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Mosby CT review > Chapter 2 Patient Care > Flashcards

Chapter 2 Patient Care Flashcards

1
Q

List 3 veins in the hand used for IV

A
  1. superficial dorsal v.
  2. dorsal venous arch
  3. Radial v.
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2
Q

List 4 veins in arm used for IV

A
  1. basilic v.
  2. cephalic v.
  3. medial cubital
  4. median v. of forearm
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3
Q

What parts of the arm can we place IV’s in

A
  1. AC space
  2. radial part of wrist
  3. back of hand
  4. front of forearm
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4
Q

What’s the difference between aseptic and sterile technique

A

Sterile is needed for invasive procedures to create a bug free environment.

Aseptic is used to reduce risk of infection

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5
Q

Name the 2 modes of intravenous contrast administration. Explain the difference

A

Drip infusion &
Bolus injection

Drips infuse slowly over a long period. Bolus is pushed fast over a short period of time.

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6
Q

What technique eliminates air from the tubing of an IV line?

A

“Bleeding” of the tubing

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7
Q

What needle gauge is used or flow rates < 3ml/sec?

A

22 G

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8
Q

What needle gauge is used or flow rates >3ml/sec?

A

20 G +

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9
Q

If an IV is located in the hand or wrist what flow rate should be used on the power injector?

A

1.5 mL/sec

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10
Q

Power injectors are capable of consistently injecting ______ volumes of contrast agent at flow rates up to ________ mL/ sec

A
  1. large

2. 5- 6 mL/sec

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11
Q

What is the difference between in intrathecal and intraarticular injections?

A

One goes into the space surrounding the spinal cord and the other goes into the joint space.

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12
Q

Why do we have to be cautious when injecting nursing mothers with Iodinated contrast agents?

A

It can be excreted in breast milk

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13
Q

How long after contrast administration should nursing mothers “pump and dump”?

A

24 hrs

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14
Q

Iodinated contrast crosses the blood brain barrier . True or False

A

True

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15
Q

If you have been in renal failure are undergoing dialysis can you still receive contrast ? Explain

A

yes.

the decision to proceed is up to the referring physician

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16
Q

List 3 contraindications to IV iodinated contrast

A
  1. iodine allergy
  2. Prior adverse rxn
  3. Renal insufficiency
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17
Q

Define a “breakthrough reaction”

A

its a repeat adverse reaction to iodinated contrast that occurs even after premedication

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18
Q

Premedication regimens usually consist of what two agents

A

Antihistamines & corticosteroids

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19
Q

In what type of patients would premedication be a likely choice

A

Those with increased risk of having an adverse rxn

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20
Q

What are the 4 H’s that the American College of Radiology says you should pay attention to before administering contrast

A
  1. History
  2. Hydration
  3. Have equipment ready
  4. Heads up ( constantly observe patient condition )
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21
Q

How do neutral contrast agents work in the GI tract ?

A

Distends bowel

Allows for clear visualization

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22
Q

Name 3 negative contrast agents

A

water, air, gas

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23
Q

3 advantages of using water as a negative contrast agent

A
  1. more palatable
  2. enhances bowel wall well
  3. no interference with 3D Imaging
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24
Q

During a chest CT you can improve image quality while acquiring an image at the end of inspiration or expiration?

A

inspiration

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25
Q

Effervescent granules act as a negative, positive or neutral contrast agent?

A

negative

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26
Q

When a patient swallows effervescent granules what is added to the bowel to the stomach and small bowel to enhance visualization?

A

gas

27
Q

During a CT colonography how is air administered to the patient ?
Can you use room air or CO2 to visualize the bowel during this scan ?

A
  • via Enema

- both

28
Q

What are the two routes of barium sulfate suspension administration?
What part of the body does it illuminate ?

A
  • oral and rectal

- GI tract

29
Q

How long does the patient have to wait to be scanned after receiving barium sulfate suspension?

A

30 - 90 min

30
Q

Name 3 cases where the use of bariums sulfate might be potentially harmful to the patient ?

A
  • bowel perforation
  • scheduled surgery to the abdomen/ pelvis
  • aspirated into the lungs
31
Q

Describe the concept of osmolality

A

the propensity of any agent to cause fluid from around a vessel to move into the vessel

32
Q

Iodinated radiocontrast media can be separated into 2 categories, what are they

A

Ionic and Non ionic

33
Q

2 Examples of High Contrast media

A
  1. conray

2. Hypaque

34
Q

3 Examples of Low Contrast media

A
  1. Omnipause
  2. Isovue
  3. Optiray
35
Q

Which has less potential to cause a bad rxn to the patient, Non ionic LOCM or Ionic HOCM?

A

Non ionic LOCM

36
Q

What does HOCM stand for? LOCM? IOCM

A
  1. High-osmolar Contrast Media
  2. Low- osmolar contrast media
  3. Iso-molar Contrast media
37
Q

Name one example isomolar contrast media

A

Iohexal

38
Q

The degree of _______ exhibited by an iodinated contrast agent is directly proportional to its _______ of iodine

A
  1. radiopacity

2. concentration

39
Q

Iodinated radiocontrast media is water soluble. True or False

A

true

40
Q

What routes of administration can you use for Iodinated radiocontrast media

A
  1. mouth
  2. Intrathecal space
  3. Intraarticular space
  4. Blood stream
  5. Artery or vein
41
Q

What does the process of medication reconciliation involve?

A

reviewing patients medications at all points of care

42
Q

What 4 pieces of information should be included in patients medication record?

A
  1. name
  2. dosage
  3. frequency
  4. route of administration
    5.
43
Q

What type of drug is coumadin ?

What is the generic name for it?

A

Anticoagulant

Generic name: Warfarin

44
Q

What type of drug is Metformin?

What is the generic name for it?

A

Type 2 diabetic medication

Generic name: Glucophage

45
Q

If a patient taking metformin also has acute kidney injury or chronic kidney disease and they are scheduled for a CT scan about how long should they be instructed to discontinue their diabetic medication before getting scanned? Why?

A

24 hr before scan and up to 2 days after scan

Renal impairment from the contrast paired with underlying kidney issues can cause dangerous amounts of metformin to build up in the body

46
Q

What is an anxiolytic drug? Name two classes.

A

drug that helps reduce anxiety

Benzodiazepines and SSRIs

47
Q

What test is a measure of blood coagulation.

What other lab value is used to asses the patients clotting ability

A
  1. Prothrombin time

2. Platelet count

48
Q

What test is used to detect abnormalities in blood clotting

A

Partial thromboplastin time

49
Q

What lab test is used to diagnose a deep vein thrombosis and possible PE

A

D- timer

50
Q

What lab test is used to screen for damage to the liver by measuring various enzymes and proteins in the body

A

Liver Function test

51
Q

Which is a more accurate measure of renal function BUN & creatinine or GFR?

A

GFR

52
Q

What part of the body is a common location for an indwelling (kept in place) catheter

A

Bladder

53
Q

Which type of catheter is used for temporary drainage, Foley or Straight-type?

A

Straight type

54
Q

Whats the difference between Hypoxemia and Hypoxia?

A

Hypoxemia: low [C] oxygen in blood

Hypoxia: low [C] oxygen in tissue

55
Q

Untreated hypoxia can lead to the patient becoming…?

A

cyanotic

56
Q

Do you need a physician to place an order for Oxygen for a patient? Why ?

A

yes. it is considered a drug

57
Q

In what units is oxygen typically delivered to the patient?

What controls the rate of oxygen delivery?

In what two forms can Oxygen be stored

A
  1. LPM
  2. oxygen flow meter
  3. liquid and gas
58
Q

Name 3 options for oxygen delivery

What flow rate can be delivered using each device?

A
  1. Nasal canula: 1-5 LPM
  2. Mask : > 6 LPM
  3. Ventilator
59
Q

Which provides a higher percentage of oxygen delivery, oxygen mask or non- rebreather mask

A

Non-rebreather mask

60
Q

What is the difference between the insertion of an endotracheal vs tracheostomy tube

A

endotracheal tube: gets to trachea through the nose or mouth

tracheostomy: gets to trachea through surgical opening

61
Q

List and describe the 4 levels of conscious states

A

Lethargic: drowsy but aroused

Obtunded: depressed conscious, hard to wake, in a state of confusion

Stupor: Semi comatose
(near unresponsive)

Coma

62
Q

What is the normal pulse rate for adults?

Is it lower or higher for children?

A

pulse rate: 60 -100 bpm

higher

63
Q

What is the normal body temperature for adults

A

97.7 - 99.5

64
Q

What are the 3 distinct stages of the cardiac cycle and which parts of the ECG wave to they correspond to ?

A

Atrial Systole: P wave

Ventricular systole: QRS complex

Complete cardiac diastole: T wave

Mosby CT review (8 decks)

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