Clinical Care Extender

Front 1

Uniform

Back 1

-tucked polo
-khaki pants
-ID badge
-white tennis shoes
-a black pen (can include notebook)

Front 2

Signing up for shifts

Back 2

-you should only sign up for one shift per week until calendar is finalized
-a blank calendar will be available for shift sign ups from the 1st through 25th of the month
-all scheduling through email

Front 3

shift hours

Back 3

7-11
11-3
3-7
7-11

Front 4

Protocol for Missing a Shift

Back 4

This is for an emergency--if known notify 3-4 days before shift

-call hospital, speak to charge nurse 15 minutes AFTER scheduled shift
-email dept coordinator with explanation

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timesheet

Back 5

-first thing and last thing you do
(YOU MAY NOT SIGN IN AND OUT AT THE SAME TIME)

Front 6

what you do on your timesheet

Back 6

-round to the nearest quarter hour
-always sign top section
-take 30 minute break for back to back shifts

Front 7

competency checklist

Back 7

-must be filled in the 2nd week of every rotation
(DO NOT have to if the second time in a row in the same dept)
-fill it out with RN only
-placed next to timesheet in binder

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Code Grey

Back 8

-Combative or disruptive person is confronting hospital stagg
-If in the area-- go to the place of the code
--To report, dial 6--Report name and location

Front 9

Code Red

Back 9

-Fire
-Report by dialing 6
-Close all doors in the area
-If you hear code red wait and follow instructions from staff

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Code Blue

Back 10

-Medical Emergency
-Report by dialing 6 and give name and number

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Code Purple

Back 11

-Child abduction
-Look for suspicious situations
-Report all incidents to security

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Code Orange

Back 12

-Hazardous materials spill
-Dial 6 and report name and location
-do not attempt to clean up manually
-try to block off area

"Orange you glad you didn't spill that on yourself"

Front 13

Code Yellow

Back 13

-Bomb Threat
-If you get the call get as much info as possible--i.e. where it is, what it loks like, when is it set to go off
-then dial 6

- if you hear the code wait for instructions

Front 14

Code Silver

Back 14

-person with a weapon or hostage situation
-dial 6 to repot
-if you hear code silver DO NOT go to the situation

Front 15

Code Pink

Back 15

-Infant Abduction
-dial 6 to report
-look for suspicious things like duffle bags unattended
-nurses carrying babies must always use bassinets
-make sure everyone has name tag

Front 16

Code White

Back 16

-Infant/Pediatric medical emergency
-dial 6 to report emergency

Front 17

Additional Emergency Codes

Back 17

-Triage Internal: Internal Disaster Emergency
-Triage External: External Disaster Emergency
-Code Trauma: Extra Patient Care Support Needed
-Code Edison: Impending Power Outage

Front 18

Fire extinguisher operation acronym

Back 18

P-ull ring from handle
A-im nozzle at base of fire
S-queeze handle
S-weep from to side to side at base of fire

Front 19

In case of fire in your area...

Back 19

R-escue those patients in danger
A-ctivate alarm
C-lose all doors
E-xtinguish fire if possible
E-vacuate area if necessary

Front 20

Standard precautions should be followed by ALL personnel at ALL times on ALL patients

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Many patients with infectious diseases do not have apparent symptoms, nor can they be visibly recognized as being infected, so standard precautions must be followed at all times

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HAI

Back 21

Healthcare associated infection

-Any infection that develops in a patient who is cared for in any setting where healthcare is delivered
-HAI's are one of the top leading causes of death in the US

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Nosocomial infection

Back 22

An infection that is acquired while a patient is in the hospital

Front 23

PPE

Back 23

Personal Protective Equipment
-used to reduced exposure i.e. gloves, gowns, masks

Front 24

Resistant Organisms

Back 24

-bacteria that are not susceptible to certain antibiotics
-usually occur in hospitals
-MRSA

Front 25

All bodily fluids are...

Back 25

potentially infectious

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Viruses

Back 26

-non living
-no organelles
-DNA or RNA but can't be both
-single or double stranded
-enveloped or non-enveloped

Front 27

Five things you can do to prevent infections

Back 27

1) Wash your hands
2) Gloves-- especially body fluid exposure
3) Cover your mouth and nose
4) If you are sick, avoid close contact with others (DON'T GO TO THE HOSPITAL)
5) Get shots to avoid disease (get vaccinations!)

Front 28

When are you allowed to transport blood?

Back 28

Blood transferred out---yes
Blood transferred in--- NO!

Front 29

Low resistance patients in hospitals

Back 29

-newborns
-the elderly
-surgical
-icu
-nutritionally, physically depleted
-immune compromised (transplant, HIV, chemo)

Front 30

Transmission Based Precautions

Back 30

1) Contact
2) Droplet---within 3 feet
3) Airborne--remain in air for long periods of time

Front 31

Airborne patients

Back 31

Are kept in special air handling and ventilation systems (Negative Pressure Isolation Rooms)

Front 32

TB Isolation Rooms

Back 32

-TB patients are kept in TB isolation rooms
-Clinical Care Extenders are never allowed to enter TB isolation rooms
-have negative pressure

Front 33

Anatomical position

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Patient's body is erect

Head eyes, toes and palms are directed forward with limbs at sides of body

Front 34

Anterior v. Posterior

Back 34

Anterior: Face or front side

Posterior: Back side (dorsal)

Front 35

Medial v. Lateral

Back 35

Medial: Toward the midline of the body

Lateral: Away from the midline of the body

Front 36

Proximal v. Distal

Back 36

Proximal: close to middle of body

Distal: away from midline of body, away from torso

Front 37

Cranial v. Caudal

Back 37

Cranial: towards the top of the head

Caudal: towards the hind parts or tail

Front 38

Superior v. Inferior

Back 38

Superior: Above or over something, based on a reference point

Inferior: Below or under something, based on a reference point

Front 39

Flexion v. Extension

Back 39

Flexion: Closing of a joint

Extension: Opening of a joint

Front 40

Supination v. Pronation

Back 40

Supination: Palm of hand faces forward/ventrally

Pronation: Palm of hand faces backward/ocassionally

Front 41

Supine v. Prone

Back 41

Suprine: Lying down facing ceiling

Prone: Lying down facing the floor (on stomach)

Front 42

Eversion v. Inversion

Back 42

Eversion: Soles of foot faces outward

Inversion: Soles of foot faces inward

Front 43

ADDuction v. ABDuction

Back 43

Adduction: move toward the midline

Abduction: moves away from midline

Front 44

Trendelenburg Position

Back 44

Patient's head is low and legs are elevated

Used to treat shock

Front 45

Reverse Trendelenburg Position

Back 45

-Patient's head is elevated and feet are lowered

-Used for head trauma victims

Front 46

Fowler's Position

Back 46

-Semi sitting position with hip at angle of 45-60 degrees

Front 47

Semi Fowler's Position

Back 47

-Semi sitting position with knees flexed and supported by a pillow

Front 48

CT

Back 48

Computerized Axial Tomography

Specialized x-ray used to examine soft tissues like the liver, brain, or pancreas

Front 49

MRI

Back 49

Magnetic Resonance Imaging

Uses magnetic fields and radio waves to create cross sectional images of head/body

Front 50

C-Arm

Back 50

X ray machine used in surgery to take pictures of spine without moving patient

Front 51

Chest Tube

Back 51

Inserted through the side of the chest into the pleural space

Use to remove air, fluid, pus

Front 52

EKG/ ECG

Back 52

Electrocardiogram

Records electrical activity of heart

Front 53

BM

Back 53

bowel movement

Front 54

CBC

Back 54

Complete Blood Count: Percent of each cell type (i.e. RBC's)

Front 55

KVO/TKO

Back 55

Keep Vein Open: Order to keep just enough flow through IV to keep vein open

Front 56

NPO

Back 56

Non per os- nothing by mouth must withhold all oral food and liquid from patient

Front 57

PO

Back 57

Per os- Administer by mouth

Front 58

PR

Back 58

Per Rectum: Administer rectally

Front 59

Inpatient

Back 59

Administered to hospital for overnight stay

Front 60

Outpatient

Back 60

Patient checks into the hospital and leaves the same day as their procedure

Front 61

Sign v. Symptom

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Signs are objective and detected by physicians (NOT NURSES)

Symptoms are subjective and reported by patients

Front 62

Ecchymosis

Back 62

bruise

Front 63

Chambers in heart

What is the pathway of blood

Back 63

Right and Left Atrium

Right and Left Ventricle

deoxygenated blood moves from right atrium to right ventricle

right ventricle pumps blood to lungs where it becomes oxygenated

newly oxygenated blood returns to left atrium

it is then pumped into left ventricle

Front 64

More detailed blood path

Back 64

Left ventricle--->Aorta--->Arteries--->Arterioles--->Capillaries---->Venules---->Veins---->Vena Cava---->Right Ventricle

Front 65

Atherolerosis

Back 65

Disease in which fatty material is deposited in the walls of arteries

Front 66

MI

Back 66

Myocardial Infarction AKA heart attack

Loss of blood supply to the heart

Front 67

CHF

Back 67

Congestive Heart Failure

Failure of heart to pump blood effectively

Front 68

Stroke

Back 68

Loss of blood supply to the brain
a "brain attack"

Front 69

Shock

Back 69

Decreased perfusion of blood to body tissues

Front 70

A little on lungs

Back 70

Right lung: 3 lobes
Left lung: 2 lobes

Front 71

Flow of air

Back 71

Nose/Mouth---->Pharynx------->Larynx----->Trachea----->Bronchus------>Bronchi----->Bronchiole---->Alveoli

Front 72

Pleura

Back 72

layer of tissue covering the lungs

Front 73

5 ways to identify a patient

Back 73

1) Ask them an open ended question
2) Wristband
3) Whiteboard
4) Chart
5) Ask nurse

Front 74

In cultural diversity in the hospital what are two things to keep in mind?

Back 74

Respect and communication

Front 75

What is the range of Cultural Competence

Back 75

Cultural Destructiveness
Cultural Incapacity
Cultural Blindness
Cultural Precompetence
Cultural Competence*
Cultural Proficiency

Front 76

Neonates

Age Range and Risk Factors

Back 76

Age Range: newborns to one month

Risk Factors: Aspiration and Suffocation

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Infants

Age Range and Risk Factors

Back 77

Age Range: one month to one year

Risk Factors: Aspiration, Suffocation and Falls

Front 78

Toddlers

Back 78

Age Range: 1 year to 3 years

Risk Factors: Choking, Injury, and Infection

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Preschool and School Age

Back 79

Age Range: 4 to 12 years

Risk Factors: Injury related to falls/ bodily damage, trauma due to abuse, asthma, and fluid/electrolyte imbalance

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Adolescents

Back 80

Age Range: 13-18 years

Risk Factors: Substance abuse, depression/suicide, and sexually transmitted diseases

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Young Adults

Back 81

Age Range: 18-40

Risk: Substance abuse, increased stress, midlife crisis, and quarterlife crisis

Front 82

Middle Adults

Back 82

Age: 40-64

Risk: Hearing and eyesight decline, bone and joint pain, and late middle life crisis with an inability to cop

Front 83

Older Adults

Back 83

Age: 65+

Risk: decreased skin integrity, apiration, sleep pattern disturbances and risks for falls, sensory and perceptual alterations

Front 84

What is the patient care team?

Back 84

All of the various health care professionals and hospital personnel that directly or indirectly participate in patient care

Patients are the final decision makers for the patient care team

Front 85

Scope of Practice

Back 85

Defines the duties or services that is a particular health are practitioner is authorized to perform

Some are authorized to practice independently

Some are not

Front 86

Allied Health Careers

Back 86

Athletic Trainer
Cardiovascular Technologist/ Technician
Diagnostic Medical Sonographer
Exercise Scientist
Medical Assistant
Medical Interpreter
Nuclear Medicine Technologist
Opthalmic Laboratory Technician
Optician (dispensing)
Pathologist's Assistant
Clinical Laboratory Scientist
Clinical Laboratory Technologist
Surgical Technologist
Respiratory Therapist
Rad/Xray/Ultrasound Tech
Registered Dietician (RD)
Occupational Therapist (OT)

Front 87

Most important member of the patient care team

Back 87

the patient

Front 88

How do I provide customer service?

Back 88

-Do you know what part of communication is effective, between words, tone, and body language?

MOST of your message is from your body language

Front 89

On every shift

Back 89

When you get to the floor , introduce yourself to the charge nurse
-They might assign you to a CNA
-Walk the floors
-Refill things and talk with patients

Front 90

Get permission from the nurse before doing the following

Back 90

-Giving water
-Giving food
-Bringing a blanket
-Walking a patient to the bathroom

Front 91

Make yourself available to the nurses by...

Back 91

Introducing yourself and asking if there is anything you can do

If you were trained but feel uncomfortable say would you mind if you showed me this time?

Front 92

Stuff you can do on shift

Back 92

-Restock
-Talk to patients
-Help nurses and CNAs
-Update staff names on patient whiteboards after shift changes
-Assisting in room turnover
-Breaking down binders
-Filling out Patient Ambassador forms

Front 93

What is HIPAA?

Back 93

Health Insurance Portability and Accountability Act

Initially intended to make it easier for patients to move from one insurance plan to another

It establishes a standard format

But it also increase risk of misuse

Requires that patients be made aware of their rights and how to protect their information

Front 94

What does PHI stand for and details

Back 94

Protected Health Information

PHI is considered confidential under HIPAA

Front 95

In reporting, what is a sentinel event

Back 95

An unexpected occurence involving death or serious physical injury, or the risk thereof

These must be reported

Front 96

What are the six vital signs and their ranges?

Back 96

1) Pulse/Heartrate: 60-100
2) Blood Pressure: Systolic/Diastolic

Systolic: 100-140, Diastolic: 60-90

3) Temp: within one degree of 98.6
4) Pain: on a scale of 0-10, 0 being no pain, 10 being the worst pain you've ever felt, report after 7
5) Ox Rate- red light on finger nail
6) Respiration Rate, 12-20 per minute

Front 97

Axillary Temperature

Back 97

Under the arm and used only when all other methods don't work

Longest and least accurate method

Front 98

Normal Resting Heart Rate

Back 98

Adults: 60- 100 bpm
Children: 80- 100 bpm
Toddlers: 100-120 bpm
Infants: 120- 160 bpm

Front 99

Normal Breathing Rates:

Back 99

Adult: 12-20
Children: 15-30
Newborns: 30-60

Front 100

Normal 02 levels

Back 100

report below 90 although 98 is normal