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Ct Review Class > Ch 4 Patient Handling And Safety > Flashcards

Ch 4 Patient Handling And Safety Flashcards

1
Q

Arrt standard of ethics 2 parts p 4

A

Code of ethics

Rules of ethics

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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

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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

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4
Q

Patient bill rights p 6-7

A

Read

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5
Q

Informed consent p 8

A

Types info patients must be given so they can make informed decisions about medical treatment

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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

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7
Q

Consent form used for ? P 14

A

Contrast agents

Surgical procedures
Sedation
Payment arrangement

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8
Q

Are consent forms required by law? P 14

A

No

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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

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10
Q

Renal function tests0 17

A

Bun
Gfr
Creatinine

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11
Q

Bun ( blood urea nitrogen) p 17

A

Kidneys ability to remove impurities from the blood

Range 5-25 mg/dl

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12
Q

Gfr ( glomerular filtration rate) p 17

A

Excretory function of kidneys

Range: 95-120 ml/min

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13
Q

Creatinine p 18

A

How well it’s removed from bloodstream by kidneys

Range: 0.6-1.7 mg/dl

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14
Q

eGFR p 18

Formula

Range

A 
75 x serum creatinine

Normal: > 60

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15
Q

Tests determine blood coagulation ability

A 
Pt
Ptt 
Inr 
D-dimer 
Platelet count
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16
Q

Pt test p19

A

Chemical interaction to blood clot

Range; 10-14sec

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17
Q

Ptt test p 19

A

Chemical interaction to blood clot

Range: 20-40 sec

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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
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19
Q

D-dimer test p 19

A

Normally less than 500 micrograms/liter fibrin equivalent under units

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20
Q

Platelet count range p19

A

Normally 150,000/ mm3 to 400,000/mm3

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21
Q

High INR indicates/ low INR

? P 20

A

High chance of bleeding

High chance of clotting

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22
Q

D-dimmer test used for most? P 20

A

Deep vein thrombosis

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23
Q

Positive d-diner test indicates ?21

A

Abnormal high levels of fibrin degradation products in the body

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24
Q

D-diner tests to diagnose? P 21

A

Conditions that cause the blood coagulate inappropriately

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25
Q

D-dimmer is ordered usually in conjunction with ct______ to rule out _______ ? P 21

A

Ct pulmonary angiography

Pulmonary embolism

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26
Q

Two ways radiation can cause damage ? P 22

A

Direct interaction with DNA bonds

Indirect effect by ionization of chemicals in the body

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27
Q

Results of radiation exposure during pregnancy ? P 22

A

Increased prenatal deaths
Abnormalities
Mental retardation
Neonatal deaths

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28
Q

Radiation safety p 22

A

Methods and tools used protect patients and personnel from ionizing radiation exposure

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29
Q

When is radiation exposure most damaging ? P 22

A

First trimester

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30
Q

Most common unit for measuring radiation?

A

Rad

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31
Q

1 rad= ___

A

0.1 joules of energy

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32
Q

Rem and sievert p 23

A

Effective dose or dose equivalent

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33
Q

1sv=____ R.E.M.

A

100

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34
Q

1 rad= ____ R.E.M.

A

1

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35
Q

Ct scans account for about ____rem( ___msv)p 23

A
  1. 31 rem

1. 5 msv )

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36
Q

Radiation strictly from X-rays are measured in ___or ____. ______

A

Rad/gy

Sv/ rem

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37
Q

Effective dose from ct produce range ? P 24

A

1-10 msv

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38
Q

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

A

More

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39
Q

Dose at the entrance of the patient a skin is ______ than at the center of the body p 24

A

Greater

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40
Q

Ct effective dose p 25

Ct head
Ct abdomen
1 radiography exposure
5 radiography exposure

A

2msv

8 msv

  1. 1 msv
  2. 5 msv
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41
Q

Radiation penumbra and why? P 26

A

Radiation extends outside the intended slice because collimating of X-ray beam is imperfect

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42
Q

Ct dose index (ctdi) p 26

A

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

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43
Q

Msad- multi slice average dose p 27

A

Indicator of radiation dose which corrects ctdi by factoring gaps and overlaps between slices or Helical due toslected table increment or pitch

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44
Q

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

A

End

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45
Q

Ctdi100 p28

A

Possibility of having multiple slices in single rotation and accounts for slices

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46
Q

CTDIw p 29

A

Weighted average of the center and peripheral ctdi100 to arrive at single measurement based on single rotation of multi row detector scanner

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47
Q

CTDIvol p 29

A

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

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48
Q

Dlp ( dose length product) p 30

A

Integrated dose in terms of total scan length

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49
Q

Effective dose p 31

A

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

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50
Q

Alara

A

As low as resonabily possible

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51
Q

Safe level of radiation

A

No level is assumed safe

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52
Q

Ct system factors affecting dose

A

X-ray tube to patient distance

Filtration

Pre patient collimating

Multi row detector design along with noise reduction strategies

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53
Q

Further tube from patient the _____ dose

A

Less

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54
Q

Filtration takes out soft rays which does _____ dose. P 32

A

Less

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55
Q

More collimation the _____ dose

A

Less

56
Q

Mdct scanners have _____ dose

A

More

57
Q

Ways mdct scanners try reduce dose (2) p 33

A

Evaluates size of anatomy and attenuation

Ma automatically adjusted

58
Q

Mas decreased dose_____

A

Decrease

59
Q

MVP only decrease to minimize dose to (2) p 35

A

Small patients

Kids

60
Q

Scanning less of the body dose______

A

Less

61
Q

Slice thickness ( single row ) , slice thickness up then dose_____

P 35

A

Down

62
Q

Mdct, slice thickness does what to dose? P 36

A

No affect

63
Q

Increasing table increment _____ dose

A

Less

64
Q

Increasing pitch _____ dose

P 37

A

Less

65
Q

Pediatric and small patient reducing two gives less dose ?

A

Kvp

Mas

66
Q

Ways reduce dose

A 
Less repeats scans
Reformat rather than rescan
Reduce multiple scans
Use prospective cardiac synchronization 
Use shield
67
Q

Two methods synchronizing cardiac scan ? P 40

A

Prospective synchronization

Retrospective synchronization

68
Q

Prospective synchronization p 40

A

Applied during the scan , serial scanning performed during cardiac r wave which is a portion of cardiac cycle

69
Q

Retrospective synchronization p 40

A

Applied after the scan, using a helical scan through the entire cardiac cycle

70
Q

Prospective cardiac gating frequently used for ? P 41

A

Calcium scoring

71
Q

Retrospective gating used for ? P 41

A

Moore accurate. When patient has irregular heart beat and looking at coronary arteries

72
Q

Dose check standard p 42

A

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
Q

Dose notification value p 42

A

Used to trigger a message when single planned and confirmed scan is likely to exceed a pre programmed CtDIvol and or DLP value

74
Q

Dose alert value p 42

A

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
Q

Medical worker dose p 44

A

Maximum effective dose of 20 msv per year , averaged over 5 years , with no more than 50msv in one year

76
Q

Oximetry p 47

A

Measuring concentration of oxygen in the blood

77
Q

Normal oxygen saturation is?

A

95-100%

78
Q

Arrhythmia p 48

A

Irregular heart beat

79
Q

Sinoatrial (sa node) p 48

A

Located right atrium

Provides main control and source of the heart . Provides nutrients and hearts natural pavemaker

80
Q

Atrioventricular (av node) p 48

A

Pathway of impulses from atria to ventricles

81
Q

Normal heart rate p 48

A

60-100 beats per min

82
Q

Sinus tachycardia p 49

A

Fast heart beat

83
Q

Sinus bradycardia p 49

A

Slow heart beat

84
Q

Supraventricular arrhythmia p 49

A

Don’t originate in ventricles

85
Q

Ventricular arrthhmias p 49

A

Come from ventricles

86
Q

Atrial contraction p 49

A

P wave - both left and right

87
Q

Ventricular contractions p 49

A

Qrs complex - both left and right

88
Q

Ventricular relaxation p 49

A

T wave

89
Q

Software used during ecg gating during which wave?

A

R wave

90
Q

Diastole p 50

A

Atria and ventricles relaxed

91
Q

Atrial systole p 50

A

Sa node triggers atria contract

92
Q

Ventricular systole p 50

A

Ventricles contract

93
Q

Cardia arrest p 51

A

Loss of heart function

94
Q

When should cpr be started? P 51

A

Patient shows signs of cardiac failure

95
Q

Cardiac arrest signs:

A 
No pulse
No respiration 
Vomiting
Seizure
Damp bluish or grayish skin tone
Incontinence or defacation
96
Q

Seizure p 52

A

Convulsive moments or periods of unconsciousness

97
Q

Signs of seizure;

A 
Uncontrollable muscle contraction 
Facial twitching 
Blank facial expression 
Loss of motor activity 
Difficulty breathing 
Confusion
98
Q

If patient has a seizure , what to do? P 52

A

Remove all restraints and objects that could harm. Ease patient into resting position on table, chair or floor

99
Q

Stroke p 51

A

Results of lack blood flow to the brain

100
Q

___________ is necessary to minimize brain dame during a stroke

A

Rapid response

101
Q

Sign of stroke:

A 
Inability to communicate 
Bilateral or unilateral numbness or paralysis 
Pupil disparity 
Incontinece 
Hypertension
102
Q

Severe reaction to contrast ? P 53

A

Anaphylactic shock

103
Q

Shock p 52

A

Insufficient blood flow to the tissues and vital organs

104
Q

Signs of shock :

A 
Altered level of consciousness
Hypotension 
Cool bluish or grayish tones 
Tachycardia 
Restlessness
105
Q

What to mess to give if patient in anaphylactic shock from ct contrast?

A

Epinephrine

106
Q

Normal oral temperature

A

97-99 f

107
Q

Normal axillary temp

A

96.5-98.5 F

108
Q

Normal rectal temp

A

97.5-99.5 F

109
Q

Most common place for pulse ? P 53

A

Radial

110
Q

Places for pulse ?

A

Apical , radial, femoral, popliteal, pedal

111
Q

Normal adult pulse

A

70-100 beats per min

112
Q

Child pulse range

A

95-110 beats per min

113
Q

Infant pulse range

A

100-180 beats per min

114
Q

Blood pressure

A

Diastolic

115
Q

Blood pressure measurement usually taken at? P 54

A

Brachial artery

116
Q

Adult blood pressure range

A

60-80

117
Q

Child blood pressure range

A

45-85

118
Q

Adult respiratory rate

A

12-20 breaths per min

119
Q

Child respiration rate

A

15-30 breaths per min

120
Q

Infants respiratory rate

A

25-50 breaths per min

121
Q

Airborne precaution p 60

A

Dissemination of either airborne droplet nuclei ( 5um or smaller ) that remain suspended in the air

122
Q

Airborne pathogen?

A

Tuberculosis

123
Q

Airborne precaution patient placement (3)p 60

A
  • 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
Q

Respiratory protection from tb

A

N95 mask

125
Q

Droplet transmission

A

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
Q

Droplet precaution examples p 61

A

Talking
Sneezing
Cough

127
Q

Droplet precaution distance

A

3 ft or less

128
Q

Types droplet precautions

A

Influenza and sars

129
Q

Droplet precaution standard

A

Wear mask if 3 ft from patient

130
Q

Contact precaution p 62

A

Reduce risk of transmission of epidemiologically important microorganism direct or indirect contact

131
Q

Direct contact p 62

A

Skin to skin contact and physically transfers the microorganisms to susceptible host from infected or colonized person

Ex bathing, turning patients

132
Q

Indirect contact p 62

A

Contact of susceptible host withy contaminated intermediate object usually inanimate in patients environment

133
Q

Nasal cannula p 65

A

Often used for oxygen therapy

134
Q

Types masks p 66

A

Simple

Nonrebreather mask

Venturi mask

135
Q

Tracheostomy p 66

A

SurgicAlly created opening in the trachea

136
Q

Negligence p 11

A

Breach or failure to fulfill the expected standard of care

137
Q

Malpractice p 11

A

Failure to do something that a reasonable person , guided by those considerations which ordinarily regulate human affairs, would do.

Ct Review Class (7 decks)

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