiety
    Relieves anxiety and muscle tension (diazepam, benzodiazepines)
  82. Antibiotic
    Destructive / inhibits growth of microorganisms (penicillins)
  83. Anticonvulsant
    Prevents / relieves convulsions (tegretol, dilantin)
  84. Antidepressant
    Prevents / relieves symptoms depression (isocarboxazid, nardil, tofranil)
  85. Antidote
    Counteracts poisons / effects (narcan)
  86. Antiemetic
    Prevents / relieves nausea and vomiting (dramamine, tigan)
  87. Antihistamine
    Counteracts histamine (benadryl, seldane)
  88. Anti-inflammatory
    Counteracts inflammation (naproxin, aspirin, advil)
  89. Antipyretic
    Reduce fever (aspirin, acetaminophen)
  90. Bronchodilator
    Dilates bronchi (isuprel, albuteral)
  91. Contraceptive
    Prevents conception (ortho-novum, triphasil)
  92. Decongestant
    Reduces nasal congestion / swelling (afrin, sudafed)
  93. Diuretic
    Increases excreation of urine (diuril, lasix)
  94. Expectorant
    Facilitates removal of secretions from bronchopulmonary mucous membrane (robitussin)
  95. Hypnotic
    Produces sleep / hypnosis (seconal, placidyl)
  96. Hypoglycemic
    Lowers blood glucose level (diabinese, micronase)
  97. Laxative
    Loosens / promotes normal bowel eliminations (metamucil, dulcolax)
  98. Muscle Relaxant
    Aids relaxing skeletal muscle (norflex, paraflex, valium)
  99. Sedative
    Produces calming effect without causing sleep (amytal, buticaps)
  100. Tranquilizer
    Reduces mental tension / anxiety (thorazine, haldol)
  101. 3 Types Injections
    • 1. Intramuscular
    • 2. Subcutanious
    • 3. Intradermal
  102. Intramuscular Injection
    • 1. Three muscles (Deltoid, Gluteus, Vastus Lateralis)
    • 2. Vastus Lateralis (used on peds, EpiPens)
    • 3. Gluteus - 1 to 3cc (21gx1)
    • 4. Deltoid - up to 1cc (23gx1)
    • 5. Use at least 3cc syringe
    • 6. 90deg angle always
  103. Subcutaneous Injection
    • 1. Fatty layer beneath skin (adipose)
    • 2. Back of arm
    • 3. Lower abdomen
    • 4. Lateral upper leg
    • 5. 3cc syringe (25g x 5/8)
    • 6. 45deg angle always
  104. Intradermal Injection
    • 1. Anterior forearm 4" above wrist, 4" below elbow
    • 2. .1cc (27g x 1/2)
    • 3. 1cc syringe
    • 4. Create wheel in skin
    • 5. Upper back used for allergies
    • 6. 10-15deg angle always
  105. Syringe Parts
    • 1. Plunger
    • 2. Rubber Stopper
    • 3. Flange
    • 4. Barrel
    • 5. Lock / Plain Tip
  106. Needle Parts
    • 1. Hub
    • 2. Hilt
    • 3. Shaft
    • 4. Lumen (guage)
    • 5. Point
  107. Ampule
    • One dose, sealed glass container
    • No need to inject air
    • Flick point end to drop med in main body
    • Hold gauze at middle and snap top off
    • Draw up meds with filter needle
    • Remove/discard filter needle
    • Replace with propper needle and inject
  108. Vial
    • Swab vial top with alcohol every time
    • Inject air equal to med required in vial
    • Draw med at eye level
    • Remove air bubbles
    • Administer meds
  109. PPD
    • TB Test
    • 4" above wrist and 4" below anticubical space

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