1. NOCTI Review

2. Terminology Review
Can you come up with the medical terms for the following word parts??

3. A-, an-
Adeno-
Adreno-
-Algia
Ang
Arth-
Auto-
Bi-
Brady-
Bronch-
Calc-
Carcino-
Cardi-

4. -cele
-centesis
Cephal-, cerebro-
Chol-
Col-
Cost-
-cyt
Cyano-
Cyst-
derm-
Dys-
-ectomy
-emesis
Endo-
Enter-
Eryth-
Gastr-

5. Ger-
Gluc-glyc-
Hem-
Hepat-
Herni-
Hyper-
Hyster-
Ile-
Inter-
Lapar-
Leuko-
Lith-
Mast-
Mamm-
Mega-

6. Melano-
Mening-
Meno-
-natal
Necro-
Neo-
Neph-
Neuro-
Noct-
Oculo-, opthalm-
Odont-
Olig-
Ooph-
Orchi-
Ortho,osteo

7. -oscopy
-otomy
-paresis
-penia
-pepsia
Per-
Peri-
-phagia
-phasia
Phleb-
-plasty
-plegia
Pleur-, pneum-
Pod-
Poly-
Pulmon-
Noct-
Oculo-, opthalm-
Odont-
Olig-
Orchi-
Ortho,osteo

8. -scler- -scope Sep- Splen- Sub- Sup- Tachy- Thorac-, -thorax Pyo-
Pyel-
Quad-
Rhin-
-rraphy
-rrhag
-rrhea
Sangui-
Salping-
-scler-
-scope
Sep-
Splen-
Sub-
Sup-
Tachy-
Thorac-, -thorax

9. Thromb-
Thyr-
Trach-
-tripsy
-trophy
Ur-
-uria
Vas-
Ven-
Xantho-

10. High Usage: Hemi- Bi- , tri-, Quad- Poly-,olig-(scant) Hyper-, hypo-
Ostomy-, otomy
-phagia, -phasia
Cyano-, erythro-, leuko-, xantho-
-paresis, -plegia
Tachy-, brady-

11. -uria
Hematuria
Glucosuria
Oliguria
Nocturia
Polyuria
Anuria

12. -pnea Eupnea – normal! How many/min?? Tachypnea Bradypnea Apnea
Hyperpnea
Orthopnea

13. Can you define these? Pallor Diaphoresis Bariatric Epistaxis Vertigo
Syncope

14. Medical Specialties Geriatrics Hematology Oncology Urology Nephrology
Gastroenterology
Obstetrics
Orthopedics
Rheumatology
Podiatry
Pediatrics
Gynecology
Endocrinology
Neurology

15. Abbreviations

16. High Usage Abbreviations
Bid
Tid
Qid HS
ADL ac pc
prn, ad lib
TPR/ BP BR
CBR
BR with BRP
NPO, PO
OOB
NKA

17. More Abbreviations GI GU VS Neuro RN, LPN, CNA, STAT MA, HA q2H
LTC, SNF
AD, AS, AU
OD, OS, OU

18. And still more abbreviations
CBC
CBC w/Diff
CPR
DNR
EKG, EEG
Etoh GB GU FC
HIPAA
ID,IM,IV,SC
LLQ,RLQ,LUQ,RUQ
LMP UA

19. Which Way Is UP?? Anterior/Posterior Medial/Lateral Proximal/Distal
Superior/Inferior
Supine/Prone
Can you put these in a sentence?

20. Eleven Systems Integumentary system Nervous system Skeletal system
Endocrine system
Muscular system
Cardiovascular system
Lymphatic system
Urinary system
Respiratory system
Digestive system
Reproductive system

21. P L A N E S

22. Body Cavities

23. Legal Terms Defamation Law Libel/Slander Ethics Criminal laws
Civil laws
Negligence
Malpractice
Assault/Battery
Fraud
Defamation
Libel/Slander
False imprisonment
Invasion of privacy
Abuse (types)
Informed Consent
Scope of practice
HIPAA

24. Patient’s Chart/Medical Records
Record of care
Legal doc
Record of observations/tx
Confidential
Errors?
Subjective (description from pt)vs objective( data from HCW)

25. Recording Patient Information:
POMR: database, problem list, educ/diagnostics/tx plan, progress notes
SBAR
SOAP
What is required to release pt records to another hospital or provider?

26. Filing Filed in sequential order - alphabetical
Indexing: guidelines of filing practices
Each part of a person’s name is a unit
Start w/ last name, first, then mid initial
Prefix is part of the name (O’Hare)(Mc, Mac, Van, De – )
St. is filed as if it were spelled out
Hyphenated name tx as single unit
Titles: ignored or are last(4th) unit

27. Numeric filing – each part of a name is assigned a # and no names appear on outside of file
Color coding: used to distinguish files within a filing sys(ex: green for all new pts) or as part of alphabetical filing sys where each letter is assigned a color
Tickler file: date oriented reminder file – usually organized by month (to do list)
Retention schedules – how long file kept on site or stored
No blank spaces – use n/a

28. If an initial is used instead of a name, tx as single unit
Identical names: index under names then location
Must have written consent to release info
Info belongs to pt! File is hospital/office

29. Insurance Ins: if pt and insured are the same person write “same”
Insured’s name – who carries the policy? Most policies assoc w/ employment
Relationship to insured: spouse or dependent?
Primary vs secondary ins
Exclusions, pre-certs
Deductible, co-pay, co-insurance
Payor, subscriber, provider

30. Employment Skills What ,when and to whom to report
Know legal limits ; HA/PCT reports to RN
Act w/in scope of practice
Professional appearance
Telephone etiquette: id self, unit
Incoming emergency call – call 911, get pt name and #, refer to MD/RN immediately
Leaving voice mails – what is acceptable

31. Employment
Policy manual- hospital quidelines /rules (dress code, sick days, chain of command)
Procedure manual: instructions for all clinical activities (vs, specimen collection, inf control)
Resume
Cover Letter: purpose?
Interview skills
Resignation from job: notice?

32. Communication Therapeutic: listen, observe,
silence, open-ended?, leading ?,
encourage, ask pt to restate, reflect, summarize
Poor: approve/disapprove, agree/disagree, advise, defend, minimize, stereotype
Use eye contact, touch but be aware of cultural aspects of comm

33. Defense Mechanisms Denial – disbelief
Withdrawal – physically or thru communic
Rationalization – explanation/excuse
Projection – blaming another or circumstance
Repression – transfer to unconscious mind
Suppression – like repression but aware

34. Infection Control

35. Aseptic Techniques Asepsis: abs of pathogen
Sterile: free from all microorg
Contaminated: pathogens present
Clean: reduces path
Aseptic Techniq: help prevent contam/spread of inf/break chain of inf
Hand hyg, PPE, cleaning equipment/environment

36. Sterilization: kills all microorg inc spores/viruses; equip only
Antisepsis: inhibit growth of path; not eff against spores/viruses; can be used on skin (alc, bet)
Disinfection: kills path but not always effec for spores/viruses; not on skin; equip
Sterilization: kills all microorg inc spores/viruses; equip only
What piece of equipment is used to sterilize instruments?
How long are sterile packs from SPD sterile?
Need a slide between this one and the next listing the standard precautions (see Box 8-1).

37. Standard/Universal Precautions
Potentially infectious material
All body fluids/all patients: potential sources of inf
ALL HCW ALL THE TIME
Break chain of inf
H/W guidelines
PPE: Gloves, gown, mask if risk of exp such as splashing
No jewelry, do not reuse gloves

38. Transmission Based Isolation Precautions
For pt with communicable diseases
In addition to SP
Type depends on pathogen, how it is spread, whether it is antibiotic resistant
Use PPE, dedicated equipment, private room
Contact, droplet, airborne

39. Patient Care

40. Military time
24 hour clock

41. Procedure Skills Pre-procedure steps: H/W, Assemble equip
ID Pt, introd self, explain proc
Post-procedure steps:
Record, report, repeat if needed

42. Personal Care Bathing: Full / complete vs partial Pre-proced steps
Wash one body area, rinse, dry, cover, next
All pts: start cleanest (face), end dirtiest (anal area). Perineal area: front to back
Back Rubs: promote circulation (q8H)
CBR pt: turn q 2H
Mouth care: q 2H

43. Removing a gown when pt has an IV:
Slip gown over IV bag if no snaps
Never disconnect IV
Dressing pt w/ 1 sided weakness/paralysis: remove clothes from good side first then dress weak side first

44. Vital Signs TPR, B/P Pre-procedure steps? Temp: ask?
Reason for palpable systolic?
Steps taken when there is an abnormality noted?

45. Temperature Oral: most common
Rectal: if pt confused, on O2, under 2 yo, can’t keep mouth closed
Rectal vs oral thermom
Hold thermometer in place when taking rectal temp; insert < 1”
Shake down “mercury” < 96 (or below lowest #)
Temperature Ranges:
Oral temp 98.6 what are rectal, axillary equiv?

46. Pulse Sites: Radial site most common
Apical if irregular, infant, cardiac hx
Other sites? Pedal, popliteal, femoral, brachial, carotid
Range: 60-90bpm

47. Respiration Respirations = 1 inspiration + 1expiration,
Pt should be unaware
Range: 12-20

48. Blood Pressure Systolic- first clear sound
Diastolic- sound muffles/last distinct sound
Ranges:Systolic 100 – 119/Diastolic 60 – 79
Pre-HTN: Systolic 120–139/Diastolic 80– 89
HTN:>140/90 or above
Hypotension: < 100/60
Blood Pressure

49. Nutrition Diets Regular Bland Mechanical soft Pureed
Na restricted, NAS
Low residue
Diabetic
Cardiac
Cl Liq
Full Liq

50. Vitamins A = eyes = night blindness D = bones = rickets/osteomalacia
K = blood clotting
C= immunity, wound healing= scurvy
B= RBC prod = anemia

51. Other Nutrients Carbs = energy Protein = tiss repair Fats = energy
K = hrt, nerv, musc function
Na = fl balance
Iron = hgb formation
Ca = musc/cardiac/bones

52. Feeding Patients Check diet orders
If pt. says diet not correct or if it doesn’t seem right ask nurse
Alternate between solids/liquids
Encourage patient to finish;don’t force
Fill spoon/fork 1/3
Make sure they swallow!

53. Intake and Output Usually measured q 8 w/ 24 H totals
Intake = sources?
Output = urine, bm, emesis, irrigation, suction
NPO = No: water, ice, candy, gum, food!

54. Output

55. Conversion Table
A cubic centimeter (cc) is a unit of measure equal to one milliliter (ml). 1 ml = 15 gtts 5ml = 1 tsp 15ml = 1 Tbsp **1 oz. = 30 ml 4 oz. = 120 ml **8 oz. = 240 ml = 1 cup

56. More Math Matters
1” = 2.54 cm
I kg = 2.2 lb

57. Elimination
Vocab:
voiding, incontinent, anuria, polyuria, nocturia, dysuria, hematuria, oliguria/scant
defecation, stool/feces, constipation, impaction, obstruction
Bedpan: facture, regular
Urine specimens: 1st AM (common), clean catch/midstream, sterile using cath, 24H
Routine: ml

58. Patient Positioning
Sims
Fowlers
Semi fowlers
Lithotomy

59. Five Basic Positions

60. Ambulation Assistive devices: cane, walker, crutches
Canes: use on pt’s STRONG side
HCW stands on weak side of pt

61. Patient Transfer Check activity order first! Dangle if first time OOB
Dangling:
sitting up on side of bed
Check vitals pre/post
Position w/c on pt’s strong side
Body mechanics?
Mechanical lift: 2 people operate

64. Immobility Can cause: Atrophy-wasting/decrease in size of a body part
Contractures- permanent shortening of a muscle or tendon
Decubutis Ulcers
DVT
CBR/immoblie pt: change position q2H

65. ROM Flexion, extension Adduct, abduct Plantar and dorsi flexion
Supinate, pronate
Circumduct
Passive ROM, Active ROM

66. Patient Assessment Hx – patient history H&P: on admission SOAP POMR
Subjective vs Objective??

67. CBC Phlebotomy RBC, WBC, Platelets, Hgb HCT
Correct color tube top for correct test
Coag tests: PT, PTT, INR
BS, A1C
HDL, LDL

68. Urinalysis Volume in 24H @ 1250ml in adult
Color: clear- pale yellow,amber, turbid=cloudy
Odor: none/malodorous
Specific gravity; conc of dissolved substances (kid function)

69. Skin Care Decubutis ulcer: bedsore
Risk factors- incontinence, poor nourishment, poor mobility
Prevention- nutrition, positioning, turn q2H, skin care
Special mattress, egg crate
Skin Care

70. Care Guidelines for Casts/Immobilizers
Elevate to reduce edema
Observe for skin discoloration, tightness, swelling, sores, skin temperature, burning, n/t, drainage, bleeding, odor, circulation
Protect skin from edges
Keep dry
Do not insert anything into device

71. Cultural Influences
Influence attitudes about health, illness/ reporting of s/s and pain/ cause of illness
Must be sensitive to specific cultural needs

72. Death and Dying 5 stages: Denial Anger Bargaining Depression
Acceptance
These stages also apply to pt/family when given some dx

73. 9 Rules of Good Body Mechanics
1. Wide Base of Support: keep feet 8-10” apart, point in direc of mvmnt
2. Bend at knees/hips not from waist
3. Use strongest muscles: shoulders, upper arms, hips, thighs
4. Use body wt to push, pull or slide. Try not to lift

74. 5. Keep the object being lifted close to your body
6. Avoid twisting
7. Avoid prolonged bending
8. Plan lift, test load
9. If unsure get help!

75. RACE Rescue anyone in immediate danger Alarm Contain
Extinguish: if fire is small, contained and does not put you in danger

76. PASS Pull the pin Aim at base of fire Squeeze the handle
Sweep side to side; stand back 6-10 feet

77. Health Care Worker Safety
Body mechanics
Report all injuries
H/W!
Use PPE as indicated
Standard/isolation based precautions
Never recap needles
Flush eyes/skin if contaminated

78. Basic First Aid

79. CPR Check scene safety CAB Check responsiveness and call 911
Check pulse and airway (carotid, brachial in infant)

80. Start compressions: 30
Open airway/pinch nostrils
Give 2 breaths
30:2
At least100/min is goal

82. Choking How do you know? Heimlich Fist technique
Pt becomes unresponsive:
Begin CPR, check for object and remove if seen

84. Infant technique?
5 backslaps/5 downward chest thrusts

85. First Aid MI
S/S:?
Tx: ?
CVA
S/S: ?
Tx:?

86. Bleeding
Tx:
Direct pressure
Elevate part
Shock
S/S: diaphoresis, pallor, rapid/weak pulse, hypotension, anxiety, n/v
Tx: raise legs, blanket, would you give po fluids?

87. Poisoning
Burns: Tx?
Remove source of heat, cool water, cover, elevate part
Heat inj: Tx?
Cool area, cool water cloths, elevate feet
Bone inj: immobilize and elevate

88. Seizure: What would you do?
Nothing in mouth, do not restrain, protect head, recovery position
Diabetic emergency: give sugar or not?
Allergic RXN?
Abuse signs?
Victims of abuse cross all socioeconoomic, gender and cultural groups