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113
CVTE 113 Semester Review
109
Medical
Professional
05/19/2012
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Term
What is the term used to describe an infection that was acquired in a hospital setting?
 Definition
Nosocomial Infection
Term
In today's hospital setting in the United States, what is the percentage of staphylococcus aureus infections are resistant to antibiotics?
 Definition
60%
Term
What does "MRSA" stand for?
 Definition
methycillin-resistant staphylococcus aureus
Term
MRSA infects nearly __________ annually in the USA, and kills more than __________.
 Definition
95,000 ; 18,500
Term
What is the percentage of MRSA infections that are linked to health care facilities?
 Definition
85%
Term
How many lines are in the ICU each year? After 10 days, what percentage get infected? Of that percentage, what percentage are fatal? What percentage lead to serious complications?
 Definition
5 million

4% (80,000) of lines get infected

5-28% are fatal

About 1/2 lead to serious complications
Term
What is the best defense controlling the spread of infection?
 Definition
Handwashing
Term
When should you wash your hands?
 Definition
1. When arriving to work
2. Before and after each patient contact (sometimes during)
3. Before and after wearing gloves
4. Before feeding a patient
5. After eating
6. After blowing nose, touching hair and face
7. After using the restroom
8. After cleanup
9. After smoking
10. When ever hands are visibly soiled
Term
What is the recommended procedure to handwashing?
 Definition
Using luke-warm water, wash hands up to 3 inches above wrist for 15-20 seconds using pleanty of soap and friction.
Term
What does "PPE" stand for?
 Definition
Personal Protective Equipment
Term
Give 5 examples of the type of PPE you will see in the hospital setting?
 Definition
1. Gloves
2. Mask/respirator
3. Gown/apron
4. Googles
5. Faceshield
Term
What is the term used to describe any item that can cut or puncture your skin?
 Definition
Sharps
Term
What is the proper procedure to dispose of needles?
 Definition
Be conscientious of where the tip is at all times. Never recap used needles. Dispose directly into a designated sharps container.
Term
Define "Standard Precautions"
 Definition
Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), secretions, excretions (except sweat), and mucous membranes. These measures are to be used when providing care to all individuals, whether or not they appear infectious or symptomatic.
Term
Name 9 substances that can transmit disease
 Definition
1. Blood
2. Urine
3. Feces
4. Semen
5. Vaginal secretions
6. Breast milk
7. Saliva
8. Spinal fluid
9. Joint fluid
Term
When should you wear gloves?
 Definition
When it can be reasonalbly anticipated that contact with blood or other potentially infectious materials. (Side note: Just wear them anytime you are with a patient!)
Term
According to the CDC, what is the preferred sequence when donning PPE?
 Definition
1. Gown
2. Mask or respirator
3. Goggles or faceshield
4. Gloves
Term
According to the CDC, what is the preferred sequence to safely remove PPE?
 Definition
1. Gloves
2. Faceshiel or goggles
3. Gown
4. Mask or respirator
Term
What are the elements of respiratory hygiene and cough etiquette?
 Definition
Covering the nose and mouth with a tissue when coughing or sneezing or use the crook of the elbow to contain repiratory droplets. Disposing of contaminated tissue appropriately and performing immediate hand hygiene.
Term
What are some extra measures that can be taken to help contain respiratory secretions?
 Definition
Provide a surgical mask for patients and space seating in the waiting room.
Term
What does "VRE" stand for?
 Definition
Vancomycin-resistant enterococcus
Term
What does "MDR TB" stand for?
 Definition
multi-drug resistant tuberculosis
Term
Name 4 blood-borne pathogens
 Definition
1. HIV
2. AIDS
3. Hepatitis B
4. Hepatitis C
Term
What does "HIV" stand for?
 Definition
Human immunodeficiency virus
Term
What does "AIDS" stand for?
 Definition
Acquired immunodeficiency syndrome
Term
Is there a vaccine for Hepatitis B?
 Definition
Yes
Term
Is there a vaccine for Hepatitis C?
 Definition
No
Term
What are the means of transmission? Remember DAVID
 Definition
1. Direct (person to person)
2. Airborne
3. Vector (host to host, ie ticks or mosquitos)
4. Indirect (person to object to person)
5. Droplets
Term
Name 4 bodily fluids in which HIV can be transmitted?
 Definition
1. Blood
2. Semen
3. Vaginal secretions
4. Breast milk
Term
What are the 3 most common ways HIV/AIDS is transmitted?
 Definition
1. Sexual contact
2. IV drug use needle sharing
3. Pregnancy/childbirth (can be prevented)
Term
How many Healthcare workers a year get stuck by needles?
 Definition
~800,000
Term
Which is easier to transmit and why? HIV or Hepatitis B?
 Definition
Hepatitis B because it is 100 times more concentrated in the blood.
Term
What type of infection is Hepatitis?
 Definition
A viral
Term
What does "C. diff" stand for?
 Definition
Clostriduim difficle
Term
What is C. diff?
 Definition
Intestinal bacterium, usually in the elderly. Releases toxins causing flu-like symptoms and severe diarhhea. Healthcare providers must utilize full-contact precautions.
Term
Flu or Cold symptom?

Starts gradually
 Definition
Cold
Term
Flu or Cold symptom?

Slight temperature after 24 hours
 Definition
Cold
Term
Flu or Cold symptom?

Normal appetite
 Definition
Cold
Term
Flu or Cold symptom?

Slight headache
 Definition
Cold
Term
Flu or Cold symptom?

Stuffy nose
 Definition
Cold
Term
Flu or Cold symptom?

Sore throat
 Definition
Cold
Term
Flu or Cold symptom?

Tired
 Definition
Cold
Term
Flu or Cold symptom?

Starts rapidly
 Definition
Flu
Term
Flu or Cold symptom?

Increase in temperature within 24 hours
 Definition
Flu
Term
Flu or Cold symptom?

Loss of appetite
 Definition
Flu
Term
Flu or Cold symptom?

Severe headache
 Definition
Flu
Term
Flu or Cold symptom?

Muscular ache and pains
 Definition
Flu
Term
Flu or Cold symptom?

Nausea and vomiting
 Definition
Flu
Term
Flu or Cold symptom?

Exhausted
 Definition
Flu
Term
What type of Antibiotics should you take for a flu or cold?
 Definition
NONE! Flu and colds are viral infections; therefore antibiotics are not necessary.
Term
What does "Code Blue" signify and what should your response be?
 Definition
Life-threatening event such as cardiac arrest. Stay out of the way unless you are on the Code Team.
Term
What is your responsibilty as a Healthcare worker when it comes to Code Blue?
 Definition
Know where call buttons and/or code numbers.
Term
What does "Code Red" signify and what should your response be?
 Definition
Fire; Remember RACE:
R-escue patients;get people out of harms way.
A-lert by pulling fire alarm, phoning operator.
C-lose doors and windows to C-ontain fire.
E-xtinguish if possible. When extinguishing, remember PASS:

P-ull pin.
A-im low at the base of fire.
S-queeze handle.
S-weep from side to side.
Term
What should you not do during a Code Red?
 Definition
Don't use elevators or phones
Term
What should you do first when working with a patient?
 Definition
Ensure you have the correct patient by checking name band and check chart to ensure you are performing the correct procedure.
Term
How should you be as a Healthcare Provider towards a patient?
 Definition
Be friendly and courteous. Don't be overly familiar; it's best to be formal. Be calm and use low-voiced competence.
Term
What is a pathogen?
 Definition
The first link in the chain of infection is the pathogen. A pathogen is anything that causes a disease. Pathogens include:



Bacterium A group of microscopic organisms that are capable of reproducing on their own, causing human disease by direct invasion of body tissues. Bacteria often produce toxins that poison the cells they have invaded. Numerous bacteria also live in harmony with the body and are necessary for human existence, such as bacteria that aid in digestion in the gut. Important bacterial diseases include "strep" tonsillitis, pneumonia, and meningitis. (example: bacterial meningitis or strep throat)

Virus A term for a group of microbes that are incapable of reproducing on their own, and must invade a host cell in order to use its genetic machinery for reproduction. Viruses are smaller than bacteria, and are responsible for the most common human diseases, the common cold and the "flu" (influenza). Viruses are also responsible for more serious diseases such as AIDS, hepatitis B, and hepatitis C. (example: hepatitis A, hepatitis B, and hepatitis C)

Fungus (example: athlete’s foot)
Term
What is a line?
 Definition
Anything that passes through the skin. (Tubing, Foley, bolt, catheter, ect)
Term
What do you do if you get stuck by a needle?
 Definition
Immediately milk the wound as much as possible and wash hands using antibacterial soap vigerously for 3-5 minutes. Report the incident immediately to your supervisor.
Term
What are two components of Standard Precautions?
 Definition
1. Universal Precautions

2. Body Substance Isolation
Term
Which important diseases transmitted by blood-to-blood?
 Definition
HIV, Hepatitus, Malaria
Term
Name some ways people do NOT contract HIV/AIDS
 Definition
Food, air, causual contact, kissing.
Unlikely, sweat, tears, vomit, feces, urine, mosquitoes or fleas
Term
How do you always leave the patient's bed when you're through?
 Definition
Bed all the way down, brakes engaged, and rails up.
(Just so you guys know, it is not allowed to put all the rails up on a patient unless there is a doctor's order to do so. It is considered a restraint and that is a violation of patient's rights.)
Term
What is a Posey? What should you do when you are completed with your procedure?
 Definition
A bed restraint. Inform the RN that you completed so they can tie the Posey down.
Term
What are some portals of entry for pathogens?
 Definition
1. Sharps
2. Openings in skin (nonintact)
3. Mucous membranes (mouth, nose, eyes)
4. Surfaces
Term
What are the components of the Chain of Infection
 Definition
1. Infectous Agents
2. Hosts
3. Portals of entry
4. Modes of transmission
5. Portals of exit
6. Resevoirs (Susceptible person)
Term
What are some methods of control in order to help break the Chain of Infection?
 Definition
1. Kill the agent
2. Change the host/environment
3. Protect the portal of entrance
4. Remove means of transmission
5. Immunize susceptible person
Term
What should you do as a Healthcare Professional do if any PPE is compromised?
 Definition
Replace it DUH!
Term
1)How many techs have some degree of MSI trouble? 2)How many have to leave the field as a result?
 Definition
1)More than 80% of sonographers surveyed reported that they had suffered from some form of MSI.
2)MSI's are career-ending in up to 20% of sonographers.
Term
What is changing about the medical setting to make these injuries more likely?
 Definition
  • Advances in ultrasound technology, leading to the ability to perform more exams in a shorter period of time.
  • A more obese (difficult to image) patient population
  • Reduced reimbursement leading to pressure for increased productivity among sonographers
  • Staffing shortages
  • Busier schedules and associated reduced break times
  • An aging sonographer workforce
  • An increase in employee awareness of the problem 
Term
What are some bad body positions to work with?
 Definition
Anything that takes the body out of a neutral position.
Term
Physical factors that increase risk: age, gender, height & weight, handedness, physical fitness, systemic illness (e.g., arthritis)
 Definition
Age: more susceptible with increasing age
Gender: more susceptible if female (more females work in sonography)
Height and weight: shorter and heavier workers are more susceptible
Hand dominance: right-handedscanners tend to have shoulder and neck injuries; whereas, left-handed scanners tend to have wrist and elbow problems
Physical fitness: poor physical fitness corresponds with more injuries
Systemic Illnesses may be a predisposing factor
Term
What are some of the symptoms associated with MSI?
 Definition
  • Pain
  • Swelling
  • Loss of sensation in affected area
  • Numbness
  • Burning or tingling
  • Tenderness
  • Clumsiness
  • Muscle spasm 
Term
What modalities are used to diagnose MSI? Which is not usually helpful?
 Definition
  • MRI may be useful
  • Ultrasound (with high frequency transducers) is useful for some cases, i.e., rotator cuff tears, carpal tunnel injuries
  • Physical exam for range of motion may be helpful
  • X-rays will probably NOT be helpful since MSI's are injuries to soft tissues 
Term
What treatments might be used for MSI?
 Definition
  • Physical Therapy
  • Analgesics, anti-inflammatories, muscle relaxants
  • Splints on wrist or elbow
  • Steroid injections to wrist proximal to carpal tunnel
  • Alternative treatments: acupuncture, acupressure, deep massage, biofeedback, yoga, magnetic fields, naturopathy
  • Surgery 
Term
List and describe the types of MSI.
 Definition
  • Carpal Tunnel Syndrome: can occur when the wrist or finger is flexed or extended over a long period of time, increasing pressure in the carpal tunnel and causing tension on the median nerve.  Leads to pain, paresthesis or numbness of some part of the hand.  Areas affected: palmar side of the thumb, index finger, and radial half of the ring finger and palm.  Most commonly seen in cardac sonographers.
  • Trigger Finger: is the inability to extend or flex a digit 
  • Cubital Tunnel Syndrome: occurs when the elbow is flexed over a long period of time, causing increased pressure and tension on the ulnar nerve. Symptoms: pain and tenderness around the inside area of the elbow which often radiates into the forearm: and tingling, numbness and/or burning sensations in the ring and little fingers.  Typically seen in cardiac sonographers who scan with the left hand. 
  •  Epicondylitis: is also a condition of the elbow.  It occures when the epicondyles (tubular protuberances on the mecial and lateral sides of the distal humerus) are inflamed.  The epicondyles serve as attachment sites for the ligaments and tendons of the elbow joint.  Repeated flexion and twisting of the joint causes this condition.  Epicondylitis of the lateral epicondyle is called tennis elbow; of the medial epicondyle, golfer's elbow.
  •  Tendonitis: is inflammation of a tendon.  Tenosynovitis is inflammation of the tendon sheath.  One type of tenosynovitis specific to the hand is deQuervain's disease. This deisease results from narrowing of the tendon sheath of the abductor pollicis brevis and the abductor pollicis longus muscles, both involved in abduction of the thumb.
  • Rotator Cuff Tear: is a partial or complete tear of the tendons converging over the head of the humerus. The rotator cuff is a common site of injury. Associated symptom: inability to move the affected arm outward (laterally) from body (abduction).
  • Thoracic Outlet Syndrome: is a symptom complex caused by conditions in which the nerves and vessels are compressed in the neck or axilla.  Symptoms: Pain and parasthesis in the hand, shoulder or arms. More common in women in middle age.  Patients may have a cervical rib and many have carpal trunnel nerve compression.  Caused by unusual postures, as in excessive stretching and reaching.
  • Bursitis: is inflammation of the bursae, usually in the shoulder, the result of pressure, tension, overuse of the arm.  The scapula may also be affected by arm abduction.
 
Term
Describe some exercises for MSI prevention.
 Definition
  • Exercise 1
  1. Hold tubing in hands with elbows bent and held against sides of body.
  2. Rotate arms outward.
  3. Hold for 3 minutes, then slowly relax arms.
  • Exercise 2
  1. Hold tubing in hands with arms straight in front of body.
  2. Keep upper arms parallel to floor, elbows bent and pull the tubing straight back.
  3. Hold for 3 seconds, then slowly relax.
  • Exercise 3 
  1.  Raise one elbow to the shoulder.
  2. Grasp elbow with opposite hand.
  3. Pull elbow and arm across chest until you feel a stretch.
  4. Straighten elbow for more stretch.
  5. Hold for 30 seconds, then repeat with other arm.
  • Exercise 4
  1. Reach behind back with one arm and grasp other arm.
  2. Pull arm upward until you feel a stretch.
  3. Hold for 30 seconds, then repeat on other side. 
  •  Exercise 5
  1.  Place one hand above elbow of other arm.
  2. Attempt to raise arm while applying resistance with hand.
  3. Repeat with other side.
  • Exercise 6
  1.  Anchor tubing to solid object or door.
  2. Stand, holding tubing in both hands with arms in front of body.
  3. Pull arms backward.
  4. Hold for 3 seconds, then relax.
  • Exercise 7
  1. Lie on back holding weight (5 lbs or less) wih one hand.
  2. Raise shoulder off the floor as weight is pushed toward ceiling.
  3. Repeat with other arm. 
  • Exercise 8
  1. Stand erect and relax shoulder.
  2. Raise shoulders toward ears.
  3. Hold briefly, then slowly and completely lower shoulders.
Term
BACK: how to prevent injury.
 Definition
The best defense against back pain is to work your abdominals.
Term
What are unsafe workload thresholds for echo, general ultrasound, cath, and vascular techs?
 Definition
Echo, >100/month
General, >150/month
Vascular, not as clear. Depends on types of studies , how long they take, ect.
Term
Who can be your allies if you are trying to change your working conditions for the better?
 Definition
Risk Management, Employee Health, and possibly Professional Society.
Term
More than __________-__________ premature, preventable deaths are related to smoking each year.
 Definition
400,000–500,000
Term
An average of about __________ minutes of life is lost for each cigarette smoked.
 Definition
5.5
Term
Smokers are __________ times as likely to die of cardiovascular disease.
 Definition
4
Term
Women who smoke are __________% more likely to develop __________ __________, and __________ times as likely to develop __________ _________.
 Definition
75%, breast cancer, 4, cervical cancer
Term
Women who smoke and take
birth-control pills increase their
risk of stroke __________-__________ .
 Definition
ten-fold
Term
Women who smoke experience menopause __________-__________ years earlier than nonsmoking women.
 Definition
5-10
Term
Smoking accounts for __________% of deaths due to emphysema, __________% of cases of esophageal cancer, at least __________ the risk of gastrointestinal cancer, causes at least __________% of cases of kidney cancer and of bladder cancer.
 Definition
85%, 80%, doubles, 40%
Term
Smoking increases the risk of laryngeal and mouth cancer __________-__________ times
 Definition
20-30
Term
Toxins in tobacco smoke are also implicated in __________.
 Definition
leukemia
Term
Second-hand smoke is responsible for __________ deaths (of nonsmokers) per year.
 Definition
50,000
Term
Passive smoke is the __________ leading cause of preventable death
 Definition
3rd
Term
Passive smoking causes about __________ times as many deaths from heart disease
as from lung cancer.
 Definition
10
Term
__________-__________% increase in fetal death in smoking mothers.
 Definition
30-50%
Term
__________ __________ __________ can significantly increase in other birth defects and low birth weight.
 Definition
Smoking while pregnant
Term
Children living in homes of smokers have __________ times as many respiratory infections.
 Definition
6
Term
Passive smoke causes up to __________ new cases of childhood asthma and exacerbates symptoms in up to __________ __________ children who already have asthma.
 Definition
26,000, a million
Term
Of 100 young smokers, 1 will be murdered, 2 will die in automobile accidents, and __________ will die from smoking
 Definition
30
Term
If you quit smoking:
 
After 1 year, __________% decrease in risk of heart attack

After __________ years, equal heart-attack risk with nonsmoker

After 5 years, __________% decrease in cancer risk

After __________ years, equal cancer risk with nonsmoker

After __________ months, significant improvement in symptoms of claudication
 Definition
50%, 10, 40%, 15, 10
Term
HIPAA Privacy:
 Definition
Protection for the privacy of Protected Health Information (PHI) effective April 14, 2003 (including Standardization of electronic data interchange in health care transactions, effective October 2003)
Term
HIPAA Security:
 Definition
Protection for the security of electronic Protected Health Information (e-PHI) effective April 20, 2005
Term
PHI
 Definition
Protected Health Information
Term
PMI
 Definition
Protected Medical Information
Term
PO
 Definition
Privacy Officer
Term
CE
 Definition
Covered Entity
Term
Who must observe HIPAA guidelines?
 Definition
Admitting clerks
Caregivers from the ED to the morgue
Physical therapists
Nutritionists
Lab personnel
Receptionists in MD offices
Transport techs
Respiratory therapists
Billing clerks
Insurance agents/clerks
School teachers/nurses
Home health personnel
Medical records clerks
Website managers
Term
When can you used PHI?
 Definition
Only to do your job
Term
What do you do if there is a breach of HIPAA?
 Definition
Breaches of the policies and procedures or of a patient’s confidentiality must be reported to the appropriate officer at the institution.
Term
Is it ever okay to fax PHI?
 Definition
Faxing PHI is appropriate when the information is needed immediately for patient care. Always include, with the faxed information, a cover sheet containing a Confidentiality Statement
Term
Information that should not be faxed (except in an emergency):
 Definition
Drug dependency
Alcohol dependency
Mental illness or psychological information
Sexually-transmitted disease (STD) information
HIV status
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