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MOH Prometric Clinical & Pharmacology Essentials

25 flashcards reviewing essential clinical procedures, patient safety protocols, and medication principles.

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Emergency Severity Index Level 1

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Emergency Severity Index Level 1

Immediate life-saving resuscitation required without delay (cardiac or respiratory arrest).

Emergency Drug for Anaphylaxis

Intramuscular Epinephrine (1:1000) administered in the anterolateral mid-thigh.

Emergency Severity Index Level 2

High-risk clinical situation, acute confusional state, severe distress, or dangerous vitals.

Antidote for Opioid Overdose

Naloxone (Narcan): competitive antagonist at mu-opioid receptors.

Antidote for Acetaminophen Toxicity

N-acetylcysteine (NAC): replenishes hepatic glutathione stores.

Five Rights of Medication

Right patient, right medication, right dose, right route, and right administration time.

Antidote for Warfarin Toxicity

Vitamin K1 (Phytonadione) and 4-factor Prothrombin Complex Concentrate (PCC).

High-Alert Medication Safety

Drugs carrying heightened risk of severe patient harm when administered erroneously.

Antidote for Unfractionated Heparin

Protamine Sulfate (1 mg neutralizes ~100 units of heparin).

Used Sharps Safety Protocol

Dispose needles directly into puncture-resistant sharps containers without recapping.

Target INR for Standard Atrial Fibrillation / DVT

Target INR is 2.0 to 3.0.

Alcohol Hand Hygiene Standard

Rub hands with alcohol formulation for 20 to 30 seconds until completely dry.

Hypoglycemia Emergency Management ('Rule of 15')

Give 15-20 g of rapid-acting carbohydrate orally, recheck blood glucose in 15 minutes.

SBAR Clinical Communication

Standardized handover framework comprising Situation, Background, Assessment, Recommendation.

Adult CPR Chest Compression Rate & Depth

100 to 120 compressions/min at a depth of 2 to 2.4 inches (5 to 6 cm).

Standard Universal Precautions

Treating all human blood and bodily fluids as potentially infectious for pathogens.

Single-Rescuer Adult CPR Ratio

30 compressions to 2 breaths.

Contact Isolation Precautions

Wearing clean gloves and gown before entering room; discard before exiting.

Emergency Cardiac Stabilization in Hyperkalemia

Intravenous Calcium Gluconate (10%): stabilizes cardiac cell membranes against arrhythmias.

Airborne Isolation Requirements

Negative pressure isolation room and fit-tested particulate respirator (N95 or higher).

Tuberculosis Infection Control Precautions

Airborne Precautions: Negative-pressure AIIR room and fit-tested N95 respirator.

Droplet Isolation Perimeter

Surgical mask worn within 1 to 2 meters (3 to 6 feet) of coughing patient.

C. difficile Infection Control Precautions

Contact Precautions: Gown and gloves; wash hands with soap and water (alcohol does not kill spores).

Neutropenic Precaution Threshold

Initiated when absolute neutrophil count falls below 500 cells per microliter.

Four Classical Principles of Biomedical Ethics

1. Autonomy (self-determination)
2. Beneficence (do good)
3. Non-maleficence (do no harm)
4. Justice (fairness).

Morse Fall Scale Purpose

Standardized clinical risk assessment evaluating history, ambulatory aid, and gait status.

Spaulding Classification: Critical Items

Items entering sterile tissue or vascular systems require complete sterilization (autoclave).

Pressure Injury Stage 1

Intact skin presenting with localized non-blanchable erythema over bony prominence.

Spaulding Classification: Semi-Critical Items

Items contacting mucous membranes (e.g., endoscopes) require high-level disinfection.

Pressure Injury Stage 2

Partial-thickness skin loss with exposed dermis or intact or ruptured serum-filled blister.

Spaulding Classification: Non-Critical Items

Items contacting intact skin (e.g., blood pressure cuffs) require low-level disinfection.

Pressure Injury Stage 3

Full-thickness skin loss with visible subcutaneous adipose tissue; bone not exposed.

Needlestick Injury Immediate Protocol

1. Wash immediately with soap and running water
2. Do NOT squeeze wound
3. Report immediately for PEP evaluation.

Pressure Injury Stage 4

Full-thickness tissue loss with exposed or directly palpable bone, tendon, or muscle.

Pediatric Dose Calculation Formula

Dose = Weight (kg) \times Dosage (mg/kg)

Central Line Bloodstream Bundle

Maximal sterile barriers, chlorhexidine skin prep, and subclavian vein preference.

IV Flow Rate Formula (gtt/min)

Flow rate = \frac{Volume (mL) \times Drop Factor (gtt/mL)}{Time (minutes)}

Catheter-Associated UTI Bundle

Sterile catheter insertion, closed drainage system, and maintaining bag below bladder level.

Normal Arterial Blood Gas (ABG) Values

pH: 7.35 - 7.45;

P a C O_{2}

: 35 - 45 mmHg;

H C O_{3}^{-}

: 22 - 26 mEq/L;

P a O_{2}

: 80 - 100 mmHg.

Surgical Safety Checklist Phases

Three distinct operative verification phases: Sign In, Time Out, and Sign Out.

Respiratory vs Metabolic Acidosis

Respiratory: pH

< 7.35

with elevated

P a C O_{2} > 45

; Metabolic: pH

< 7.35

with low

H C O_{3}^{-} < 22

Surgical Time Out Verification

Team pause confirming correct patient, correct planned procedure, and correct surgical site.

Signs of Local Anesthetic Toxicity (LAST)

Perioral tingling, metallic taste, tinnitus, lightheadedness, progressing to seizures and cardiac arrest.

Infiltration vs Extravasation

Infiltration is leakage of non-vesicant solution; extravasation is leakage of vesicant solution.

First-Line Drug for Symptomatic Bradycardia

Atropine IV 1 mg (repeated every 3-5 min up to maximum 3 mg).

IV Extravasation First Response

Immediately cease infusion, disconnect administration tubing, and aspirate drug remnants.

Rapid Response Activation

Acute physiological deterioration in respiratory rate, oxygenation, pulse, or consciousness.

Defibrillable Cardiac Arrest Rhythms

Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT).

Hypovolemic Shock Manifestations

Tachycardia, progressive hypotension, cool peripheries, and oliguria from blood or fluid loss.

Non-Defibrillable Cardiac Arrest Rhythms

Asystole and Pulseless Electrical Activity (PEA) (CPR + Epinephrine, no shock).

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