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COPE Exam-->Written+Practical

Terms in this set (84)

What does P.R.N mean?
Pro Re Nata: administer as needed
What does BM mean?
bowel movement
What does TKO mean?
to keep open; order to keep just enough flow through iv to keep vein open
What does CBC mean?
complete blood count; percent of each cell type
What does NPO mean?
nothing by mouth
What does PO mean?
administer by mouth
What does PR mean?
per rectum: administer rectally
Under what conditions are health scholars allowed to dispense medication
never
what 2 things must you do when you are going to miss a shift
if it is >48 hours, you just need to email the department coordinator.
<48 hours,
1. call the floor at beginning of shift and speak with charge nurse either 15 minutes BEFORE SHIFT or 15 minutes AFTER SHIFT STARTED to make sure that the message is delivered. If charge nurse is unavailable, take down the name of the person you spoke to.
2. email the department coordinator
what do code blue, silver, red, orange, yellow, pink, and gray mean?
blue: adult medical emergency; cardiac arrest
silver: person with weapon or hostage situation
yellow: bomb threat
pink: child abduction
red: fire
orange: hazardous materials spill
gray: combative or disruptive person is confronting staff (notify sarah/incident)
name 4 different types of personal protective equipment (ppe) that you could use while interning at the hospital
-gown
-glove
-mask
-goggles
-face masks
what are 5 ways of identifying a patient before transport (in no particular order)?
1. patient's nurse
2. main nurses' station whiteboard
3. open-ended question
4. patient's wristband
5. patient's chart (we're not allowed to see this)
when applying for a leave of absence, when should health scholars submit their request?
at least 14 days prior to the intended start date of the leave
name 4 out of 6 signs of fainting
hot, dizzy, clammy, loss of hearing, loss of vision, nausea
name 5 arteries in the body where a pulse can be measured
carotid, brachial, femoral, popliteal, posterior tibial, dorsalis pedis, radial
what is the central premise of universal health precautions
everything/everyone is infected
assume infected
what is the normal heart rate or pulse for an adult
60-100 beats per min
5 areas to measure temperature
normal temp is?
oral, axillary, tympanic, rectal, temporal
normal temp is 98.6F
what is the time frame given to health scholars to sign up for all shifts for the upcoming month
First ten days of the month 1-10 shift preference for the next month
On the 15th, a link to calendar goes out by the DC
15-25, participants may reschedule via email
25-31, participants may add additional shifts via email until the end of month
1 of new month: calendar is finalized and participants may add more shifts via email
according to the center for disease control (cdc), what is the best way to prevent the spreading of nosocomial infection?
-must wear mask when out of the room
-cannot have fresh flowers or fruit
-needs a clean environment
What is the number you have to dial to "call a code" in the hospital
4000
what does PHI stand for and what are three forms of PHI
PHI is protected health information
three forms of PHI: written, electronic, oral
-name, SSN, address, DOB, family info
where do you palpate the pulse on an infant, child, and adult
radial
name 2 out of 5 general ways to protect privacy
-close doors and draw curtains
-make sure discussions about patient conditions cannot be overheard
-knock before entering rooms
-keep patient records locked and away from public areas
-do not give names or info when visitors ask about patients. direct all inquiries to a staff member that can help them
what pulmonary condition is defined as decreased air entry caused by permanent enlargement of the airspace (alveoli)?
Emphysema
a homeless man enters the hospital with a fever. he has had a chronic cough for several months, producing bloody-sputum, and complains of night sweats. chest x-rays (CXR) reveals cavitation's with air-fluid levels in the apex of his left lung. sputum samples are acid fast positive but do not stain well with gram staining. what is the infectious disease?
Tuberculosis
what are the three transmission-based precautions
1. excellent hand washing
2. personal protective equipment (ppe)
3. environmental controls
what five items does your complete uniform consist of
1. health scholar polo shirt (tucked in at all times)
2. long khaki pants
3. I.D. badge (must be visible at all times)
4. White, non-canvas shoes with socks
5. Long haired tied back
name two things associated with the normal aging process that geriatric patients are most at risk for
1. decreased skin integrity
2. depression
3. decreased lung, muscle size, gum tissue, impaired vision, loss of short term memory, etc
who accredits st johns
the joint commission
what are the national patient safety goals
-identify patients correctly
-improve staff communication
-use medicine safely
-use alarms safely
-prevent infection
-identify patient safety risks
-prevent mistakes in surgery
health scholars who do not know the answer to a question asked by hospital accreditation surveyors should do what
Tell the surveyors that you're unsure so you will ask staff and come back as soon as possible to tell them
when is your competency checklist due and where do you submit it when it is complete
due at the end of week 2 of the rotation (try to do it at first shift); must be completed with an RN only; place completed checklists IN THE FRONT POCKET OF THE DEPARTMENT BINDER
your best fired says his grandmother is on the floor and asks about her case. what do you do?
you can't tell him anything
a myocardial infarction, heart attack, causes a loss a blood supply to some part of the heart and possibly some long lasting cardiac damage. name at least 3 symptoms of a heart attack
-severe retrosternal pain
-pain in left arm and/or jaw
-dyspnea
-diaphoresis (Sweating)
name the 5 components that make up the patient care team
-effective communication
-patient-centered focus
-common goal
-understanding roles
-confidence in team members

1. Allied Health Positions
2. Nursing
3. Physician
4. Volunteer
5. The Patient
what do you call the pressure of blood against the artery walls between heartbeats, when the heart is relaxed and filling with blood?
blood pressure
systolic vs diastolic pressure
systolic: the greatest force exerted a/g the walls of the arteries by blood pumped from the heart during contraction

diastolic: the least force exerted against the walls of the arteries by blood when the heart relaxes
normal BP
120/80 mmHg
normal respiration rate of adults
12-20 breaths per minute
name the 6 vital signs
- temperature
-pulse/heart rate
-blood pressure
-respiratory rate
-oxygen saturation
-pain level - not objective
normal o2 saturation
97-99%

97-99% of hemoglobin binding sites are occupied
health scholars should always be suspicious of what four types of abuse
-child
-elder
-domestic
-sexual/non-sexual harassment
two different types of wipes and minutes to use
purple: disinfect. 2 min
bleach: c diff 4 minutes
name 3 things you must do before transporting a patient
-hand hygiene
-grab wheelchair/gurney and wipe down with purple wipes
-check with nurse
????
which position is a patient placed in when he or she exhibits shock symptoms and has no evidence of head or spinal injury?
Trendelenburg Position
name at least 5 careers that fall into the category of allied health
Emergency med tech, physician assistant, occupational therapist, registered dietitian, respiratory therapist, X-ray tech, clinical lab specialist, CNA, surgical technologist, clinical lab scientist
name the 5 cardiovascular conditions that we discussed and define what each one means.
-Atherosclerosis: disease in which fatty material is deposited in the walls of arteries

-MI: heart attack; loss of blood supply to the heart

- CHF: congestive heart failure; failure of heart to pump blood efficiently

- Stroke: loss of blood to the brain

-Shock: decreased perfusion of blood to body tissues
what is a scope of practice?
what you are allowed to do in your job
in order of occurrence, what things do you absolutely have to do if you are injured, regardless of how minor the injury is, while volunteering in the hospital?
1. tell the charge nurse immediately
2. seek treatment - go to ED in case of serious injury
3. page cope health solutions - sarah @ 888 248 2914
what do you do when you have been exposed to a patient's blood?
-Wash cuts with soap and water
-Flush splashes to the nose, mouth, or skin with water
-Irrigate eyes with clean water, saline, or sterile irritants
-Report the exposure to the charge nurse/supervisor
-Document- complete assessment documentation and employee health follow up as direction
-Page- report the exposure to Program Manager (Sarah; 888 248 2914)
can you transport blood if asked/begged
NEVER!
you notice that by accident, you assisted a patient in an isolation room without wearing PPE, what steps should you take next?
-notify the charge nurse that you didn't wear PPE
-throughly wash hands with soap and water
-exame clothing to ensure there was no contact with the patient's body fluids
-notify program director --INCIDENT. report & call 888 248 2914
what is the pathway of blood through the body, starting with the left ventricle and ending with the right ventricle?
left ventricle --> aorta --> systemic circuit --> vena cavae--> right atrium --> right ventricle --> pulmonary trunk --> pulmonary veins --> left atrium --> left ventricle
what is the proper way to put on PPE
gown --> glove --> mask
what is the proper way to take off PPE
glove --> gown --> wash hands --> mask --> wash hands
what is the emergency contact #
(888) 248-2914
after transferring hospital locations, how many hours do you need to serve minimum
how much does it cost to transfer
what else happens
174 hrs
$50
reapply again and retest
how many program meetings each month
2 mandatory meetings on sat or sun of 1st and 3rd month of the rotation at 12 pm and 2 pm
exemplary service award & outstanding dedication award
exemplary service: recipients are chosen based on recommendations from program staff, leaders, and manager
outstanding dedication: served the most hours in their department for the previous rotation
how many shift reschedules can you do per rotation
3; no more than 1 a month
what is a timesheet/how does it work
when signing in and out, always round to the nearest quarter hour and remember to sign the top section of the sign in sheet and sign the signature section after signing out each shift

only 30 min break if 8 hour shift
what is competency checklist
documentation of participant's training and competency for each department; found in departmental binder next to time sheet; must fill out a new one EVERY ROTATION
what is hours audit request form
request for documentation of hours completed
what is counseling report
what is it used for
what can it result in
when a participant requires instruction or guidance to correct behaviors to ensure all procedures and policies are observed

commonly used for: missed shifts, missed meetings, late or incomplete competency checklists, expired CPR or TB tests

can result in being released from the program
what is the patient experience survey (HCAHPS)
& how can you inform the patient about it
the survey scores affect a hospital's funding and patient referrals. health reform- new government policies stress patient care, in turn affecting a hospital's financial reimbursement.
the survey determines 30% of value-based incentive payments back to the hospital to reward quality

we can tell the patients about the survey when we are discharging them
what are the 8 domains of HCAHPS
-nurse communication
-cleanliness & quietness
-pain management
-discharge management
-physician communication
-responsiveness of hospital staff
-communications about medications
-overall ranking
what is phone etiquette
never put someone on hold for more than 30 sec without checking in with them
what is AIDET
Acknowledge
-smile, eye contact, stop what you are doing

Introduction
-welcome to hospital, introduce yourself, state purpose, id patient

Duration
-time expected for procedure/results, explain delays

Explanation
-test for procedure, role of medical staff, expected pain/discomfort, what will happen next

Thank you
-for choosing the hospital, patience/assistance/understanding, offer verbal and/or written post-procedure instructions
what is KIAHI
Knock
Introduce
Assess
Hand Hygiene
Identify (patient-at least 2 ways)
what are standard precautions for infection prevention
-presumed infection
-100% of bodily fluids are presumed to be infectious
what are transmission-based precautions for infection prevention
-utilized for patients known or suspected to be infected or colonized with significant pathogens that can be transmitted
-the health care worker needs protection from pathogens. staff must use: excellent hand washing, personal protective equipment (ppe), & environmental controls
Contract precaution
-what
-example
-ppe required
-color of sign
-will we have to go inside this room
-anybody can become infected or a carrier of an infectious agent by contact with patient, bedding, hospital gown, personal items, etc
-prevention: hand hygiene + gloves + isolation protocol
-scabies is an example and so is MRSA
-ppe required: gown, mask, gloves
-sign is YELLOW GOLD
-yes inside
Contact spore precaution
-what
-sign
-precautions
-will we have to go inside this room
C.DIFF
brown sign
family and visitors shouldn't eat in room. hand hygiene with soap and water ONLY
-yes inside
Droplet precaution
-what
-example
-ppe required
-color of sign
-will we have to go inside this room
-when people sneeze or coughs
-flu, strep throat
-mask, gown, gloves
-GREEN sign
-yes inside
Airborne precaution
-what
-example
-color of sign
-will we have to go inside this room
-may be transmitted over long distance by air
-measles, tb, shingles, chicken pox
-BLUE sign
-no we do not go inside
immunocompromised precaution
-need protection from normal germs of staff and visitors
-don't have a strong immune system
-must wear mask when out of the room
-cannot have fresh flowers or fruit
-needs a clean environment
Neonates + Infants
-Age group
-things to consider
-interventions
neonates: newborn - 1 month
infants: 1 month - 1 year

-consider: sense of protection from parents, cry to communicate, easily over-stimulated, neck muscles not fully developed, high risk for aspiration/suffocation/falls

-interventions: involve parents, keep items away from face, support head, consider responses to external stimuli, provide familiar environment, crib rails always raised
Toddlers
-Age group
-things to consider
-interventions
1 year- 3 years

-consider: begin to explore environment, high risk for choking/injury/infection

-intervention: encourage parent presence during procedure, explain what will be done before starting, allow toddlers to make choices when possible, avoid having any small objects at the bedside and make sure that small pieces of food are given to the toddler
Preschool & School Age
-Age group
-things to consider
-interventions
4 - 12 years

-consider: can follow directions, use language correctly, increased sense of independence, high risk for injury related to falls/bodily damage, trauma due to abuse (physical & sexual), asthma, and fluid/electrolyte imbalance

-interventions: explain procedures before you begin, encourage the child to verbalize thoughts and feelings, be suspicious of any unexplained signs of injury/report them to a healthcare provider
Adolescents
-Age group
-things to consider
-interventions
13 - 18 years

-consider: experiencing a time of rapid physical & emotional growth, model good listening & teaching skills, high risk for: substance abuse/depression/suicide/STDs (green gown is suicide; do not interact with them unless they call out to you then make it brief)

-intervention: provide privacy & freedom whenever possible, involve them in decision-making, explain procedures in advance, encourage questions regarding fear, be alert to signs of substance abuse, take suicide threats seriously
Young Adults
-Age group
-things to consider
-interventions
18 - 40 years

- consider: physical maturation nearly complete in early 20s, cognitive functioning peaks during 20s, gaining increased responsibilities, relationship changes, high risk for: substance abuse/increased stress/quarter-life crisis/midlife crisis

-interventions: support their feelings and recognize that they may be struggling to balance all of their roles and responsibilities, encourage them to maintain regular eye/physical/dental exams
Middle Adults
-Age group
-things to consider
-interventions
40 - 64 years

-consider: physical signs of aging, all body systems exhibiting change (energy, hormone, metabolic rate all decrease), high risk for hearing & eyesight decline/bone and joint pain/ "late" midlife crisis

-interventions: encourage regular eye/physical/dental exams, preserve skin integrity, promote physical activity as tolerated, allowing lighting adjustments, encourage the use of glasses & hearing aids, encourage the use of assistive devices/canes/walkers, exhibit an interest in hobbies/community/future
Older Adults
-Age group
-things to consider
-high risks
-interventions
65 + years

-consider: depression, changes in (skin, lung, gum tissue, stomach, muscle size, balance, vision, self respect, temperature, short term memory)

-high risk for: skin, aspiration, sleep pattern disturbances, falls, sensory and perceptual alterations, fragile

-interventions: help change position, monitor diet, monitor temperature, take patient to restroom regularly, use chairs with arms to facilitate getting up an down, consider hearing and vision loss in communication
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