Ch 4 Patient Handling And Safety Flashcards
1
Q
Arrt standard of ethics 2 parts p 4
A
Code of ethics
Rules of ethics
2
Q
Code of ethics p 4
A
Assist certificate holders and candidates in maintaining a high level of ethical conduct and providing protection , safety and patient comfort
3
Q
Patient bill of rights goals p 6
A
Strengthen consumer confidence in healthcare system
Reaffirm importance of strong relationship
Reaffirm patient safeguard in their personal info
4
Q
Patient bill rights p 6-7
A
Read
5
Q
Informed consent p 8
A
Types info patients must be given so they can make informed decisions about medical treatment
6
Q
Metformin p 13
When start taking again?
A
Refrain from taking 48 hrs following prevent lactic acidosis
Kidney function should be checked to resume
7
Q
Consent form used for ? P 14
A
Contrast agents
Surgical procedures
Sedation
Payment arrangement
8
Q
Are consent forms required by law? P 14
A
No
9
Q
Screening for contrast agents p 17
A
Previous contrast reaction
Allergies to iodine or barium
Conditions such as hypertension, heart disease , asthma, sickle cell anemia, renal impairment , and diabetes
10
Q
Renal function tests0 17
A
Bun
Gfr
Creatinine
11
Q
Bun ( blood urea nitrogen) p 17
A
Kidneys ability to remove impurities from the blood
Range 5-25 mg/dl
12
Q
Gfr ( glomerular filtration rate) p 17
A
Excretory function of kidneys
Range: 95-120 ml/min
13
Q
Creatinine p 18
A
How well it’s removed from bloodstream by kidneys
Range: 0.6-1.7 mg/dl
14
Q
eGFR p 18
Formula
Range
A
75 x serum creatinine
Normal: > 60
15
Q
Tests determine blood coagulation ability
A
Pt Ptt Inr D-dimer Platelet count
16
Q
Pt test p19
A
Chemical interaction to blood clot
Range; 10-14sec
17
Q
Ptt test p 19
A
Chemical interaction to blood clot
Range: 20-40 sec
18
Q
INR test p 19
A
Standardize prothrombin time for those taking anticoagulants
Ranges:
- 2.0-3.0 for patients on anticoagulant drugs
- 2.5- 3.5 for patients with high risk of clot formation
19
Q
D-dimer test p 19
A
Normally less than 500 micrograms/liter fibrin equivalent under units
20
Q
Platelet count range p19
A
Normally 150,000/ mm3 to 400,000/mm3
21
Q
High INR indicates/ low INR
? P 20
A
High chance of bleeding
High chance of clotting
22
Q
D-dimmer test used for most? P 20
A
Deep vein thrombosis
23
Q
Positive d-diner test indicates ?21
A
Abnormal high levels of fibrin degradation products in the body
24
Q
D-diner tests to diagnose? P 21
A
Conditions that cause the blood coagulate inappropriately
25
D-dimmer is ordered usually in conjunction with ct______ to rule out _______ ? P 21
Ct pulmonary angiography
Pulmonary embolism
26
Two ways radiation can cause damage ? P 22
Direct interaction with DNA bonds
Indirect effect by ionization of chemicals in the body
27
Results of radiation exposure during pregnancy ? P 22
Increased prenatal deaths
Abnormalities
Mental retardation
Neonatal deaths
28
Radiation safety p 22
Methods and tools used protect patients and personnel from ionizing radiation exposure
29
When is radiation exposure most damaging ? P 22
First trimester
30
Most common unit for measuring radiation?
Rad
31
1 rad= ___
0.1 joules of energy
32
Rem and sievert p 23
Effective dose or dose equivalent
33
1sv=____ R.E.M.
100
34
1 rad= ____ R.E.M.
1
35
Ct scans account for about ____rem( ___msv)p 23
0. 31 rem
| 1. 5 msv )
36
Radiation strictly from X-rays are measured in ___or ____. ______
Rad/gy
Sv/ rem
37
Effective dose from ct produce range ? P 24
1-10 msv
38
Greater the distance traveled through the tissue and the the denser tissue the X-ray photons penetrate, the _____ the dose is decreased along the photons path
More
39
Dose at the entrance of the patient a skin is ______ than at the center of the body p 24
Greater
40
Ct effective dose p 25
Ct head
Ct abdomen
1 radiography exposure
5 radiography exposure
2msv
8 msv
0. 1 msv
0. 5 msv
41
Radiation penumbra and why? P 26
Radiation extends outside the intended slice because collimating of X-ray beam is imperfect
42
Ct dose index (ctdi) p 26
Average dose along z-axis( long axis of body) , over the central slice of series of collected slices and accounted for,the radiation within the slice thickness as well as penumbra. Dose not factor in variation in dose from gaps and adjacent tissues
43
Msad- multi slice average dose p 27
Indicator of radiation dose which corrects ctdi by factoring gaps and overlaps between slices or Helical due toslected table increment or pitch
44
Since slice obtained with mdct is not indivudually collimated , it does not have radiation penumbra . Only ______slices of slice volume have penumbra effect with mdct
P 28
End
45
Ctdi100 p28
Possibility of having multiple slices in single rotation and accounts for slices
46
CTDIw p 29
Weighted average of the center and peripheral ctdi100 to arrive at single measurement based on single rotation of multi row detector scanner
47
CTDIvol p 29
Accounts for helicAl studies performed on multi row detector scanners and indicates the average radiation dose over all three directions (x,y,z axis)
CTDIvol= CTDI vol
-----------
Pitch
48
Dlp ( dose length product) p 30
Integrated dose in terms of total scan length
49
Effective dose p 31
Calculated sum of the absorbed dose of all tissues in the body, each individually multiplied by weighting factor for that organ or region. Since different parts of the body are having varying sensitivities to adverse effects of radiation, the effective dose is an indication of the overall risk to patient from radiation
50
Alara
As low as resonabily possible
51
Safe level of radiation
No level is assumed safe
52
Ct system factors affecting dose
X-ray tube to patient distance
Filtration
Pre patient collimating
Multi row detector design along with noise reduction strategies
53
Further tube from patient the _____ dose
Less
54
Filtration takes out soft rays which does _____ dose. P 32
Less
55
More collimation the _____ dose
Less
56
Mdct scanners have _____ dose
More
57
Ways mdct scanners try reduce dose (2) p 33
Evaluates size of anatomy and attenuation
Ma automatically adjusted
58
Mas decreased dose_____
Decrease
59
MVP only decrease to minimize dose to (2) p 35
Small patients
| Kids
60
Scanning less of the body dose______
Less
61
Slice thickness ( single row ) , slice thickness up then dose_____
P 35
Down
62
Mdct, slice thickness does what to dose? P 36
No affect
63
Increasing table increment _____ dose
Less
64
Increasing pitch _____ dose
| P 37
Less
65
Pediatric and small patient reducing two gives less dose ?
Kvp
| Mas
66
Ways reduce dose
```
Less repeats scans
Reformat rather than rescan
Reduce multiple scans
Use prospective cardiac synchronization
Use shield
```
67
Two methods synchronizing cardiac scan ? P 40
Prospective synchronization
Retrospective synchronization
68
Prospective synchronization p 40
Applied during the scan , serial scanning performed during cardiac r wave which is a portion of cardiac cycle
69
Retrospective synchronization p 40
Applied after the scan, using a helical scan through the entire cardiac cycle
70
Prospective cardiac gating frequently used for ? P 41
Calcium scoring
71
Retrospective gating used for ? P 41
Moore accurate. When patient has irregular heart beat and looking at coronary arteries
72
Dose check standard p 42
Designed to intervene with a message to the tech that ask to confirm of exam settings before proceeding with a scan that might lead to high exposure
73
Dose notification value p 42
Used to trigger a message when single planned and confirmed scan is likely to exceed a pre programmed CtDIvol and or DLP value
74
Dose alert value p 42
Used to trigger a message when the cumulative dose at location plus the dose for next landed and confirmed scan is likely to exceed pre programmed value
75
Medical worker dose p 44
Maximum effective dose of 20 msv per year , averaged over 5 years , with no more than 50msv in one year
76
Oximetry p 47
Measuring concentration of oxygen in the blood
77
Normal oxygen saturation is?
95-100%
78
Arrhythmia p 48
Irregular heart beat
79
Sinoatrial (sa node) p 48
Located right atrium
Provides main control and source of the heart . Provides nutrients and hearts natural pavemaker
80
Atrioventricular (av node) p 48
Pathway of impulses from atria to ventricles
81
Normal heart rate p 48
60-100 beats per min
82
Sinus tachycardia p 49
Fast heart beat
83
Sinus bradycardia p 49
Slow heart beat
84
Supraventricular arrhythmia p 49
Don't originate in ventricles
85
Ventricular arrthhmias p 49
Come from ventricles
86
Atrial contraction p 49
P wave - both left and right
87
Ventricular contractions p 49
Qrs complex - both left and right
88
Ventricular relaxation p 49
T wave
89
Software used during ecg gating during which wave?
R wave
90
Diastole p 50
Atria and ventricles relaxed
91
Atrial systole p 50
Sa node triggers atria contract
92
Ventricular systole p 50
Ventricles contract
93
Cardia arrest p 51
Loss of heart function
94
When should cpr be started? P 51
Patient shows signs of cardiac failure
95
Cardiac arrest signs:
```
No pulse
No respiration
Vomiting
Seizure
Damp bluish or grayish skin tone
Incontinence or defacation
```
96
Seizure p 52
Convulsive moments or periods of unconsciousness
97
Signs of seizure;
```
Uncontrollable muscle contraction
Facial twitching
Blank facial expression
Loss of motor activity
Difficulty breathing
Confusion
```
98
If patient has a seizure , what to do? P 52
Remove all restraints and objects that could harm. Ease patient into resting position on table, chair or floor
99
Stroke p 51
Results of lack blood flow to the brain
100
___________ is necessary to minimize brain dame during a stroke
Rapid response
101
Sign of stroke:
```
Inability to communicate
Bilateral or unilateral numbness or paralysis
Pupil disparity
Incontinece
Hypertension
```
102
Severe reaction to contrast ? P 53
Anaphylactic shock
103
Shock p 52
Insufficient blood flow to the tissues and vital organs
104
Signs of shock :
```
Altered level of consciousness
Hypotension
Cool bluish or grayish tones
Tachycardia
Restlessness
```
105
What to mess to give if patient in anaphylactic shock from ct contrast?
Epinephrine
106
Normal oral temperature
97-99 f
107
Normal axillary temp
96.5-98.5 F
108
Normal rectal temp
97.5-99.5 F
109
Most common place for pulse ? P 53
Radial
110
Places for pulse ?
Apical , radial, femoral, popliteal, pedal
111
Normal adult pulse
70-100 beats per min
112
Child pulse range
95-110 beats per min
113
Infant pulse range
100-180 beats per min
114
Blood pressure
Systolic
--------
Diastolic
115
Blood pressure measurement usually taken at? P 54
Brachial artery
116
Adult blood pressure range
90-140
---------
60-80
117
Child blood pressure range
85-130
--------
45-85
118
Adult respiratory rate
12-20 breaths per min
119
Child respiration rate
15-30 breaths per min
120
Infants respiratory rate
25-50 breaths per min
121
Airborne precaution p 60
Dissemination of either airborne droplet nuclei ( 5um or smaller ) that remain suspended in the air
122
Airborne pathogen?
Tuberculosis
123
Airborne precaution patient placement (3)p 60
- monitored negative air pressure in relation to surrounding area
- 6-12 air changes per hour
- appropriate discharge of air outdoors or monitored high efficiency filtration of room air before the air is circulated to other areas of the hospital . Keep door closed and patient in the room
124
Respiratory protection from tb
N95 mask
125
Droplet transmission
Contact of conjunctive or the mucous membranes of the nose or mouth of susceptible person with large particle droplets ( larger than 5um) containing micro organisms generated by person who has a clinical disease or who is a carrier
126
Droplet precaution examples p 61
Talking
Sneezing
Cough
127
Droplet precaution distance
3 ft or less
128
Types droplet precautions
Influenza and sars
129
Droplet precaution standard
Wear mask if 3 ft from patient
130
Contact precaution p 62
Reduce risk of transmission of epidemiologically important microorganism direct or indirect contact
131
Direct contact p 62
Skin to skin contact and physically transfers the microorganisms to susceptible host from infected or colonized person
Ex bathing, turning patients
132
Indirect contact p 62
Contact of susceptible host withy contaminated intermediate object usually inanimate in patients environment
133
Nasal cannula p 65
Often used for oxygen therapy
134
Types masks p 66
Simple
Nonrebreather mask
Venturi mask
135
Tracheostomy p 66
SurgicAlly created opening in the trachea
136
Negligence p 11
Breach or failure to fulfill the expected standard of care
137
Malpractice p 11
Failure to do something that a reasonable person , guided by those considerations which ordinarily regulate human affairs, would do.
