NHA CPCT/A cheat sheet

Normal adult resting vital signs: oral temperature 36.5-37.5 C (97.6-99.6 F), pulse 60-100 beats/min, respirations 12-20/min, blood pressure under 120/80 mmHg.

Pulse sites in order of common use: radial, brachial, carotid, temporal, femoral, popliteal, posterior tibial, dorsalis pedis.

Count respirations for a full 60 seconds without telling the patient, since awareness alters rate and depth.

Body temperature routes: oral, axillary (about 0.5 C lower than oral), tympanic, rectal (about 0.5 C higher than oral), temporal.

Orthostatic hypotension is a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.

Range of motion types: active (patient moves joint), passive (assistant moves joint), resistive (patient moves against resistance).

Fowler position elevates the head of bed 45-60 degrees; semi-Fowler is 30-45 degrees; Trendelenburg lowers the head below the feet.

Standard precautions apply to all body fluids except sweat, regardless of a confirmed diagnosis.

Pain assessment tools: numeric rating scale for adults, Wong-Baker FACES for children, FLACC for nonverbal or infant patients.

Chain of infection links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host; breaking any link prevents spread.

Five moments of hand hygiene: before patient contact, before aseptic task, after body fluid exposure risk, after patient contact, after contact with patient surroundings.

Alcohol-based hand rub is used when hands are not visibly soiled; soap and water is required for visible soil and for Clostridioides difficile spores.

Don PPE in order: gown, mask or respirator, goggles or face shield, gloves; remove in reverse order with gloves last.

Transmission-based precautions: contact (gown and gloves), droplet (mask within 3 feet), airborne (N95 and negative-pressure room).

Needlestick injury first step is wash the site with soap and water; then report and follow post-exposure protocol.

Safety risk factors: age over 65, impaired mobility, sedating medications, and history of falls raise fall risk; use bed alarms and low beds.

Restraints require a provider order, time-limited renewal, and frequent monitoring of circulation, skin, and toileting needs.

Fire response sequence RACE: Rescue, Alarm, Contain, Extinguish or Evacuate; PASS for extinguisher use: Pull, Aim, Squeeze, Sweep.

Order of draw for evacuated tubes: blood culture, sodium citrate (light blue), serum separator (gold/red), heparin (green), EDTA (lavender), glycolysis inhibitor (gray).

Light blue citrate tube must be filled to the marked line and mixed by gentle inversion; a short draw invalidates coagulation results.

Tourniquet application time should not exceed 1 minute; prolonged use raises potassium and hemoconcentration.

Preferred venipuncture sites: median cubital, cephalic, and basilic veins in the antecubital fossa.

Antiseptic for blood culture and routine venipuncture is 70% isopropyl alcohol; allow it to dry completely before puncture.

Hemolysis causes falsely elevated potassium, LDH, and AST; avoid small needles, excessive suction, and vigorous shaking.

Common needle gauges: 21 for routine adult draws, 23 for small or fragile veins, 25 for pediatric or very fragile draws.

Capillary puncture preferred site is the lateral side of the distal phalanx of the middle or ring finger; heel stick for infants.

24-hour urine collection discards the first void and includes all urine through the final void at the 24-hour mark.

Standard 12-lead EKG uses 10 electrodes: 4 limb leads and 6 precordial leads V1 through V6.

Limb lead placement: LA and LL on the left arm and leg, RA and RL on the right; RL is the ground electrode.

Precordial placement: V1 4th intercostal space right sternal border, V2 4th ICS left sternal border, V4 5th ICS midclavicular, V3 midway between V2 and V4.

Standard paper speed is 25 mm/s and gain is 10 mm/mV; one small box = 0.04 s, one large box = 0.20 s.

Heart rate from rhythm strip: 300 divided by number of large boxes between R waves, or count R waves in 6 seconds times 10.

Normal sinus rhythm: rate 60-100, regular rhythm, P wave before every QRS, PR interval 0.12-0.20 s, QRS under 0.12 s.

Artifact sources: patient movement, muscle tremor, loose electrodes, and 60-cycle electrical interference; correct by repositioning and ensuring good contact.

Holter monitor records 24-48 hours of continuous rhythm; event monitor is used for intermittent symptoms.

Before EKG, ensure skin is dry and clean, electrodes are not expired, and limb leads are placed on fleshy areas not bone.