NHA Notes:
Module 1:
• Kidney disease = limit sodium
• Metabolism is impacted by age
• Honey is a simple carbohydrate/ simple sugar
• Excessive Exercising is a warning sign for anorexia
• Drug Scheduling/ Controlled:
• Schedule I: Weed, Heroin, LSD (The worst stuff, nonprescription)
• Schedule II: Meth, Cocaine, Fentanyl (Almost the worst,
nonprescription)
• Schedule III: Steroids, Ketamine, Testosterone (Mid stuff, 5-6 month
refill)
• Schedule IV: Xanax, Ambien, Ativan (Prescription Drugs, 5-6 month
refill)
• Schedule V: Easily accessible drugs (Year’s worth of refills)
• Patient Care Medical Home Definition: It is a care delivery model
supported by an interdisciplinary team and led by a primary care provider (PCP).
• Antihistamines: Allergies
• Antihypertensives: High Blood Pressure
• Diuretics: Increase Peeing
• Antipyretic: Reduces Fever
• Willow Bark: Pain Relief
• Gingko Bilbo: increases blood flow and helps memory
• Melatonin: Sleep Hormone
• Black Cohosh: Helps Menopause
• Methods of intaking Medicine:
• Subcutaneous: Under the skin
• Oral: Via Mouth
• Topical: applied on skin surface
• Vaginal: self explanatory lol
• Inhalation: Breathing via mouth or nose
• Side Effect: other effects that are known that can happen when taking a
drug
• Adverse Effect: Usually an allergic reaction
• Contradiction: it’s in the name
• Indication: Problems or symptoms the meds are for.
• Anticoagulants: delays blood clotting
• Bronchodilator: relaxes air way muscles.
• Antiemic: reduces nausea and vomiting
• Antipsychotics: controls psychotic symptoms.
Module 2:
• 5 stages of grief in order: Denial, Anger, Bargaining, depression,
acceptance.
• Smoking is a risk factor for COPD
• Aging is a risk factor for Osteoporosis
• High blood pressure is a risk for chronic kidney disease
• Eating high fat foods is a risk for colorectal cancer and inflammation
bowel diseases a risk
• CVA: Cerebrovascular Accident
• BP: Blood Pressure
• PVD: Peripheral Vascular Disease
• MI: Myocardial Infraction
• DO NOT ABBREVIATE MEDICATION NAMES
• Outbreak: Sudden rise of disease
• Endemic: Illness constantly present in a community
• Epidemic: disease that spreads rapids to a large population
• Pandemic: Pandemic World-Wide outbreak
**LOOK AT BASIC SKELETAL TERMS**
• Superior: Above
• Inferior: Below
• Anterior: Front or side (usually front)
• Dorsal: Back
• Lou Gehrig’s disease: AKA Amyotrophic lateral sclerosis disease, is a
fatal neurodegenerative disease. Affects motor neurons in the brain and spinal
cord.
• Homeostasis: the body keeping stability
• Anatomical Position standing up right
• GERN: detected via endoscopy and is acid reflux
• Diverticulosis: detected via colonoscopy, the muscular wall in the
colon
• Celiac Disease: Detected via upper endoscopy into biopsy, small
intestine
• UTI: detected via urine tests, urinary tract
• Spinal Cavity: Midline of back
• Thoracic Cavity: Chest Cavity
• Abdominal Cavity: Abdomen
• Pelvic Cavity: Pelvis
• Rheumatoid Arthritis: messes with connective tissue mainly in joints.
• Gout: accumulation of uric acid in joints, typically ankles
• Muscular dystrophy: inherited gene that affects muscle fibers.
• Myalgia: Term for general muscle pain
Module 3:
• BMI Levels:
• Underweight: 18.5 & below
• Normal: 18.5-24.9
• Overweight: 25-29.9
• Obese: 30+
• Obese I: 30-34.9
• Obese II: 35-39.9
• Obese III: 40+
• Different ways to check for temp:
• Auxiliary: Under the armpit and not very accurate
• Oral: Mouth, not for young children
• Tympanic: Ear
• Temporal Artery: on the “temples” least invasive and very accurate
• Rectal: most accurate mainly for infants
• respiration rates:
• Adult: 12-20 a minute
• Newborn: 30-60
• pulse oxidation 95% or higher
• Can use the earlobe or big toes if the finger isn’t available
• Any heart rate over 100 UNLESS IF THEY ARE 3 OR YOUNGER, is not normal
• Brady- : Slow
• Tachy- : Fast
• -Tension: blood pressure
• -Cardia: heart (rate)
• -Pnea: respirations
• Hypo- : Below
• Hyper- : Above
• Ortho- : Straight or Vertical
• Vital Signs: Body Temperature, Pulse Rate, Respiratory rate, and Blood
Pressure.
• Orthostatic Vital Signs: are different methods on taking vital signs in
different positions to check for things.
• Different Arteries:
• Femoral: Upper-Inner thigh, used for determined circulation on lower
extremities
• Brachial: Inner upper arm, used for blood pressure readings
• Radial: lower-inner arm, used for palpatory method for blood pressure
if brachial isn’t an option
• Carotid: Side of the neck, or for emergencies
• Blood Pressure ranges/ levels:
• Systolic (aka top number *#*/#): less than 120
• Diastolic (aka bottom number #/*#*): less than 80
• Normal: Top is below 120 and Bottom is below 80
• Elevated: Top is 120-129 and bottom is below 80
• Stage 1 Hypertension: top is 130-139 and bottom is 80-89
• Stage 2 Hypertension: Top is 140+ and bottom is 90+
• Hypertensive Crisis: 180/120+
• 98.6°F (37°C) is common known as the “average” body temp
• Auscultated: the act of listening to the body for signs
Module 4:
• Needle info:
• 18-22 gauge needles are larger and used for thicker medications or
drawing blood.
• 23-25 gauge needles are commonly used for intramuscular and
subcutaneous injections.
• 26-30 gauge needles are used for intradermal injections, insulin
administration, and other subcutaneous injections where minimal tissue damage is
desired.
• 5°-15° Intadermal
• 15°-35° intravenous
• 45°-89° Subcutaneous
• 90° IM aka intramuscular
• A month in medical terms is 30 days
• Multidose vials are only good for 28 days
• Clinical Decision support system (CDSS): Checks for medication
interactions and allergies
• Computerized provider order entry system (CPOE): it’s in the name
• Electronic health record system (EHR): digitalization of paper copies
• Electronic Medication administration record (eMAR): digital report
system for medication administration to someone by someone
• Prone: Whole body facing down
• Supine: Whole body facing up
• Left and right lateral: laying on the depicted side
• Semi-Fowlers: Sitting halfway-upright 45°
• Fowler’s: sitting upright 90°
• Trendelenberg: Laying on back at a slight backwards angle
• Lithotomy: on back with legs suspended upwards
• Sim’s: between lateral and prone
• Loratadine: a type of allergy medication
• Automated External Defibrillator: is for patients without a pulse and
who aren’t breathing
• CPR: is for lack of breathing and is unconscious
• Adipose means fat, insulin gets injected subcutaneously at 45°
Module 5:
• Money comes first on all things big, aka insurance
• 4 stages of wound healing & more info:
• Stage 1: Hemostasis, body tries to stop bleeding
• Stage 2: Inflammation, occurs at day 1-3. Pain, swelling, etc
• Stage 3: Proliferative, on day 3-21, the healing process
• Stage 4: Remodeling, New healthy skin takes place
• Dehiscence: Wound complication were edges don’t meet
• Evisceration: A wound complication and your abdomen guts are protruding
• Hemorrhaging: bleeding wound
• Infection: the wound is infected
• Mayo stand general info:
• Should be above the waist
• Stays 12 inches away
• The 1 inch edge of a sterile instrument package is considered non
sterile, including the outside of the packaging
• Everything makes a stop to the mayo stand when unpacking something
• Colposcopy: To examine inside the vagina and cervix
• Staples: For high tension
• Non absorbable Suture: used on skin that can be easily removed
• Sterile tape: used for not much tension
• Cyanoacrylate: used to make a strong bond flexible bond.
Module 6:
• Autoclave general info:
• Minimum temp of 121.1
• Unwrapped items stay for 20 minutes
• Exposure control plans get updated annually if nothing happens
• Staff gets reminded of blood borne pathogens annually
• If you touch something like blood, always wash yourself first then
report
• OSHA requires employees to have a Hepatitis B vaccine.
• Different precautions:
• Droplet: coughing or sneezing
• Airborne: SOL
• Contact: touch
• General term: Transmission-based precautions
• Common Infectious Disease Symptoms:
• Fever, headache, cough, runny nose, malaise, and sleepiness.
• 8 hours for Chemical Sterilization
• Asepsis = Eliminate & wash hands
• 15-20 minimum hand washing
• Alcohol based hand sanitizer minimum of 60% alcohol
• You can return to work after being fever-free for 24 hours without meds
Module 7:
• adult normal hearing can hear tones at 25 decibels
• Chain of custody is mandatory for some drug transportation
• Abnormal Tympanogram shows a flat line, normal shows peaks
• HbA1c (hemoglobin A1c): normal range is less than 5.7% to have diabetes
under control
• Don’t consume vitamin c or iron supplements before a fecal occult blood
testing for 3 days
• ^^^Same thing with antihistamines and skin tests
• Analytical phase is when things get maintained and calibrated
• 5-minute minimum time for an accurate pregnancy test
• Times & and collectors initials on collections
• Urine Collection Methods:
• 24-hour-urine: checks for sporadic substances
• Clean-catch: UTI, more chemical stuff
• Random: more like professional drug screening
• First void: first pee of the day
• Normal Total Cholesterol Levels: 130 to 200 mg/dL
• Order Entry is important
• 3 breathing tests for spirometry testing
• 15 minutes for scratch allergen testing for seeing wheels (skin
swelling)
Module 8:
• Characteristics of collecting timed specimens: They monitor therapeutic
medication levels
• EDTA tubes should be inverted 8 to 10 times
• 70% alcohol for skin disinfection prior to a phlebotomy test
• IMPROPER DATA ENTRIES ARE IMPORTANT
• Butterfly needle system info: 22-gauge, 1/2 inch
• Stop everything and alert provider if they’re an emergency
• HALF AND HOUR 30 min prior time before centrifugation
• Antecubital Vein first
• Color of blood tubes:
• Light Blue: Sodium Citrate
• Red: Clot Activator
• Green: Lithium Heparin
• Tiger: Serum Separator Gel
• Lavender: EDTA
• Gray and red marbled: clot activator & serum separator gel
• Gray: Sodium fluoride
• Gold: SST
• Yellow: ACD Solution
• Order: Blue, red, gold, green, lavender, gray, yellow
• 15 minutes minimum for leaving the bandage after a phlebotomy or
capillary puncture
• Ask about past events involving a phlebotomy if patient seems anxious
• Diagnosis code on a laboratory requisition form
Module 9:
• Somatic Tremors (aka involuntary muscle movement) produce irregular
spikes on a 60-cycle interference in EKG tracing
• Wandering baseline is from breathing or patient wearing lotion or cream
on their skin
• Interrupted baseline is from breaks in EKG tracing
• Frequency spikes can be from near by electrical equipment
• EKG 12 Lead placement, 10 electrodes, 6 chest, 4 limb:
• V1 is placed in the 4th intercostal space, right sternal border, Red
• V2 in the 4th intercostal space, left sternal border, Yellow
• V3 midway between V2 and V4, Green
• V4 in the 5th intercostal space, mid-clavicular line, Blue
• V5 in the 5th intercostal space, anterior axillary line, Orange
• V6 in the 5th intercostal space, mid-axillary line, Purple
• RA: right arm, mid upper, White
• LA: Left arm, mid upper, Black
• RL: Right Leg, any part above ankle, green
• LL: Left leg, any part above ankle, red
• Atrial Fibrillation: characterized by irregular rhythms, no P wave, and
narrow QRS complexes
• Semi-fowlers assists breathing
• Electrolyte gel is a conductor
• Wave meanings
• P Wave: atrial depolarization
• T Wave: Ventricular repolarization
• Q Wave: early Ventricular depolarization
• U Wave: late ventricular repolarization
• Sinus has narrow QRS complexes
• Ventricular has wide QRS complexes
• The duration of a standard calibration box is 0.2 seconds, the height
is 10mm
• Supine is the best position for a EKG
• Have the patient sit on their hands if there are too many somatic
tremors
Module 10:
• Female Patient need to start annual mammograms at 45 years of age
• Live Video substitutes in-person
• Colorectal cancer screenings start at 45 years old
• Long-term care facilities are for people who can no longer take care of
themselves
• A 65-year-old who has a history of smoking should get screenings to
check for Abdominal Aortic Aneurysm
Module 11:
• Clearinghouse: cleans outs claims from third-party payers
• A/R aging report: Accounts Receivable, money owed
• A/P aging report: Accounts Paid, money paid out
• Health Care Facilities give out usernames and access codes to log into
patient portals
• Elective and costly medical services can require preauthorizations
• Medical Equipment Inspection logs document timelines of scheduled
maintenance
• Interoperability: really important documentation
• Reconciliation: making sure patients have the proper amount in their
account
• Practice management software includes patient medical records and the
encounter form
• Diagnosis codes (ICD-10-CM): reason for patient visits
• ICD-10-PCS: for hospital or inpatient only
• Procedure codes (CPT): treatment or services rendered by provider
• HCPCS: for admin of medication and durable medical equipment
• Drop down menus = greater accuracy
• Provider Preferences = change duration
• Medical Necessity should be supported with code selections
• Advance Beneficiary Notice of Non coverage may not be covered by a fee-
for-service Medicare plan
Module 12:
• Virtual Visits are mainly communication based
• Active Listening includes paraphrasing
• Communication between medical professionals can use more complex words,
not with patients
• All types of communication must be documented period.
• When situations escalate always get a higher-up
• Therapeutic communication can encourage and support the patient
• If the patient is upset in any sense, let them get through it and
support them
• Kinetic, Kin-, or Kine-, pertains to hands on. Touch, using hands, etc.
• Closed Ended questions: direct and get a simple answer
Module 13:
• Be aware of possible domestic abuse. If someone is bruised and hurt all
over and/or all at different stages it could be abuse
• Some states don’t allow a health care provider or health care employees
to be a patient’s health care proxy
• Employers are NOT covered entities under HIPAA
• Patients with a DNR can receive chemotherapy, antibiotics, dialysis, or
any life-sustaining treatments
• If a patient is seeing a different health care provider, they need to
sign the information release form
• OSHA = Work place safety
• HIPAA = Patient Privacy
• Duty of care: think about it
• Patient’s bill of rights: the right for all information regarding
treatment and procedures
• CLIA (Clinical Laboratory Improvement Amendments): a group of laws that
handle testing and specimens
• Health Information Technology for Economic and Clinical Health
(HITECH): prohibits the sale of a PHI (protected health information)