NCCT NCMA cheat sheet

Normal adult vital signs: oral temperature 36.5-37.5 C (97.7-99.5 F); resting pulse 60-100 beats/min; respirations 12-20 breaths/min; blood pressure under 120/80 mmHg; oxygen saturation 95-100% on room air.

Blood pressure cuff width should cover about 40% of upper-arm circumference and the bladder length about 80%; a cuff that is too small falsely raises the reading, and one that is too large falsely lowers it.

Draw order for capillary and venous specimens follows the order of draw to prevent additive cross-contamination; EDTA tubes are inverted gently 8-10 times, and heparin tubes are never shaken vigorously because hemolysis alters results.

Standard precautions apply to all patients: gloves for contact with blood, body fluids, mucous membranes, and non-intact skin; hand hygiene before and after glove use; sharps go immediately into a puncture-resistant container at the point of use.

Needle safety: never recap a used needle with two hands; use the safety device, activate it one-handed, and dispose in a sharps container filled no more than three-quarters full.

Medication administration rights include the right patient, drug, dose, route, time, and documentation; two patient identifiers (name plus date of birth or medical record number) are verified before any dose.

Common medical abbreviations to interpret correctly: NPO (nothing by mouth), PRN (as needed), BID (twice daily), TID (three times daily), QID (four times daily), PO (by mouth), and q4h (every 4 hours).

Anaphylaxis after an injection presents with hives, wheezing, hypotension, and swelling; epinephrine is the first-line drug, so the injection site and emergency kit must be known before administering any immunizing agent.

Sterile field rules: sterile items contact only sterile items; a sterile package that is torn, wet, or past its expiration date is contaminated; the edge of a sterile wrapper is considered unsterile.

Appointment scheduling types: wave (patients arrive at intervals and are seen in arrival order), modified wave (combination of interval and open access), and open access (same-day slots held for urgent needs).

Telephone triage documentation must record the caller's name, relationship to the patient, chief complaint, advice given, and the name of the person who gave it, plus the time and date.

Release of protected health information requires a signed authorization naming the specific information, the recipient, the purpose, and an expiration date or event; psychotherapy notes need a separate authorization.

The minimum necessary standard limits uses and disclosures of protected health information to the least amount needed to accomplish the purpose.

Accounts receivable aging buckets are typically 0-30, 31-60, 61-90, and over 90 days; the percentage of claims older than 90 days is a key indicator of collection problems.

Clean and dirty claims: a claim is rejected when it fails front-end edits (missing identifier, invalid code) and denied when the payer reviews it and finds it not payable; rejections are corrected and resubmitted, denials are appealed.

Insurance terms: deductible is the amount paid before benefits begin; coinsurance is the patient's percentage share after the deductible; copayment is a fixed dollar amount per visit; the explanation of benefits is not a bill.

Medical record retention and correction: never erase or white out an entry; draw a single line through the error, write the correction, initial and date it, and keep the original legible.

Supply inventory control uses a par level (minimum quantity on hand) and reorder point; a perpetual inventory ledger records receipts and issues so that reorder points reflect actual usage.