Diagnostics Pre-test Flashcards

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Questions and Answers

What is the definition of Battery in a medical context?

A type of medication

A medical condition

Consent for treatment

Intentional, non-consensual touching of the patient (correct)

What are contraindications to venipuncture? (Select all that apply)

Extensive scarring (correct)

Ipsilateral mastectomy (correct)

Obvious area of skin infection (correct)

Healthy skin

What is a common complication of venipuncture?

Nausea

Infection

Thrombosis

All of the above (correct)

What is the target vein for venipuncture?

Median cubital vein Signup and view all the answers

What angle should the needle be inserted for venipuncture?

15-20 degrees Signup and view all the answers

Where should a tourniquet be placed during venipuncture?

3-4 inches above venipuncture site Signup and view all the answers

What direction should the bevel of the needle face when inserting for venipuncture?

Up Signup and view all the answers

What are the most commonly used catheters for IV access?

Over-the-needle catheters Signup and view all the answers

What gauge are large bore IVs typically?

16 or 18 gauge Signup and view all the answers

What is the most commonly used artery for arterial puncture?

Radial artery Signup and view all the answers

What is an indication for arterial puncture?

Obtaining true levels of gases in blood Signup and view all the answers

What is a common complication of arterial puncture?

All of the above Signup and view all the answers

What should be done to prevent hematoma after arterial puncture?

Apply pressure for 10 minutes Signup and view all the answers

What are contraindications for arterial puncture? (Select all that apply)

Negative Allen test Signup and view all the answers

Which sites are common for IM injections?

Vastus lateralis Signup and view all the answers

What is the optimal site for intradermal injection?

Ventral forearm Signup and view all the answers

What is the needle size range for local anesthesia?

27-30 gauge Signup and view all the answers

The _____ stitch lies in a plane perpendicular to the skin and is useful for closing deeper wounds.

Vertical mattress Signup and view all the answers

Incisions should be made along tension lines.

True Signup and view all the answers

What are the three conditions that must be met for informed consent?

Capacity, adequate information, voluntary consent Signup and view all the answers

What does PARQ stand for in medical consent?

Procedure, Alternatives, Risks, Questions Signup and view all the answers

Verbal consent is as binding as written consent.

True Signup and view all the answers

Study Notes

Battery

Intentional non-consensual touching of a patient.

Contraindications to Venipuncture

Avoid areas with skin infection, extensive scarring, or previous IV sites.
Do not puncture on the side of ipsilateral mastectomy, hematomas, or fistulas.

Complications of Venipuncture

Potential complications include infection, thrombosis, vein laceration, hematoma (most common), and vasovagal syncope.

Boundaries of the Cubital Fossa

Defined by lateral epicondyle, pronator teres, and brachioradialis muscles.

Target Vein for Venipuncture

The median cubital vein is the preferred site.

Venipuncture Angle

Insert needle at an angle of 15-20 degrees.

Tourniquet Placement

Apply 3-4 inches above the planned venipuncture site.

Needle Orientation for Venipuncture

Bevel of the needle should face upward during insertion.

Common Catheters for IV Access

Over-the-needle catheters are typically used.

Large Bore IV Size

Use 16 or 18 gauge needles for large bore IVs.

Contraindications to IV Access

Avoid IV access in burned, swollen, or injured extremities, cellulitis, and areas of poor circulation.

Common Artery for Arterial Puncture

The radial artery is predominantly used for this procedure.

Indications for Arterial Puncture

To obtain accurate levels of gases dissolved in blood to assess ventilation and oxygenation.

Complications of Arterial Puncture

Risks include hematoma (most common), thrombosis, arterial spasm, nerve damage, and rare infections.

Hematoma Prevention Post-Arterial Puncture

Apply pressure to the puncture site for 10 minutes to minimize hematoma formation.

Contraindications to Arterial Puncture

Avoid if the arterial pulse is not palpable, due to arterial diseases, coagulopathy, or infection in certain areas.

Common IM Injection Sites

Deltoid, ventrogluteal (first choice), vastus lateralis (preferred in infants), and dorsogluteal.

Purpose of Intradermal Injections

Commonly used for skin testing, including allergies and TB testing.

Needle Sizes for Injections

IM injections: 18-22 gauge, Subcutaneous: 26-29 gauge, Intradermal: 25-27 gauge.

Optimal Intradermal Injection Site

The ventral forearm is the best site for intradermal injections.

Endotracheal Tube Insertion Depth

In adults, the tube should be inserted 18-24 cm.

Sedatives for Endotracheal Intubation

Fentanyl and midazolam are commonly used sedatives.

Paralysis Agents for Intubation

Succinylcholine is typically employed for muscle relaxation during intubation.

Indications for Endotracheal Intubation

Necessary when a patient cannot maintain a patent airway or if they're at risk of inadequate ventilation.

Contraindications to Endotracheal Intubation

Laryngeal disruption can prevent intubation.

Contraindications for Applying a Cast

Do not apply casts during acute injury phases or over existing infections or wounds.

Types of Splints

Include gutter splint, posterior mold, and sugar tong splint.

Indications for Volar Splint

Used for fractures of the 4th and 5th phalanges and metacarpals.

Indications for Sugar Tong Splint

Effective for colles and forearm fractures.

Timing for Cast or Splint Checks

Re-assess the condition within 3-7 days after application.

Categories of Local Anesthetics

Classified into esters and amides.

Examples of Esters

Include benzocaine, cocaine, procaine, and tetracaine.

Examples of Amides

Include lidocaine, mepivacaine, bupivacaine, dibucaine, and prolocaine.

Factors Affecting Local Anesthesia

Rate of conduction, nerve fiber diameter, presence of myelin, anesthetic solution, vascularity, and concentration impact anesthesia effectiveness.

Indications for Local Anesthesia

Suitable for any procedure localized to one area with expected discomfort.

Contraindications to Local Anesthesia

Include unstable BP, true allergies, severe liver or renal disease, and mental instability.

Needle Size for Local Anesthesia

Use 27-30 gauge needles.

Type of Nerve Block for Incision & Drainage

A regional field block is typically used.

Incision Technique

Incisions should follow tension lines.

Common Complication of Local Anesthesia

The most frequent issue is anxiety over injection leading to a vasovagal reaction.

Systemic Complications of Local Anesthesia

May include hypotension, bradycardia, and central nervous system reactions.

Contraindications for Suturing

Assess each case individually; avoid in immunocompromised patients, grossly contaminated wounds, or puncture wounds.

Suture Sizes

Use 6-0 for facial lacerations; 3-0, 4-0, or 5-0 for torso or extremities.

Suture Placement Angle

Maintain a 90-degree angle or less during placement.

Time Frame for Sutures Removal

Face: 5 days; scalp, torso, extremities: 7-10 days; high-tension areas: 10-14 days.

Simple Interrupted Stitch

A basic suture technique with alternating throw motions.

Vertical Mattress Stitch

Suture lies perpendicular to skin; effective for deeper wound closure.

Horizontal Mattress Stitch

Stitch parallels skin; useful for tissue flaps or when tension needs to be applied to one side.

Continuous-Running Baseball Stitch

Utilizes a series of running stitches for effective closure.

Indications for Incision and Drainage

To address localized infections that are tender and not resolving.

Contraindications for Incision and Drainage

Avoid on facial furuncles near the mouth and abscesses near the rectum/genitalia in high-risk patients.

Patient's capacity for decision-making, provision of adequate information, and voluntary consent.

PARQ Elements

Procedure, Alternatives, Risks, Questions.

Reasonable Person Standard

Providers must disclose all material information necessary for a reasonable patient's decision-making.

Emergencies, patients unable to consent, waiver of consent, public health needs, and therapeutic privilege.

Therapeutic Privilege

Allows providers to withhold certain information based on patient's mental state, where disclosure may cause harm.

Verbal consent carries the same weight as written consent, though the latter is preferred.

Injection Degrees of Entry

Intradermal: 15 degrees, Subcutaneous: 45 degrees, Intramuscular: 90 degrees.

Anesthetic Injection Timing

Anesthetic should be injected upon withdrawing the needle.

Digital Block

Used to anesthetize fingers; beneficial for suturing and relocating fingers, utilizing 1-2% lidocaine without epinephrine.

Indication for Surgeon's Knot

Important when consistent tension must be maintained during closures.

Standard Precautions

Guidelines designed to reduce the spread of infectious diseases through contact with body fluids.

Surgical Hand Scrub Materials

Use chlorhexidine gluconate or povidone iodine solutions for effective sterilization.

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Description

This quiz covers essential terms and definitions related to diagnostics in healthcare, focusing on procedures such as venipuncture. It includes key concepts like battery, contraindications, and complications. Perfect for healthcare professionals preparing for examinations.