Download 2- Instructor`s Resource Manual Key Term Assessment A. Definitions

KEY TERM ASSESSMENT
A. Definitions
1. C
13. O
2. Q
14. D
3. U
15. T
4. E
16. H
5. K
17. A
6. N
18. I
7. R
19. W
8. J
20. M
9. V
21. S
10. L
22. F
11. P
23. B
12. G
B. Word Parts
Directions: Indicate the meaning of each word part in the space provided. List as many medical
terms as possible that incorporate the word part in the space provided.
Word Part
Meaning of Word Part
1. aer/o
air
2. an-
without
3. anti-
against
Medical Terms That Incorporate
Word Part
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4. septic
infection
5. a-
without
6. micro-
small
Word Part
Meaning of Word Part
7. non-
not
8. path/o
disease
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Medical Terms That Incorporate
Word Part
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9. -gen
producing
10. para-
apart from
11. enter/o
intestine
12. -al
pertaining to
13. peri-
surrounding
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Instructor’s Resource Manual
14. natal
pertaining to birth
15. post-
after
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EVALUATION OF LEARNING
1. List four examples of types of microorganisms.
Bacteria, viruses, protozoa, fungi, and animal parasites.
2. Define medical asepsis.
Practices that are used to reduce the number and hinder the transmission of pathogens;
something that is medically aseptic is clean and free from infection.
3. What type of microorganisms may remain on an object that is considered medically aseptic?
Pathogen.
4. What is the name given to an organism that uses organic or living substances for food?
Heterotroph.
5. Why do most microorganisms prefer a neutral pH?
If the environment of a microorganism becomes too acidic or basic, it dies.
6. List five examples of how microorganisms can enter the body.
Mouth, nose, throat, ears, eyes, intestinal tract, reproductive tract, open wounds, breaks in
the skin, and mucous membranes.
7. List three examples of how a microorganism can be transmitted from one person to another.
Direct contact with an infected person or discharge; indirect transfer through droplet
infection from the lungs; contaminated hands and equipment; contaminated food and water;
and insects.
8. List four examples of factors that would make a host more susceptible to the entrance of a
pathogen.
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Poor health, poor hygiene, poor nutrition, and stress.
9. List five protective devices of the body that prevent the entrance of microorganisms.
The skin, the mucous membranes of the body, mucus and cilia in the nose and respiratory
tract, coughing and sneezing, tears and sweat, urine and vaginal secretions, and
hydrochloric acid secreted by the stomach.
10. What is the difference between resident flora and transient flora?
Resident flora (also known as normal flora) reside and grow in the epidermis and deeper
layers of the skin (dermis) and are generally harmless and nonpathogenic and difficult to
remove from the skin. Transient flora live and grow on the superficial skin layers
(epidermis), are picked up on the hands in the course of daily activities, are often
pathogenic and attached loosely to the skin, and can be removed easily by proper hand
hygiene.
11. List three examples of when handwashing should be performed in the medical office.
When the hands are visibly soiled, before eating, and after using the restroom.
12. How does antiseptic handwashing sanitize the hands?
Through mechanical scrubbing action and through the action of the antiseptic.
13. List five examples of when an alcohol-based hand rub may be used to sanitize the hands.
Before and after patient contact; before and after removing gloves; after contact with body
fluids or excretions, mucous membranes, nonintact skin, and wound dressings (as long as the
hands are not visibly soiled); when moving from a contaminated body site to a clean body
site during patient care; and after contact with inanimate objects when providing patient
care.
14. What are the advantages and disadvantages of alcohol-based hand rubs?
Advantages: Usually more accessible than sinks, do not require rinsing, less time involved,
and contain emollients to prevent the hands from drying out.
Disadvantages: More expensive than soap and cause a brief stinging sensation if applied to
broken skin.
15. List six medical aseptic practices that the medical assistant should follow in the medical
office.
Following the OSHA Bloodborne Pathogens Standard.
Keeping the medical office free from dirt and dust.
Ensuring the reception area and examining rooms are well ventilated.
Keeping the reception area and examining rooms bright and airy.
Eliminating insects.
Carefully disposing of wastes such as urine, feces, and respiratory secretions.
Not letting soiled items touch clothing.
Avoiding coughs and sneezes of patients.
Wearing minimal jewelry or no jewelry at all.
Teaching patients aseptic practices to control the spread of infection at home.
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16. What are advantages of latex gloves?
They are soft and elastic, which allows them to stretch to fit more comfortably; they are thin,
which allows for a better feel, dexterity, and grip; they are lower in cost than most non-latex
gloves, and they have a proven barrier protective capability.
17. What guidelines should be followed when working with gloves?
a. Keep fingernails trimmed short (less than ¼-inch long) to reduce the risk of tearing gloves.
b. Wear correct size gloves. Gloves that are too small may rip during application or become
uncomfortable to wear. Gloves that are too large make it difficult to perform tasks.
• Do not use oil-based hand lotions or creams because they can damage and deteriorate
latex gloves.
c. Do not store gloves in areas where there are extremes in temperatures (near heater or air
conditioner). This can cause deterioration of the gloves.
18. What does the acrynom OSHA stand for, and what is the purpose of OSHA?
Occupational Safety and Health Administration; the purpose of OSHA is to assist employers
in providing a safe and healthy working environment for their employees.
19. What is the purpose of the OSHA Occupational Exposure to Bloodborne Pathogens
Standard?
To reduce the risk to employees of exposure to infectious diseases.
20. Who must follow the OSHA Standard? List examples.
The OSHA standard must be followed by any employee with occupational exposure.
Examples are MAs, physicians, nurses, dentists, dental hygienists, medical laboratory
personnel, emergency medical technicians, correctional and law enforcement officers,
firefighters, hospital laundry workers, morticians, and custodians.
21. What is the purpose of the Needlestick Safety and Prevention Act?
To reduce needlestick and other sharps injuries among health care workers.
22. List five examples of other potentially infectious materials (OPIMs).
Semen and vaginal secretions; cerebrospinal, synovial, pleural, pericardial, peritoneal, and
amniotic fluids; any body fluid that is visibly contaminated with blood; any body fluid of
which the identity is unknown; saliva in dental procedures; any unfixed human tissue; and
any tissue culture, cells, or fluid known to be HIV-infected.
23. List examples of nonintact skin.
Skin with dermatitis, abrasions, cuts, burns, hangnails, chapping, and acne.
24. What is the purpose of the exposure control plan (ECP)?
To stipulate the protective measures that are taken by the medical office to eliminate or
minimize employee exposure to bloodborne pathogens and other potentially infectious
materials.
25. List three examples of items to which a biohazard warning label must be attached.
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Containers of regulated waste; refrigerators and freezers used to store blood and OPIM; and
containers used to store, transport, or ship blood or OPIM.
26. What is the purpose of a Sharps Injury Log? What type of offices must maintain this log?
The purpose of the log is to help employers and employees keep track of all needlestick
injuries to help identify problem areas that need attention and ineffective devices that may
need to be replaced. The log must be maintained by employers with more than 10 employees
at risk for occupational exposure.
27. Define an engineering control, and list three examples of engineering controls.
All control measures that isolate or remove health hazards from the workplace; examples
include readily accessible handwashing facilities, safer medical devices, biohazard sharps
containers and biohazard bags, and autoclaves.
28. What is a safer medical device?
A device, based on reasonable judgment, that would make an exposure incident involving a
contaminated sharp less likely to occur.
29. What should be done before and after gloves are applied?
The hands should be sanitized.
30. List six guidelines that must be followed when using personal protective equipment.
Protective equipment must not allow blood or other potentially infectious material to pass
through it.
The employer must provide appropriate personal protective equipment at no cost to you and
ensure that the equipment is available, readily accessible, and used correctly.
Alternatives, such as non-latex and powderless gloves, must be provided for employees who
are allergic to latex gloves.
If your gloves become contaminated, torn, or punctured, replace them as soon as practical.
If a garment is penetrated by blood or other potentially infectious materials, it must be
removed as soon as possible and placed in an appropriately designated container for
washing.
All personal protective equipment must be removed before leaving the medical office.
When protective equipment is removed, it must be placed in an appropriately designated area
or container.
Utility gloves may be decontaminated and reused.
If you believe that using protective equipment would prevent proper delivery of health care
or would pose an increased hazard to your safety or that of a coworker, in extenuating
circumstances you may temporarily and briefly decline its use.
31. List four guidelines that must be followed with respect to biohazard sharps containers.
Locate them as close as possible to the area of use, maintain in an upright position, do not
reach into the container with your hands, replace them on a regular basis (recommendation:
3⁄4 full), and do not allow them to overfill.
32. What procedure should be followed when a sharps container located in an examining room
becomes full? Explain the reason for your answer.
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Close the container, and then remove it from the room. This prevents protrusion or spilling of
the contents of the container.
33. Explain how to prepare regulated medical waste for pickup by a medical waste service.
Place biohazard bags and sharps containers into a box provided by the medical waste
service. Seal it securely with packing tape. A biohazard warning label must appear on two
opposite sides of the box.
34. How should regulated medical waste be stored while waiting for pickup by the medical waste
service? Explain why.
In a locked room inside the facility or in a locked collection container outside for pickup by
the medical waste service. The storage area should be labeled with one of the following: an
Authorized Personnel Only sign or the biohazard symbol. Regulated waste is stored in a
locked area to prevent unauthorized access to such items as needles and syringes.
35. What information is included on a regulated medical waste tracking form?
Type and quantity of waste (in pounds) and where it is being sent. After waste is destroyed, a
record documenting its disposal is sent to the office.
36. What is the most likely means of contracting hepatitis B in the health care setting?
Through contact with blood and blood components, such as serum or plasma.
37. What side effects may occur after the administration of a hepatitis B vaccine?
Mild side effects, such as soreness at the injection site; serious reactions are extremely rare.
38. What post-exposure prophylaxis (PEP) is recommended for an unvaccinated individual who
has been exposed to hepatitis B?
Administration of hepatitis B immune globulin (HBIG), which is a passive immunizing agent,
and administration of the hepatitis B vaccine, which is an active immunizing agent.
39. What are the symptoms of acute viral hepatitis B in individuals who have symptoms?
Fatigue, headache, loss of appetite, nausea, vomiting, malaise, muscle and joint pain,
abdominal pain, dark urine, clay-colored stools, jaundice, and an enlarged and tender liver.
40. Why is chronic viral hepatitis B considered such a serious condition?
Patients with chronic hepatitis face an increased risk of liver damage that leaves them
vulnerable to developing such diseases as cirrhosis of the liver and liver cancer.
41. Why is chronic hepatitis C known as “an epidemic that occurred in the past?”
A large number of individuals became infected with hepatitis C more than 30 years ago and
are just now being diagnosed with it.
42. What are the symptoms of acute HIV infection?
Fever, sweats, fatigue, loss of appetite, diarrhea, pharyngitis, myalgia, arthralgia, and
adenopathy.
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43. Explain what occurs during the asymptomatic period and the symptomatic period of the
AIDS infection cycle.
Asymptomatic period: The patient has no symptoms, but the virus is multiplying and
destroying CD4+ T cells, which causes a weakening of the immune system. The patient
produces HIV antibodies, but they are unable to destroy the virus. The patient can transmit
the virus during this stage.
Symptomatic period: Chronic enlargement of the lymph nodes, lack of energy, weight loss,
recurrent fevers and sweats, diarrhea, persistent or frequent yeast infections, and persistent
skin rashes.
44. What are the characteristics of full-blown AIDS?
The presence of opportunistic infections and unusual cancers.
45. How is HIV transmitted? How is it not transmitted?
HIV is transmitted through sexual contact with an infected person, sharing drug injection
needles with someone who is infected, or transfer from an HIV-infected mother to her infant
and through breast milk. HIV is not transmitted through casual contact or even extensive
contact among family members.
46. List five AIDS-defining conditions.
Kaposi’s sarcoma, Pneumocystis carinii pneumonia, cytomegalovirus infection, herpes
simplex 1 and 2, mycobacterial infections, candidiasis, cryptosporidiosis, toxoplasmosis, and
cryptococcosis.
47. What is the CDC’s definition of AIDS?
HIV-positive and a CD4+ T cell count less than 200 cells/mL or the presence of one or more
AIDS-defining conditions.
CRITICAL THINKING ACTIVITIES
A. Infection Process Cycle
Carefully review the infection process cycle and the requirements for growth needed by
microorganisms. Create an environment in a medical office that would function to interrupt the
infection process cycle and discourage the growth of pathogens.
Answers vary based on individual student responses. Examples of responses are provided.
Practicing good hand hygiene.
Keeping the office clean and free from dirt and dust.
Ensuring that the office is well ventilated.
Eliminating insects.
Properly disposing of waste.
Limiting the amount of jewelry worn.
Not letting soiled items touch clothing.
Having tissues available for patients who are coughing and sneezing.
B. Handwashing
Using the principles outlined in the handwashing procedure, explain what may happen under the
following circumstances:
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1. The medical assistant’s uniform touches the sink during the handwashing procedure. The
uniform may pick up microorganisms and transfer them to patients.
2. The hands are not held lower than the elbows during the handwashing procedure. Bacteria and
debris will be carried onto the forearm.
3. Friction is not used to wash the hands. Microorganisms may not be removed from the hands.
4. Water is splashed on the medical assistant’s uniform during the handwashing procedure.
Microorganisms grow easily in a moist environment.
5. The medical assistant continually uses water that is too cold to wash hands. This may cause
chapping and cracking of the skin, making it easier for pathogens to enter the body.
6. The medical assistant turns off the running water with his or her bare hands. The hands will be
contaminated.
7. The medical assistant does not clean his or her fingernails daily. Dirt and microorganisms will
collect underneath the fingernails.
8. The medical assistant’s skin becomes chapped. Microorganisms lodge in the crevices of
chapped hands.
C. Personal Protective Equipment: Gloves
In which of the following situations does OSHA require the use of clean, disposable gloves?
1. Performing a urinalysis on a urine specimen that contains blood Yes.
2. Sanitizing operating scissors for sterilization Yes.
3. Performing a finger puncture Yes.
4. Performing a vision screening test on a school-aged child No.
5. Cleaning up a blood spill on a laboratory work table Yes.
6. Drawing blood from an elderly patient Yes.
7. Measuring the weight of a college student No.
8. Testing a blood specimen for glucose Yes.
D. Personal Protective Equipment
Create a collage of items or articles that can and cannot be used as PPE following these
guidelines:
1. Using items cut from a magazine, colored pencils, or markers, create a collage of items that
are designated as PPE by OSHA.
2. On the reverse side of the sheet, create a collage of items or articles that are not permitted to
be used as PPE.
3. In the classroom, choose a partner and trade sheets. For each PPE item, provide examples of
the procedures or tasks that may require its use. For each item that is not PPE, explain why it
should not be used as PPE.
E. OSHA Standard
The following situations may occur in the medical office. For each situation, indicate an
appropriate action to take that complies with the OSHA Occupational Exposure to Bloodborne
Pathogens Standard.
c TO THE INSTRUCTOR: Listed in the following are the situations and a suggested action
that could be taken to meet the OSHA Standard. In a classroom setting, ask the students to relay
the actions they indicated to comply with each situation.
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1. Situation: You just gave an injection to a patient, and after withdrawing the needle, you
notice that there is no sharps container in the room.
Action: Recap the needle using a one-handed recapping technique.
2. Situation: You are getting ready to apply gloves and notice that you have a cut on your
finger.
Action: Cover the cut with a Band-Aid.
3. Situation: You accidentally get some blood on your bare hands while removing your gloves.
Action: Wash your hands immediately with soap and water.
4. Situation: A part-time clinical MA was just hired. She is not immunized against hepatitis B.
Action: Offer her the hepatitis vaccine at no cost. If she declines the vaccine, ask her to sign
a waiver form. File the information in the employee’s OSHA record.
5. Situation: A clinical MA who has worked at the office for 5 years changes her mind and
decides she wants the hepatitis B vaccine.
Action: Inform the physician so that he or she can order the administration of a hepatitis
vaccine for her. File the vaccine administration record in the employee’s OSHA record.
6. Situation: You are wearing a protective laboratory coat over your scrubs. While performing
a laboratory test, some blood splashes onto your lab coat but does not penetrate through to
your scrubs.
Action: Remove the lab coat and place it in an appropriate container for laundering. Put on
a clean lab coat, and continue the blood testing.
7. Situation: You go into an examining room and notice that the biohazard sharps container in
that room is completely full.
Action: Close the sharps container in the examining room according to the manufacturer’s
instructions. Take the container to a locked room where biohazard materials are stored for
pickup by the medical waste service.
8. Situation: You are performing laboratory testing. You accidentally drop a blood tube and it
breaks.
Action: Apply gloves and pick up the glass using a brush and dustpan. Throw the broken
glass in a biohazard sharps container.
9. Situation: You are wearing a protective lab coat over your scrubs, and you are getting
ready to leave for the day.
Action: Remove the lab coat, and place it in the appropriate container for laundering.
10. Situation: You remove your gloves after giving an injection to a patient and accidentally
discard them into the biohazard sharps container.
Action: Leave the gloves there. Do not try to retrieve them.
11. Situation: You are separating serum from whole blood, and you accidentally spill some of
the serum on the countertop.
Action: Apply gloves and clean up the area as soon as possible with soap and water followed
by a disinfectant.
12. Situation: By mistake you throw a tourniquet into the sharps container after drawing a
patient’s blood.
Action: Leave the tourniquet in the sharps container.
13. Situation: A new clinical MA has been hired at the medical office, and she is allergic to latex
gloves.
Action: Provide her with non-latex gloves at no cost to her.
14. Situation: You have just drawn blood from a patient, and you accidentally stick yourself
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with the needle.
Action: Wash the area immediately with soap and water. Report the incident to the physician
so that post-exposure prophylaxis can be instituted. If the office has more than 10 employees,
document the incident in the Sharps Injury Log.
15. Situation: Your office has only one refrigerator, and blood tubes need to be stored in it, but
the staff would like to put their lunches in it.
Action: This is not permitted. Purchase another refrigerator if possible.
16. Situation: During an office meeting, a coworker suggests an idea to save money by emptying
full sharps containers into a biohazard bag so that the containers can be reused.
Action: Explain to her that this is not permitted under the OSHA Standard.
17. Situation: A new employee wants to know where she should eat her lunch.
Action: She should eat her lunch in a room that does not contain blood or OPIM.
18. Situation: You are applying a pair of disposable gloves, and one of the gloves tears while you
are pulling it on.
Action: Remove the glove, and put on another one.
19. Situation: You are removing a stopper from a tube of blood so that you can transfer the
serum to another tube. A small amount of serum accidentally spatters into your eye.
Action: Flush your eyes with water immediately, and report the incident to the physician.
20. Situation: You have just been assigned the responsibility of performing all venipunctures
required in your office. You notice that the sharps container is located on the opposite side of
the room to the blood drawing chair.
Action: Move the sharps container closer to the blood drawing chair.
21. Situation: A technician is coming to your office today to repair your blood chemistry
analyzer.
Action: The analyzer should be inspected for blood or OPIM. If present, decontaminate the
analyzer with a disinfectant.
22. Situation: A new employee has been hired who has already had the hepatitis B vaccination
series.
Action: Obtain documentation of the dates of the vaccination for her OSHA medical record.
23. Situation: Utility gloves are used and reused in your office for the sanitization of surgical
instruments.
Action: Before use, the gloves should be examined to ensure that they are not cracked,
peeling, torn, or punctured.
24. Situation: Your office has run out of biohazard bags used to transport specimens to the
laboratory, and you notice that an employee is using plastic bags as a substitute.
Action: Call the laboratory and have them deliver more biohazard bags. Plain bags do not
bear the biohazard warning label.
25. Situation: A medical assisting extern student does not wear gloves to recap a needle after
drawing medication into a syringe to give an injection to a patient.
Action: Tell her she is doing a great job. She does not need to wear gloves because she is in
no danger of occupational exposure.
26. Situation: You accidentally close (and lock in place) the lid of a sharps container that is only
one-half full.
Action: Replace the sharps container with a new one. A sharps container must not be opened
after it has been closed.
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F. Discarding Medical Waste
Indicate where each of the following (used) items should be discarded using these acroynyms:
RWC: regular waste container
BSC: biohazard sharps container
BB: biohazard bag waste container
1. Urine testing strip RWC.
2. Lancet BSC.
3. Gloves with blood on them BB.
4. Blood tube BSC.
5. Tongue depressor RWC.
6. Razor blade BSC.
7. Capillary pipet BSC.
8. Dressing saturated with blood BB.
9. Patient drape RWC.
10. An empty urine container RWC.
11. Sutures caked with blood BB.
12. Thermometer probe cover RWC.
13. Patient gown RWC.
14. Disposable diaper RWC.
15. Dressing saturated with a purulent discharge BB.
16. Clean disposable gloves RWC.
17. Disposable vaginal speculum BB.
18. An outdated vaccine BSC.
19. Syringe and needle BSC.
20. Examining-table paper RWC.
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