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349 Cards in this Set
- Front
- Back
Denying care to a patient whom you suspect to have a disease
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Patient abandonment
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Rely on a living host organism to sustain their existence
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Parasite
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Microorganisms that live off of dead or decaying matter
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Saprophytes
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A common saprophyte that causes tetanus or lockjaw.
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Clostridium tetani
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Dead tissue
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Necrotic
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Require dead tissue, cannot live in healthy living tissue
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Saprophyte
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Microorganisms that Grow in or on tissue of another life form causing disease or damage
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Pathogenic
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Examples of pathogenic microorganisms
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Bacteria,mold,viruses,fungi, yeast, rickettsaie,and protozoa
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Disease producing
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Pathogenic
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Play vital roles in maintaining normal human body function
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Non pathogenic microorganisms
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Normal flora, live in deep cracks and folds of the skin or body and help maintain chemical balances
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Resident microorganisms
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Very short life Span, reside on external surfaces growing and multiplying. Found on floors and walls
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Transient microorganisms
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First link in infectious process chain
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Infectious or causative agents
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A true parasite
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Helminths (worms)
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Exists in equilibrium with host, but are potentially pathogenic if balance is disturbed
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Normal flora
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Normal flora for intestinal tract and involved in production of vitamin k
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E coli
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After Repeated exposure of pathogens the host will develop tolerance for it. This relationship is called
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Commenalism
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Person who withstands effects of pathogen, they have no symptoms but are able to pass the pathogen to others
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Carriers
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Occurs when one of the infectious agents invades the body through entry portal, and begins to grow
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Infection
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A pathogen will not develop into infection unless
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It can withstand host defense mechanism
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Number of microorganisms that have invaded the host
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Dose
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Measure of the pathogenicity, or ability to invade host tissues, withstand defense, and cause infection
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Virulence
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Ability to move through tissue is sometimes degraded to as
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Invasiveness
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Based on aggressiveness and toxicity of microorganism
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Virulence
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T or F...a pathogen does not need to be aggressive to be virulent.
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T
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Primitive single celled plant like organisms that reproduce rapidly
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Bacteria
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Reproduce asexually by binary fission ( cells divide to form daughter cells then daughter cells divide and so on)
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Bacteria
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---cells divide every 30-120 mins
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Bacterial
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3 physical characteristics of bacteria
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Size, shape, attachments
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3 basic bacterial shapes
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Rod, spherical, and spiral
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Bacterial attachments include protective capsules and hair like outgrowths called
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Flagella
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If a bacteria will hold a gram stain it's referred to as
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Gram positive
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Only ones to Form spores and form them in specific places within cell, making them easy to identify
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Bacilli
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Physiological requirements of bacteria
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Oxygen and nutrition
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Require oxygen to live
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Aerobic
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Those that survive without oxygen
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Anaerobic
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Bacteria that obtain their nutrition from living sources
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Parasites
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Gram positive cocci responsible for impetigo, boils, infected lacerations, pneumonia, menengitis, and septicemia
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Staphylococcus
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Caused by group a strep and include strep throat, pneumonia and otitis media
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Streptococcal infections
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Bacteria that cause wound infection
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Pyogens
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Pus forming
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Suppurative
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Non spore forming, faculative anaerobes (grow w or w/o oxygen) and commonly found on surface of skin and nose and throat
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Staphylococci
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These infections often appear as watery, blood stained abscesses
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Strep
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Spread via direct contact or inhalation of air containing contaminated droplets, easily transmitted thru cough, sneeze, talk or laugh
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Strep
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Spreading of strep is prevented by using
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Strict aseptic technique
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Cause sexually transmitted disease by invading mucus membranes of genitourinary tract
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Neisseria gonorrhoeae
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Most common enteric bacillus found in intestinal tract
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Escherichia coli- e coli
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3 common types of enteric bacilli
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E coli, proteus mirabilis, and p vulgaris
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Anaerobic bacteria most commonly encountered are
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Clostridia
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Spore forming bacilli, most difficult type of bacteria to destroy
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Clostridia
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2 types of clostridia that cause severe wound infections
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Tetani and perfringens( welchii)
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When introduced to wound, tetani causes the disease known As
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Tetanus or lockjaw
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Can occur postoperatively as result of improperly sterilized instruments or materials
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Surgical tetanus
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Causes severe infection of muscle tissue reffered to as
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Gas gangrene (clostridial myonecrosis)
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Gas gangrene destroys tissue providing nutrients for ---- to thrive on
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Clostridium perfringens
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Non spore forming bacilli (rod shaped) has wax like coating which makes it nearly as hard to destroy as spore forming bacteria
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Mycobacterium tuberculosis
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This microorganism is transmitted primarily by inhalation of contaminated droplets through cough, sneeze, or kissing
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Tuberculosis
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Surrounded by multilayer cell membrane rather than cell wall, flexible so shape varies. Smallest that can reproduce and livevoutside a host cell
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Mycoplasma
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Several families are pathogenic producing diseases such as pleuropneumonia and pelvic inflammatory disease
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Mycoplasma
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They can only live and reproduce inside a living host cell
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Rickettsiae also called obligate intracellular parasites
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Act as parasites in intestinal tract and salivary glands of insects such as lice, ticks, and bedbugs
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Rickettsiae
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Rickettsias produces 2 forms of infection
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Rocky mountain spotted fever and scrub typhus
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2 structural categories of fungi
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Yeast and mold
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help amoebas propel and ingest food particles
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Pseudopods- False feet
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Smallest known microorganisms, are parasites and multiply only within living cells
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Viruses
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Viruses invade host, reproduce and then break down through a process called
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Lysis
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---cells are specific for certain parts of body, measles effects skin, rabies effect brain
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Viral
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Begins when infectious agent finds a location (reservoir) where it can grow
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Chain of infection
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T/F. Any break in the chain will disrupt infectious process and prevent spread of disease
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T
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2nd link in chain of infection is location where agent grows and multiplies
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Reservoir
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Portal of exit is --- link in chain
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3rd
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3 primary modes of transmission
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Contact, droplet, and airborne
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Contact w body secretions
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Direct contact
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When u touch objects that are contaminated w infectious agent
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Indirect contact
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Occur when agents are dispersed through air over long distance ( more than 3 ft)
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Airborne transmission
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Transmission occurs thru mosquitoes, fleas ticks bites
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Vectorborne
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Any place a pathogen can enter body
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Portal of entry
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Last link in infection chain, a host is susceptible to pathogenic invasion
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Susceptible host
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4 stages of infectious process
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Incubation, prodromal, illness, convalescence
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Invasion of microorganism to onset of symptoms
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Incubation
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Onset of nonspecific symptoms to onset of specific symptoms, more likely for organism to spread during this time
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Prodromal
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Symptoms appear in this illness period
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Illness
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Recovery period when symptoms subside and continue til healed
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Convalescence
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5 major defense systems the body uses to prevent entry and spread of infection
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Skin, mucous membranes, tears, lymphatic system, and antibody formation
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Best natural barrier to infection
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Skin
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Lymphatic system produces --- to fight infection
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Leukocytes (white blood cells) called lymphocytes
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During infection ----- attack, engulf, and digest pathogenic microorganisms in tissue
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Lymphocytes and leukocytes
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4 parts of lymphatic system
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Tonsils adenoids spleen and thymus gland
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Cells found in walls of blood vessels and loose connective tissue, attack invading foreign organisms
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Macrophages or histiocytes
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Normal persons defense is the immune system that creates substances called
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Antibodies
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Antibodies are created to fight specific foreign substances called
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Antigens
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2 ways antibody production is acquired
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Contracting disease, or artificially induced by inoculating person w vaccine or toxoid related to disease
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When pathogens enter deep body tissue the body responds by
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Inflammatory response or inflammation
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First reaction that occurs after microorganisms invade injured tissue
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Blood flow increases to that area
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After initial attack blood flow slows and ---- occurs due to fluid build up in injured tissue
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Swelling (edema)
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Process of pus formation and pus forming infections
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Suppuration
Suppurative |
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If infection is to great to be controlled at entry site the lymphatic system transports infection to lymph nodes, this is called
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Regional infection characterized as painful swollen glands
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If infection spreads from lymph nodes to circulatory system into blood stream it's known as
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Systemic infection- resulting in septicemia
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Link- reservoir
Infected patient |
Break- prevent organism transfer by handwashing
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CDC recommend a 2 tier system of precautions in hospitals
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Standard precautions and transmission based precautions
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Examples of standard precautions
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Hand washing, wear gloves, gown, mask, clean n disinfect, prevent injuries
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3 types of transmission based precautions
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Airborne, droplet, contact
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Airborne precautions
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Private room w negative air pressure, wear mask
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Droplet precautions
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Mask w/in 3 ft
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Contact precautions
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Private room or same infection room mate, wear gloves,
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How to wash contaminated clothes
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Hot soapy water
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Inflammation of liver
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Hepatitis
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Hep A and E are contracted thru
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Ingestion
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Hep B C and D are transmitted by
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Contact w infected blood or body fluids, known as serum hepatitis
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Mandatory vaccine for all military healthcare workers
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Hep B vaccine
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Inflammation of meninges covering brain n spinal cord caused by bacteria, viruses, fungi, or parasites
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Meningitis
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Most serious of meningitis and sometimes fatal
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Bacterial meningitis
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Often called aseptic meningitis, most common of three
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Viral meningitis
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Type of meningitis occurs mainly in infants and elderly
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Pneumococcal meningitis
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Diseases we call "common cold" caused by
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Rhinoviruses
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Acute, febrile respiratory infection that may exhibit systemic manifestations
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Influenza
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Highly contagious infection primarily affects lungs but can cause necrosis in any organ
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Tuberculosis
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2lab tests done to detect exposure to HIV virus
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Enzyme linked immune sorbent assay (elisa) and western blot test
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Most common sexually transmitted disease, as many as 40 types
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HPV
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Acute form of syphilis is characterized by primary stage lesions known as
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Chancres
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T/F Syphilis is communicable in all 5 stages
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F- only communicable in primary and secondary stages
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First stage of syphilis
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Primary- forms single hard red lesion called chancre
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6-8 wks after primary lesion appears, pt enters --- stage of syphilis
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Secondary
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In this stage of syphilis there are no signs of infection, divided into 2 parts
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Latent- early- continues 4 yrs. Late latent starts at 4 yr mark
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Considered destructive stage of syphilis
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Late stage
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Also called the great imitator because it mimics almost any other disease, noninfectious at this point
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Syphilis, late stage
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Medical aseptic practice, inhibits the spread and transfer of pathogenic organisms by limiting contacts of patient and creating barrier
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Isolation technique
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For patients with lowered level of resistance isolation means barriers are protecting them from outside world, this is reffered to as
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Reverse isolation
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Placing patients together in same living space
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Cohorting
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Double bagging technique requires
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2 techs, one bags item and places in second bag that second tech is holding
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--- cleaning is done everyday
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Routine cleaning
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--- cleaning directed primarily toward objects the patient had contact with
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Terminal cleaning
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Most effective type of isolation unit
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Private room
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Disinfectants are classified as
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Sporicides, considered sterilants if contact time is long enough to destroy all microbial life
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Low level disinfectant
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Sanitizer
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Useful in disinfectant in concentrations of 70-95%
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Alcohol-either ethyl or isopropyl
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T/F can not use alcohol on lensed instruments because it dissolves the cement holding lens in place
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T
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Mixture of iodine and detergent, kills bacteria after 20 mins. Most frequently used as antiseptics
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Iodophors
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Commonly known as household bleach, effective in concentrations from 1 to 5 %
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Chlorine compounds
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Extremely caustic, capable of killing almost all organisms but not spores
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Phenolics
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Agent of choice for dealing with e coli
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Phenolics
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Fumes are So toxic they are not suitable for housekeeping use
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Formaldehydes
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8 steps for disinfecting
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Disassemble, thoroughly clean and dry, rinse thoroughly, allow to air dry, submerge in disinfectant solution, time the exposure to disinfectant,remove, rinse w sterile water
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Instruments put directly in blood stream or sterile areas
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Critical items- must be sterilized to reuse
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Objects that come in contact w intact mucous membranes but don't penetrate body surface, should be sterilized but can be disinfected
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Semi critical
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Objects that touch skin or nothing at all, wash w detergent or low disinfectant
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Non critical items
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Physical removal of organic material from objects
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Cleaning
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Normally accepted max size of sterile package should not exceed
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12x12x20, and 12lbs for woven, 16-17 lbs for metals
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2 basic ways to wrap sterile objects
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Diagonal method most used, and straight method
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Sterile wrapped items are sterile for
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28-30 days
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Basic methods of sterilization
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Physical, chemical, ionizing
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The special tape used to seal sterile packages are
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External chemical indicator showing it's been sterilized
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A paper strip placed inside sterile package is
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Internal chemical indicator, it too changes color when package is sterilized
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Developed hierarchy of needs theory
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Dr Abraham Maslow
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--- oxygen in body is carried in the blood bound to protien hemoglobin in the red bloodcells
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98%
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Nutrition increases body's ability to produce --- we need to carry vital oxygen throughout body
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Red blood cells
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5 basic needs in hierarchy of needs
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Physiological needs(oxygen,food,sleep), safety and security, love and belonging, self esteem, self actualization
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2 vitamins necessary for production of RBCs
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Vit B12 and folic acid
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The nursing process is a --- used to identify patients problem and assist the patient to expected outcome of recovery
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Systematic method
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Refers to physical changes that can be measured and occur in steady manner
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Growth
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Relates to psychological and social functioning
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Development
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A unit for measuring energy
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Calorie
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Energy requirement of the body
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Caloric requirement
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Standard unit for measuring heat, can serve as measure of energy metabolism
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Calorie
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1 gram of protien yields
1 gram of carbs yields 1 gram of fat 1 gram of alcohol |
4,4,9,7
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T/F b12 deficiency is normally due to lack of absorption not lack of diet
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T
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Pernicious means
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Destructive
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Vitamin c deficiency
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Scurvy
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Minerals are important for human
|
Metabolism
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Minerals and their chemical symbols are
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Sodium Na, chloride Cl, potassium K, calcium Ca, iron Fe
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Principal minerals oi extracellular body fluids
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Sodium and chloride
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Help maintain electrolyte balance ( homeostasis) and regulate ph level
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Sodium and chloride
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Pain at IV site
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Phlebitis
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T/F you can add potassium to an already infusing IV solution
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F- it can result in overdose of potassium in blood stream, known as hyperkalemia
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calcium absorption can not happen without the help of
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vitamin D
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delivers highest amount of calcium per tablet
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calcium carbonate
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oxygen carrying component of blood, stored in the liver, spleen, and blood marrow
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iron Fe
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injectable iron can be given by
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deep IM using the Ztrack method only
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should not be taken within two hours of iron
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coffee or tea, reduces absorption by 50%
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larger molecules are constructed from smaller ones, requiring input of energy
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anabolism
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larger molecules are broken down into smaller ones, releasing energy
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canabolism
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a form of energy (a catalyst) used to increase the rate of chemical reactions in a lab
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heat
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a particular molecule that can change the rate of a reaction without itself being consumed
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catalyst
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a lipid splitting enzyme is called
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lipase
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a protein splitting enzyme is called
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protease
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starch splitting enzyme is called
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amylase
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substances that release ions in water resulting in electrically charged particles (ions)
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electrolytes
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electrolytes that release hydrogen ions (H+) in water are called
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acids
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molecule products are hydrogen ions (H+) and chloride ions (Cl) are written
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HCl or H+ +Cl
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electrolytes that release ions that combine with hydrogen ions are called
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bases
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the catalyst for the cell to perform its particular function in order to maintain chemical balance in the body
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enzyme
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when acids and bases combine they will react to form water and electrolytes called
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salts
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ionizes (separate) to release hydrogen ions
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acid
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ionizes to release ions that can combine with hydrogen ions
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bases
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substance formed by reaction between acids and base
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salt
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universally used to represent H+
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pH
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keeps track of decimal place in a H+ concentration
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pH scale
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solutions with more hydrogen ions (H+) than hydroxyl ions (OH-) are said to be
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acidic
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have a ph value less than 7.0 (neutral)
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acidic
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neutral solution because the water synthesizes and releases an equalt number of acid and base ions
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distilled water
|
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solutions with more (OH-) and fewer (H+) are said to be
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basic (alkaline), ph values are more than 7.0
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normal pH of blood
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7.35-7.45
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blood pH in range of 7.5-7.8 is called
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alkalosis, making one dizzy and agitated
|
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when blood pH falls to range of 7.0-7.3
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acidosis, feeling of fatique or disoriented, making breathing difficult
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dissolve in water or react with water to release ions
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inorganic substances, placing them in catagory of electrolytes
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dissolve in organic liquids such as ether or alcohol, and if they do dissolve in water they do not release ions
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organic, placing them with non-electrolytes
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2 catagories of inorganic substances
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molecules and ions
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plays important role in transportation of chemicals within body
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water
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made up of 90-95% water
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blood plasma
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oxygen is received into body through
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inspiration
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inorganic compound produced as a waste product of expiration
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carbon dioxide
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major component of body fluids where most biochemical reactions occur, helps regulate body temp
|
water
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used in release of energy from glucose molecules
|
oxygen
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waste product that results from metabolism, reacts with H2) to form carbonic acid
|
carbon dioxide
|
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any chemical compound that enters into metabolic synthesis and contains both carbon and hydrogen atoms are called
|
organic
|
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simple carbs, or sugars include
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monosaccharides (single sugars-glucose,fructose,galactose) and diaccharides(double sugars-sucrose,lactose)
|
|
more complex carbs are called
|
polysaccharides-molecule of starch
|
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synthesized polysaccharide starch molecule is called
|
glycogen
|
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controls lipid metabolism, removing lipids from circulation and altering their molecular structures
|
liver
|
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building blocks of proteins
|
amino acids
|
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___ is process that occurs in the liver in order to remove the nitrogen containing proteins. these proteins are then converted to waste called ___
|
deamination, urea
|
|
primary means of heat loss of the body
|
radiation
|
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the heat moves from the body directly into the molecules of cooler objects you are in contact with
|
conduction
|
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continuous circulation of cooler air that is warmed over a surface, cool air is heated moving away from body and being replaced with cooler air moving toward body to be warmed, this continuous cycle of air circulated is
|
convection
|
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body temp rises producing sweat onto skin surface, it then evaporates carrring heat away to cool the skin
|
evaporation
|
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controls functions to regulate body temp
|
hypothalamus
|
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excessively lowered body temp from prolonged exposure to cold
|
hypothermia
|
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when air temp is higher than body temp and body continues to gain heat resulting in circulatory system collapse
|
hyperthermia
|
|
type of exercise involves constant muscle tension
|
isotonic
|
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produces change in muscle tension without changing muscle length, no muscles involved exercise
|
isometric
|
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exercise involves both muscle contraction and joint movement
|
isokinetic, lifting weights
|
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exercise that involves taking in more oxygen than required
|
aerobic
|
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exercise that requires less oxygen than body needs
|
anaerobic
|
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theraputic treatment exercises
|
range of motion (ROM) exercises
|
|
first line of defense to fight disease
|
white blood cells
|
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do their work outside circulatory system to protect against disease at cellular level
|
wbc or leukocytes
|
|
white blood cells grouped in granulocytes that have relatively short life span of 12 hours
|
leukocytes: neutrophils, eosinophil, and basophils
|
|
agranulocytes have 2 types of leukocytes
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monocytes and lymphocytes
|
|
largest cell found in blood
|
monocytes- a white blood cell in agranulocyte catagory
|
|
most active phagocytic(engulfing) leukocytes are
|
neutrophils and monocytes
|
|
basophils help to prevent intravascular blood clot formation by ___and increasing blood flow to injured tissues by
|
releasing heparin, releasing histamine
|
|
lymphocytes that produce antibodies
|
B lymphocytes (B cells)
|
|
produce biochemicals called cytokine for proper cell reproduction directly linked to immune responses
|
t lymphocytes (Tcells)
|
|
Largest lymphatic organ in upper left quadrant of abdomin
|
Spleen
|
|
Plasma cells release antibodies that are transported into blood and throughout body helping destroy bactia
|
Primary immune response
|
|
Following primary immune response bcells clone and remain dormant to serve as memory cells, so when antigen is reencountered the body uses these to attack
|
Secondary immune response
|
|
Direct exposure to live pathogens stimulate individual immune response
|
Naturally acquired active immunity
|
|
Exposure to vaccine, pathogen is killed or weakened stimulates immune response wout severe symptoms
|
Artificially acquired active immunity
|
|
Injection of gamma globulins, immunity for short time without stimulating immune response
|
Artificially acquired passive immunity
|
|
Antibodies passed thru placenta from mother with active immunity, short term immunity for infant
|
Naturally acquired passive immunity
|
|
Occurs immediately at site of injury at cellular level destroys harmful agent
|
Inflammatiom
|
|
3 or 4 days after injury macrophages debris the wound and synthesize collagen
|
Reconstruction
|
|
Final stage of wound healing developed scar and may take up to 2 yrs
|
Maturation
|
|
Wound with little tissue damage or loss, dr incision closed w sutures
|
Primary intention closure
|
|
Wound w tissue loss, edges are not approximated and is left open to close from inside out, higher risk ofinfection
|
Secondary intention closure
|
|
Delay in suturing, an abdominal wound left open for drainage and later sutured
|
Tertiary intention closure
|
|
Immediate reaction to a major injury, usually short term
|
Shock and disorientation
|
|
State of equilibrium within the human body
|
Homeostasis
|
|
Caused from not taking in enough fluids
|
Hypovolemia, fluid volume deficit
|
|
Excessive intake of parenteral fluids
|
Hypervolemia, fluid volume excess
|
|
3 major electrolytes that help keep body systems in check
|
Sodium, calcium, and potassium
|
|
Can occur from profuse sweating, vomiting, a sodium deficit
|
Hyponatremia
|
|
Sodium excess is referred to as
|
Hypernatremia
|
|
Occurs from excessive intake of salt without ingestion of water
|
Hypernatremia, sodium excess
|
|
Potassium deficit, use of diuretics or loss of fluid
|
Hypokalemia
|
|
Potassium excess, severe renal failure, severe burns
|
Hyperkalemia
|
|
Basic purpose of infusion therapy
|
Administer fluids w or w/o meds into circulatory system
|
|
Advantages of IV therapy
|
Rapid absorption and onset of action, in cress drug effect
|
|
Specific type of IV solution is determined by
|
Pt condition,Fluid balance, and purpose for iv
|
|
Refers to relative concentration of dissolved substances in solution as compared to solution concentration in RBCs
|
Tonicity
|
|
T/F IV solution should be isotonic (same concentration as RBCs)
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T
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Providing nutrition via IV bypassing gi tract
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Parenteral hyperalimentation
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Hyperalimentation solutions are infused thru
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Catheter in large central vein to prevent damage and irritation
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Initial steps for initiating iv
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Wash hands, gather materials, verify order
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Meds are added to IV in
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Pharmacy or nursing unit
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IV vary in size from
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100-2000cc
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External tab on IV bag for medications differs from entry port by
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Sealed w self-sealing protective rubber cover, entry port is sealed w plastic diagram
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Hang IV bag
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24-36 in above pt
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Inline chamber on IV is used to
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Mix or meter solutions by volume control set
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Wing tipped needles normally used in
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Peds or small veins like scalp
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Indwelling catheters are known as
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Over needle catheters used for long term therapy
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Inside the needle caths are used for
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Drug therapy, chemo
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Electronic infusion device used for
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Precise flow rate due to pt condition or meds given
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Infusion controller are used for
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Monitor of flow rate for meds that cause tissue damage
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To prime IV you must
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Insert spike fill drip chamber half way and flush tubing to eliminate air bubbles
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What is Put on IV bag
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Time strip, w start time at fluid level and stop time at empty level and hourly intervals
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T/F you can put IV in arm of mastectomy pt
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F- can cause edema
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For long term IV start IV in
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Most distal vein possible to preserve other sites for future use
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To reduce infection change IV sites every
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48-72 hrs
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When applying tourniquet
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Apply 3 inches above site, tit enough to obstruct venous flow bu t not arterial flow
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If u open clamp before u release tourniquet you will
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Blow the vein
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After IV is in place check pt and IV site
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Every hr
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Excess volume of IV fluid can cause
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Circulatory overload, cyanosis,edema, distended neck veins
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First thing u should check after u assess the pts condition is
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Infusion rate
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Infiltration occurs when
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Needle penetrates vein wall
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Characters of infection
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Redness pain edema
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Change IV tubing every
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24-48 hrs
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Kvo means
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Keep vein open, flow rate is set to slowest to prevent clotting
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Flush heparin lock every
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4-8 hrs with 2 ml of saline
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Hematest and specific gravity tests for
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Occult blood
Hydration |
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Normal specific gravity of urine
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1.005-1.025
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Normal fasting blood glucose levels
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70-115mg/dl
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Subjective data
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Pt description of problem
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Sf507 form should star with
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Addendum, it is a continuation form
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Inspection of body cavity or organ
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Endoscopic exam
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Total loss of vision limited to specific area of eye
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Anopsia- homonymous is same sided, heteronymous is opposite sides, hemainopsia is half blind
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No contacts can be worn --- when going for flying class 1 and 1a
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For 90 days before
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Used to test color vision
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Pseudoisochromatic plate set
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PIP is given for
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Color vision 14 plates
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Must be --- away from pip test plates
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30 inches
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If pt passes confrontation visual field test record
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Ftfc to indicate full to finger counting
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Normal breathing is 500 ml known as
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Tidal volume
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The amount of air that can be inspired beyond tidal volume is
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3100ml called inspiratory reserve volume
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Even after strenuous expiration --- air still remains in lungs
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1200ml residual volume
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Pft instructions That pt can understand
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The test shows how hard and fast u can breathe
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Initiates stimulation of the heart muscle to contract w electrical stimulation
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Sa sinoatrial node, pacemaker
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SA is located in
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Right atrial wall
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Sets pace of heart, sinus rhythms, and heart rate
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Sa node
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3 distinguishable waves on ecg
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Deflection waves
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Most commonly used during minor surgical procedures
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Knives with detachable blades
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Used to clamp blood vessel and tissues
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Hemostat
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When do u do wound cleaning
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After physician has examined it
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Actual removal of particles and dead tissue from wound
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Debridement
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Adhesive skin closure are used to
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Approximate wound edges in areas w minimal tension on wound
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3 types of anesthetic agents are
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Topical,local infiltration, digital blocks. Most common used is lidocaine (shoo sine)
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Lidocaine (xylocaine) w epi is used for
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Decrease bleeding by vasoconstricting
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Places u do not use epinephrin
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Fingers toes nose eArs, penis, or flap of skin
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Digital block is performed by
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Injecting anesthetic along the nerve path, not in the nerve
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Suctioning equipment must be strong enough to
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Provide airflow of 30 liters per min and vacuum 300 millimeters of mercury when clamped
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How to determine injury of unconscious pt
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Moi
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Pt is unalert and breathing is slower than 8 bpm
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Bag valve mask w high flow oxygen
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Pt is alert and breathing rate is faster than 24 bmp
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Give high flow oxygen by non rebreather mask
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Most common cause of airway destruction in conscious pt
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Large poorly chewed food
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If u can't find radial pulse u
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Feel carotid, if unable to feel it begin resuscitation immediately
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Check -- pulse when conscious, and --- pulse when unconscious
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Radial,
Carotid |
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Situations for immediate transport
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Child birth, poor gen impression,shock chest pain w systolic bp less than 100
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For responsive pt focus exam on
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Area of complaint
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For seated pt use short spine board or
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Ked- Kendrick extrication device
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Remains the Standby in wartime and disasters
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Army field litter
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Helps u gather additional info to further interventions
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Detaied physical, done in route to hospital, after initial and focused exam
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Racoon eyes is indication of
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Skull fracture
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Bluish discoloration of ears
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Battle signs- indication of basal skull fracture
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When light is shined in eyes they should
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Dilate in darkness and constrict in light, if already constricted it may be cns damage
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Used for pupil testing
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Perrla- pupils equal round reactive to light accomodation
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Addy RTFM al breathing in chest may be
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Hemothorax
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Asymmetrical breathing in chest may be
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Hemothorax, pneumothorax, flail chest, or sucking chest wound
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|
Emergency room log
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Generated every 24 hrs w list of pts seen in time period
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When irrigating eye
|
Hold irrigation tube 1/2 to 1 in above eye
|
|
Smashed finger or toe resulting in black andred
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Sublingual hematoma
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