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What does very cloudy urine indicate the presence of?
High bacteria count
What is the reference range for substances that are acid? That are alkaline?
- acidic: 0-6
- alkaline: 8-14
What does specific gravity measure?
Measured by comparing weight of substances in urine to weight of distilled water
- How much stuff is in the urine
What is the normal specific gravity of urine?
What is anuria? Polyuria? Oliguria?
anuria- absence of urine output
oliguria- urine output less than 30 mL per hour
polyuria- excessive urine output
What is the minimum volume of urine needed for a urinalysis?
What does pH measure?
the potential of hydrogen ions
What is the normal pH of urine? Of blood?
What will taking a diuretic do to the physical property of urine?
will dilute urine- no color-clear- low specific gravity
What does pyridium do to the urine?
What causes ketones to be present in urine or blood?
rapid breakdown of fat
What is the normal renal threshold?
What organ keeps blood pH normal?
What do the presence of of nitrites in the urine indicate?
How much urine is normally excreted per hour?
30 mL per hour
What type of urine specimen is best for urinalysis?
First morning void
is it good for a pregnant women to have protein in her urine?
What characteristics will be seen in the urine of someone with a UTI? With diabetes?
UTI- Cloudy urine, ammonia smelling, high specific gravity, ph greater than 7, positive for nitrites and leukocytes
Diabetes- sweet smelling, pale yellow, low sg, high glucose, positive ketones
How long an urine sit untested?
Within 1 hour
Frothy urine indicates the presence of what?
high protein count
What does the stool for guaiac test for? What color does it turn?
What is an oppurtunistic infection? A hospital acquired infection? An endogenous infection? An exogenous infection?
Opportunistic Infection- Infection that occurs when body's defenses weaken
HAI's- Enter body through use of equipment during treatment and from Healthcare workers who do not follow proper precautions
Endogenous Infection- Infection/disease originating within body
Exogenous Infection- Infection/ disease originating outside of body
What are the body's natural defenses against infection and how do they work?
-Skin: body's outer barrier or shell
-Mucous Membranes: line digestive, respiratory, digestive, reproductive tracts, trap pathogens in mucus
- Cilia: tiny hair-like structures lining respiratory tract, trap pathogens as they pass by
- Coughing/ Sneezing: forcibly propels or pushes pathogens out of body
- Tears- contain bacteria killing chemical lysozomes, washes pathogen out of eye - Fever- raises body temperature causing hostile environment
-Inflammetion- body produces WBC
-Immune System- produces antibodies
What type of cleaning is the use of alcohol on the skin?
What is zephiran chloride?
What is the process of Disinfection? Sterilization?
Disinfection- Kills pathogens on surfaces and equipment using physical and chemical means
Sterilization- Killing pathogens using steam under pressure, gas
What contributes to lower limb amputations in diabetics?
- Peripheral vascular disease and elevated blood glucose levels damage blood vessels
- This results in poor circulation to lower extremities causing reduced 02 and nutrients to extremities
- Open areas become non-healing due to reduced circulation which leads to infection -Infected wounds of lower extremities -Damaged nerves due to diabetic neuropathy
What is diabetic retinopathy? Diabetic nephropathy? Diabetic neuropathy?
Diabetic Retinopathy- Elevated blood glucose levels cause blood vessels of retina to weaken and break causing hemorrhage- chronic hemorrhage causes scarring of retina
Diabetic nephropathy- End stage of Kidney Disease - leads to kidney failure- dialysis
Diabetic Neuropathy- nerve damage caused by decreased circulation and elevated blood glucose levels that damage nerves
What is the first thing you do when using a meter you have never used before?
Read the manual
When must you do quality control on a meter?
- Beginning of everyday in hospital or clinic setting
- When new vial of strips is opened
- When new battery is inserted
- If meter is dropped If strips were left opened
- Whenever symptoms do not fit reading
What is the normal fasting blood glucose level?
What are the symptoms of hypoglycemia? Hyperglycemia?
Hypoglycemia: shakiness, sweating, headache, dizziness, pale skin, hunger, agitation, confusion, siezure
Hyperglycemia: polydipsia, fatigue, polyuria, headache, blurred vision, dehydration, fruity breath
What is the purpose of the hemoglobin A1C?
Gives picture of average blood glucose over past 120 days - Life of RBC. Confirms self testing results and whether treatment plan is working to control blood glucose levels.
What is ketoacidosis?
Rapid breakdown of fat by body in response to need for glucose
What is the proper angle for needle insertion during venipuncture?
What position should the patient's arm be in after venipunture?
Hold out arm straight or above head
What is the maximum time a tourniquet can be applied for?
What is the order of procedure for preparing skin for venipuncture?
How far should a needle be inserted for venipuncture?
How long do you apply direct pressure after an arterial stick?
What is the order of draw for additives in vacuutainer tubes?
- Blood Cultures
- SPS or ACD tubes
- Sodium citrate
- SST Serum Gel First
- EDTA liquid or spray
How is malaria transmitted? How is it treated?
- Bite from infected mosquito
What does entamoeba cause?
What organism causes "Traveler's Diarrhea"?
What symptoms does ascaris cause?
abdominal pain, shortness of breath
How is trichomonas transmitted?
How is enterobius diagnosed?
Cellophane tape test
How is toxoplasmosis transmitted?
Contact with feces from infected birds and cats
Who is at risk for getting toxoplasmosis?
Pregnant women and people with weakened immune systems
What organism causes tapeworm?
How is trichonosis diagnosed?
What is thrush? How is it treated?
Candida albicans infection of mouth and throat; Nystatin swish and swallow
What vitamin is contained in Brewer's yeast?
What is yeast missing that prevents it from making its own food?
What is ringworm caused by?
Where is candida albicans normally found?
Normal flora found on skin and mucous membranes of mouth, vagina, rectum
What is onychomycosis?
Fungal infection of nail bed
How do treat a systemic yeast infection?
IV Diflucan or amphotericin B
Where do yeast infections occur most often?
Skinfolds of breast, groin, axilla, baby's butt
What precautions must be taken when applying Nystatin powder?
- Squeeze powder onto gauze away from your eyes and patient's eyes
- Apply to skin while wearing gloves
How do you prevent thrush when using a steroid inhaler?
Rinse mouth with water after using inhaler to prevent thrush
What is tinea pedis?
What oppurtunistic infections can occur in a patient with AIDs?
- Kaposi's Sarcoma
- Pneumocystis pneumonia
- Giarda lamblia
- Streptococcal pneumonia
What cells does HIV invade?
What type of virus is HIV?
How is mononucleosis transmitted?
Direct contact with saliva of infected person
How is West Nile Virus transmitted?
Spread through bite of mosquito that bit infected bird
What serious illnesses can West Nile Virus cause?
What color is gram positive? Gram negative?
+ purple ; - pink
How do we stop the growth of bacteria?
- Remove food supply
- Unfavorable temperature
- Acidic or alkaline environment
- Exposure to light
How fast do bacteria reproduce?
Every 30 minutes
What kind of bacteria is clostridium difficile?
- Clostridium difficile: Gram positive Bacilli
- E-coli: Gram Negative Bacilli
- Streptococcus pyogenes: Gram Positive Bacilli
- Staphylococcus Aures: Gram Positive Cocci
What bacteria most commonly causes hospital acquired infections?
How do you prevent the spread of MRSA?
Isolation Precautions- gloves, gown, mask, goggles or faceshield
What bacteria causes strep, scarlet fever, and rheumatic fever?
What does streptococcus viridans cause?
Subacute bacterial endocarditis
What bacteria causes food poisoning? List all known.
- Basilius Saraus
What does Neisseria meningitides cause?
What antibiotics are used to treat bacterial infections?
What does pathogenic mean? Non-pathogenic?
pathogenic- able to cause disease
nonpathogenic- does not cause disease
What is the name of the rod shaped bacteria? Spiral shaped? Round or oval shaped?
What is an aerobe? An anaerobe?
aerobe- bacteria that grows in presence of 02
anaerobe- bacteria that grows without 02
What is passive immunity and give an example of a vaccine that provides it?
- Antibodies from another source injected into person who have been exposed to pathogen
- Provides temporary immunity so body can immediately fight pathogen until body can produce its own antibodies against pathogen
-ex: tetanus vaccine
What is active immunity and give an example of a vaccine that provides it?
-Injection of inactive or dead pathogen or toxin produced by pathogen which stimulates immune response in body - vaccine.
-Body takes 5-6 days to begin producing antibodies against pathogen after vaccination
-ex: flu vaccine
What is the most accurate method of taking a temperature? Least accurate?
What are the normal temperature ranges?
Rectal- 98.6- 100.6
Temporal artery- 98.6-100.6
What does febrile and afebrile mean?
febrile- patient has fever
afebrile- patient doesn't have fever
What factors affect an accurate temporal artery temperature measurement?
- Dirty probe - small ear canal- incorrect positioning of probe- Dirty probe lens
- Hair on forehead
- Heavy make-up
- !n-correct positioning
- Moving probe too quickly across forehead
What pulse points do we measure vital signs at?
- radial, apical, brachial
What is a normal pulse rate?
What does bradycardia and tachycardia mean?
Bradycardia- heart rate less than 60 bpm
Tachycardia- heart rate more than 100 bpm
How long do you take an apical pulse for?
What are the ranges used when measuring the quality of a pulse?
When are respirations measured?
During/ after taking pulse
What is a normal 02 sat value?
94% or greater
Where is the pulse oximeter probe placed to obtain an accurate 02 sat reading?
index finger tip
How do you measure pulse pressure?
Difference between systolic and diastolic reading; s-d
What pulse point is palpated while the palpatory blood pressure is being taken?
What pulse points are used to check for circulation in the lower extremities?
dorsalis pedis and posterior tibial and popliteal
What happens if the blood pressure cuff is deflated too rapidly?
You will get an anaccurate reading
Why do we wait in between taking a palpatory and auscultatory blood pressure?
To allow for complete refilling of blood into brachial artery
What is a normal blood pressure?
90/60 - 120/80
What do the P, QRS, and Twaves measure?
- P Wave: Atrial Depolarization
- QRS: Ventricular Depolarization and Atrial Repolarization
- T Wave: Ventricular Repolarization
What is the PR interval?
- Time required for impulse to leave SA node and travel through atria, AV node, Bundle of His, both bundle branches, and purkinje fibers
What lead is the ground lead on an EKG?
Where do we put V1, V2, V3, V4, V5, V6?
V1- 4th intercostal space at right bottom of sternum
V2- 4th intercostal space at left bottom of sternum
V3- Midway between V2 and V4
V4- 5th Intercostal space at the junction of mid-clavicular line
V5- At horizontal level of position 4 at anterior axillary line
V6- At the mid axillary line on the same horizontal level as V4 and V5
Where should the EKG machine be placed to perform an EKG?
Left side of patient's bed
Which electrolytes contribute to he normal electrical conduction of the heart?
Sodium, calcium, potassium
What is postural drainage?
Positioning patient so gravity helps secretions flow downward and out; head lower than lung
How do you measure a pulse deficit?
Apical pulse value subtracted from radial pulse value
What do the horizontal and vertical lines on the EKG paper measure?
Horizontal Line: measures duration of waveforms in seconds
Vertical Line: measures amplitude or voltage or strength of muscle contraction
How many seconds does a small box equal? Large box?
Small: 0.04 seconds
Large: 0.20 seconds
How many large boxes in a 6 second strip?
Which method is the most accurate in measuring rate?
Small box method
What major medical complication can occur as a result of untreated atrial fibrillation or atrial flutter?
How many pwaves in atrial fibrillation? Atrial flutter?
-A fib: no clear waves, just deflections
-Atrial flutter: many
What do the P Waves look like in atrial flutter? Atrial fibrillation?
-A fib: no clear waves, just deflections
-Atrial flutter: Sawtooth shape
What arrhythmia is the most common cause of cardiac arrest?
- Ventricular fibrillation
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