12-20 Flashcards
behavior established by custom or law, recognized and approved behavior
standards of conduct
garpu
fork
propriety of dress, speech, or conduct
modesty
a mental position with regard to a fact or state; a feeling or emotion
attitude
effective communication includes
verbal facial expression other body language
maintaining privacy and reliance with entrusted patient info
confidentiality
garaj
garage
compositie body of customs, practices, and rules
law
law that arises from interpretation of our constitutions, statues, and admin regulations by judges
case law
bilik tidur
bedroom
a civil wrong, as opposed to criminal wrong, involving a breach of duty or standard of care that results in injury
tort
action was deliberately taken
intentional misconduct
occurs when a person has a reasonable fear of physical touch/injury as a result of another person’s use or treat of force
civil assault
occurs when a person intentionally and inappropriately touches another w/o consent
civil battery
slander (spoken) & libel (written)
defamation
cawan
cup
occurs when a person is restrained/confined w/o proper authorization or consent
false imprisonment
action NOT deliberately taken
unintentional misconduct
breach/failure to fulfill a required standard of care; a medical standard of care is determined by the degree of care/skill a reasonable medical professional would have provided under the circumstances
negligence
Can negligence be a basis for tort action b/c even though you intended to help you actually caused damage by failure to perform as were expected?
YES
_______ as a basis for civil liability comes form English Common Law
negligence
For negligence to be found, the civil proceedings must establish the following:
- what standard of care was owed by the RT to patient 2. that there was a breach of duty 3. that the cause of injury was the RT’s negligence 4. that the injury to the patient actually occurred
Patient’s consent can be ____, ____, or _____
written, oral, or implied
True or False: Even if the patient has previously given consent, they can revoke it at any time
TRUE
for consent to be valid:
–patient must be of legal age/mentally competent –patient must offer consent voluntarily –patient must be adequately informed about the medical care being recommended
“let the master answer”; this doctrine required that an employer pay victims for the torts committed by the employees
Respondeat superior
the person who initiates the lawsuit in a civil case
plaintfiff
person being sued in a lawsuit
defendant
the thing speaks for itself - this doctrine applies to a situation that suggest that an injury could not have occurred if there had been no negligence
res ipsa loquitur
who is responsible for the operation of the hospital?
hospital admin and medical staff
___________ is responsible for planning, developing, and maintaining programs that implement the policies and achieve goals esablished by the governing board
hospital admin
how does hospital admin due their job?
–organize admin functions of hospital –delegating duties –establish formal meetings w/ personnel –provides teh hospital w/ admin direction
director of radiology and radiology management staff have following responsibilities:
–participate in medical staff activities –establish an effective working relationship w/ the medical staff, etc –develop and approve all policies/procedures for the dept –review and evaluate the quality and appropriateness of radiologic services –advise the medical staff and admin of equipment needs, modifications, etc
What is the ultimate objective of the diagnostic radiology dept?
to aid physicians in their efforts to diagnose and treat disease
measuring of radiation exposure received by personnel in the performance of their duties
personnel monitoring
The recommendation of the _______ are the standard and they should apply (radiology safety)
National Counsel on Radiation Protection and Measurements (NCRP)
true or false: this is an example of radiation safety precautions: monitoring of radiology personnel, including monthly badge reports
true
true or false: this is an example of radiation safety precautions: equipment calibration and safety maintenece
true
To spill
Derramar
true or false: this is an example of radiation safety precautions: no rules for the safe use, removal,handling and storage or radioactive materials
false, there are rules
true or false: this is an example of radiation safety precautions: rules for protection of non-radiology personnel and patients
true
true or false no records need to be maintained of radiation exposures of individuals for whom personnel monitoring is required
false, records do need to be maintained
education provided by the institution in knowledge, info, and sills related to specific tasks, policies, and procedures
in-service education
term synonymous with quality control but usually used to refer to the monitoring and testing of imaging equipment, as well as the control of variables in the clinical setting
quality assurance
is a federal agency that is concerned about safety in the workplace
OSHA
3 important revenue-producing dept:
–radiology –lab –pharmacy
what is the largest single expense in a hospital?
film
a certificate issued by a review committee to the purchaser or applicant after the need for the equipment/expansion has been established and is well documented
Certificate of Need (CON)
the staff of a radiology dept represents __% - ___% of a hospital’s labor force and cost
3-5
what is the most expensive capital item in the hospitals today?
major equipment in a radiology dept
what is the annual typical procedures breakdown of cost for chest radiographs%
30%
what is the annual typical procedures breakdown of cost for fluoroscope exams?
10%
pyelographic studies, what is the annual typical procedures breakdown of cost for
9%
what is the annual typical procedures breakdown of cost for of general radiographic exams?
51%
3 types of equipment service contracts:
- original equipment manufacturer (OEM) 2. time and materials contract (T&M) 3. Independant service organization (ISO)
aquisition cost of the equipment plus the cost of maintaining it through its useful life
life cycle cost
radiographs that have to be repeated b/c of inadequate technical quality
retakes
when a film is processed, unexposed ______ is removed from the film when it’s transported through a fixer bath
silver
an _______ recovery unit has a stainless teel, negatively charged cathode and a carbon, positively charged anode
electrolytic
medicare’s system of reimbursement;payment is limited to a set amount allocated to a specific diagnosis
diagnosis-related groups (DRGs)
the gov’t response to the high cost of health care; reimburses hospitals for tests/treatments for Medicare and Medicaid Patients
prospective payment system (PPS)
admin evalutation of RT’s:
–observation of technologist at work (observe patient care, radiation protection practices, and how techs dress, etc) –Interviewing patients (communicate with patients through oral and written questionnaires) –interviewing techs (talk to the RT; conduct in-service sessions to help educate the employee)
solving problems by thinking all all possible causes and ruling them out individually
troubleshooting
problems with ____________ equipment is the primary problem in most radiology dept
film-processing
the temp of processing solutions should not vary by more than ___*F which makes film processing a critical operation
0.5 degrees F
devise used to expose films precisely so that each film will have the same desnity provided the processor chemicals, temp, and other variables remain constant
sensitometer
devise used to measure the density of a radiograph (the amount of light transmitted through the radiograph)
densitometer
most common problem with film processing besides temp variations is difficulty maintaining the proper concentration of chemicals in the processing solutions true or false
true
term used to refer to adjustment of voltage, amgerpage, distance, time, and other factors considered in the determination of producing a diagnostic radiographic study
exposure factors
the use of ______ exposure devices requires an extremely fine ability to position the patient
automatic
who is the judge of quality in radiographic images?
radiologist
as a student you NEVER pass a ____ w/o it being checked by a radiologic technologist
film
a term applied to radiation having sufficient energy to produce ions (i.e., displace electrons from atoms); x-rays are one form of ionizing radiation
ionizing radiation
Two Sources of Ionizing Radiation:
–• Natural environmental or background radiation –• Man-made radiation
true or false: Although background radiation varies from place to place it accounts for more than half of the exposure that the general public receives.
true
The use of medical and dental radiographs and radioactive materials to diagnose and treat disease accounts for __% of the general public’s exposure to human-made radiation
90
the amount of radiation required to redden the skin
Erythema dose
a quantity of x-rays or gamma rays that would produce ions in one cubic centimeter of air (coulomb/kilogram or C/kg)
Roentgen (R
unit of absorbed dose of any type of radiation (gray or Gy)
Radiation absorbed dose (rad)-
a unit measuring the biologic effect of x-, alpha, beta, and gamma radiation on humans (sievert or Sv)
Roentgen-equivalent-man (rem)
the amount of activity known as radioactive disintegration that a radionuclide gives off (Becquerel or Bq)
Curie (Ci)
what is the traditional units and SI units for: exposure
R C/kg
what is the traditional units and SI units for:\ absorbed dose
Rad Gy
what is the traditional units and SI units for: dose equivalent
Rem Sy
what is the traditional units and SI units for: activity
Ci Bq
In ____, Congress charted the National Council on Radiation Protection and Measurements (NCRP) as a nonprofit corporation
1964
The NCRP does:
• Provides information and recommendations in the public interest about radiation measurements and protection • Allows for a pooling of resources from organizations to facilitate studies in radiation measurements and protection • Develop basic concepts about radiation protection and measurements and develop the applications of these concepts • Make a concerted effort to cooperate with international governmental and private organizations with regard to radiation measurements and protection
the absorbed dose multiplied by the appropriate quality factor and measured in rems or sieverts
Effective dose equivalent (EDE)
No-threshold concept is
the belief that there exists no known level below which adverse biologic effects may occur.
ALARA
“as low as reasonably achievable”
Dose Limits: Radiation workers
max EDE of 5 rem per year
Dose Limits: General public
max EDE of 0.5 rem per year (1/10th limit)
Dose Limits: Students under 18
0.1 rem per year
Dose Limits: Pregnant women
0.5 rem per year (0.05 rem per month
Three main types of interactions with matter:
• Photoelectric effect • Compton scatter • Pair production
Photoelectric effect:
• Photon knocks an inner-shell electron out of orbit • All of the photon’s energy is absorbed (photon no longer exists) • The ejected electron is known as a photoelectron • The atom and the photoelectron together are known as an “ion pair” • Shows up as white on x-ray
Compton scatter:
• Photon knocks out an outer-shell electron out of orbit • Only a percentage of the photon’s energy is transferred to the ejected electron • The original photon continues but in a different direction (scatter) • The ejected electron is known as a recoil electron (this is secondary radiation)
Pair production:
• Does not occur in diagnostic radiology • Photon of extremely high energy (1.02 meV) approaches the nucleus of an atom • A positive electron (positron) and a negative electron (negatron) are formed • The positron reacts with an orbital electron, both particles disappear and create two photons that move in opposite directions (annihilation reaction)
a genetic material in the nucleus of all cellular organisms
DNA
The DNA molecule is less than __% of the cell so it is hit less frequently than water molecules
1
Basic Types of Cells:
Germ cells- responsible for sexual reproduction Somatic cells- perform all other body functions
Four Possible Results of Radiation Hitting a Cell
1) Pass through with no damage 2) Temporarily damage cell, but cell subsequently regains normal function 3) May damage the cell and no repair takes place 4) Kills the cell
The Law of Bergonie and Tribondeau states that
cells are most sensitive to the effects of radiation when they are rapidly dividing.
Lymphocytes (mature white blood cells) are considered the most
radiosensitive
. Cells that make up the lens of the eye, the ovaries, and testes are also extremely
radiosensitive
______ cells are the least sensitive because they are highly differentiated and do not divide
nerve
the time between the initial irradiation and the occurrence of any biologic change
latent period
occurs when a large dose (larger than 100R) is received by the entire body in a short period of time.
Acute radiation syndrome
Long-term effects may not manifest for periods of
one to thirty years
Long-term Biologic Effects
Somatic effects- occur in general body cells (cancer, cataracts) Genetic effects- occurs in future generations
Two sources of medical radiation exposure:
• x-rays- external source • radionuclides- internal source
Kilovoltage controls the quality of the
x-ray beam
Milliamperage controls the quantity
of x-rays produced.
An internal source of radiation is
radionuclides
are used in nuclear medicine for diagnosis and in cancer treatments in radiation therapy or oncology.
radionuclides
is the time it takes for the activity of that nuclide to be reduced to half of its initial value.
radioactive half-life of a substance
methods of protection from external sources of radiation are
time, distance, and shielding
The best defense for technologists for internal radiation sources is good ______because these sources can be ingested, inhaled, and absorbed through the skin
housekeeping
The exposure factors of kilovoltage, time, and distance are directly related to the _____of radiation exposure a patient receives.
amount
As high as possible __ should be used unless it interferes with the study. This allows for less ___(quantity) and a decreased skin dose.
kV mAs
rate of exposure is directly related to distance as a function of the_______ law.
rate of exposure is directly related to distance as a function of the inverse square law.
Inverse Square Law:
The intensity of the beam is inversely proportional to the square of the distance
Where= I1 is original intensity
I2 is new intensity
D1 is original distance
D2 is new distance
Two correlations derived from the Inverse Square Law
1) When the tube distance is doubled, the beam of radiation will have one-fourth the exposure rate
2) When the tube distance is decreased by one-half, the resulting exposure rate is increased four times
In diagnostic radiology, ______is usually the metal used to absorb the harmful soft x-rays.
aluminum
_____are used to absorb scattered radiation that is created by the interaction of primary radiation with matter before this scatter reaches the film.
Grids
the restriction of the primary radiation to a limited area
Collimation
______________ contributes to fewer repeats by performing processor control and maintenance, film analysis, equipment evaluation, and dark room procedures.
Quality control program
Lead is most commonly used because it has a high atomic number (____) which makes it efficient in the absorption of scatter radiation.
82
Three Types of Gonadal Shielding Devices:
1) Shadow shield
2) Flat contact
3) Shaped contact shield
Personnel Protection:
1) Utilize Bucky slot cover
2) Wear protective apparel
3) Put as much distance between you and the patient as possible
4) Utilize the shielded booth
5) Do not hold the patient or cassettes
6) If you do stand out wear an apron and do not stand in the primary beam
a holder containing a strip of radiographic film worn by personnel to measure the occupational exposure by measuring the degree of blackening of the film
Film badge
ethics is a discipline that deals with
morals ars they relate to behavior
patients presenting themselves for radiographic exams are first impressed by which:
personal appearance of tech
when a patient asks the tech what the radiograph shows about his/her conditions, the tech should:
tell the patient that the referring physician will have the answers
whichof the following behaviors owuld be considered unethical for a tech?
criticising the physician
if an instructor is regimental or appears distant, students should
take responsibility for their own learning
the techs first duty is:
the patient
techs who examine terminally ill patients should do which of the following:
simply respect the patients right of choice
some patient’s require more time and attention than otehr because they are:
more sick than others
professional confidentiality means:
respecting patietn’s right to privacy
moral and ethical conduct of individuals who are handling patients for radiographic exams is a responsiblity of
the student
an effective defense for the teach sued by a patient claiming negligence would be
the exam was performed in a manner that was customerary and accepted in the medical community
res ispa loquitur is a Latin phrase that means
the thing speaks for itself
what is the underlying motiviation for all forms of law?
ALL of the above:
to protect people and property
to proivde a means for correcting injustice
to compensate for injury
situations in which a tort action may be brought against a tech are:
all of the below:
imprudent conduct conduct by the radioloic technologist
bodily harm inflicted on a patient
invasion of privacy
conditions would be considered a breach of standard care except:
patient’s condition did not improve after the test
law in our society is based on which
all:
state / federal constituions
statues of state and federal legisltatures
regulations issued by the exectuive brance of govt
laws are framed and shaped by which:
community values
community laws/values are
generally in agreement
patient info msy be given w/o the patient’s cosnet to:
none:
insurance company
patient’s employer
mediare
performance standars for the radiology dept are set by
cheif radiologist
hospital standards are set to confrom with
the JCAHO guidelines
what is primary concern of the hospital?
patient care
an organization chart is designed to indicate which:
all:
lines of athority
positions of personnel
areas of responsibility
hospital-wide committee that functions to maintain a safe working condition is the committee on
hospital safety
an in-service education program in radiology dept is
a requirement
radiology dept policies/procedures are contained in the
department procedures manual
person responsible for verifying the qualifications of the technial staff is
radiology admin
radiologica compliance eval is a function of
quality assurance program
standards for hopsital services are established by
JCAHO
what is the purpose of the certificate of need requirement?
to limit equipment and space to the community needs
staffing needs are computed by
all:
number of procedures/year
number of radiographic rooms available
type of procedures performed
the decision to purchase new radiology equipment is based on
the number of patiens who need radiographic service
cost of radiographic exams include the cost of:
all:
labor
film/development
equipment
silver from radiographic film can be reclaimed by:
recovering free silver from the fixer
cost of producing a radiograph is highest for:
personnel
tend to move radiologic servies out of hospitals and into clinics was accelerated by the govt
all:
PPSA/DRG
TEFRA
Medicare payments
cost of healthcare since 1995 has:
increased
guideline for staffing in a dept of radiology is ____ production hour(s) per procedure:
1
quality assurance is the responsibility of
all:
chielf radiologist
chief tech
each radiology employee
quality assurance involved all except:
the ethnic origin of the employees
what is the advantage of the pyramidial arrangment for dept admin?
economy in personnel cost
what is the disadvantage of the pyramidial admin arrangement?
communication from teh base to the upper level is difficult
evaluating quality in the radiology dept may include all of the follwoing except:
checking the patients code of ethics
troubleshooting is an activity for
equipment testing after malfunction occurrs
equipment monitoring is an activity involving
periodic routine equpment testing
film processign requires which:
all:
exact combo of chemicals
near-constant solution temp
controlled replenishment of solutions
a sensimeter is an instrument used to do which:
provide a controlled amount of light to the film
a denseimeter is a device for which;
measureing the blackness or density of the film
in diag exray which of teh following interactions will occur?
all:
modified scattering
unmodified scattering
photoelectric interaction
the roentgen unit is a meaure of
the number of ions created in the air
what is the filtration manufactured into the xray tube called?
inherent filtration
what do the letters RAD stand for?
radiation absored dose
when radiation interacts with matter and changes direction it is called
scatter radiation
which is a factor that will affect patient dose?
all:
filtraions
distance
time
which exam will give the patient the highest gonadal dose?
abdomen
the law of Bergonie and Tribondeau implies that sensitivity is greatest in:
all:
rapidly dividing cells
the youngest state of the organism
cells with the shortest life span
the basis for the NCRP’s policies/regulations for peronnel and patients is:
ALARA
the general pop. is allowed to what fraction of the dose allowed for occupationally explosed people?
1/10
film badge worn by most radiologic techs measures:
amount of total body radiation
which are most sensitive of the body?
white blood cells
high speed intensifying screens are used for some exams b/c
the patient dose is reduced
primary concern in radiation to the gonads is to prevent:
genetic effects
sensititvity to radiation in humans is greatest
during embroyonic stage
allied health developed as a result of which
all:
specialization
advancements in science/technology
medical economics
nursing profession:
has specialized in many areas
medical technologist:
analyzes and performs tests for dianjosis an treatment
histotechnologists:
identify, mount, and stain human tissue
medical records admin:
plans, designs, and managest patient records
dietician does:
manages and administers institutional food service
physical therapist :
is concerned mainly with restoring function
occupational therapist:
develops and maintains a client’s ability to perform daily living tasks
respiratory therapist:
administers therapeutic procedures for respiratory emergencies
EMT/paramedic:
administers basic life support and definitive therapy
