Chapter 2 Patient Care

Question 1

List 3 veins in the hand used for IV

Answer 1

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

Question 2

List 4 veins in arm used for IV

Answer 2

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

Question 3

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

Answer 3

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

Question 4

What’s the difference between aseptic and sterile technique

Answer 4

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

Aseptic is used to reduce risk of infection

Question 5

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

Answer 5

Drip infusion &
Bolus injection

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

Question 6

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

Answer 6

“Bleeding” of the tubing

Question 7

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

Answer 7

22 G

Question 8

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

Answer 8

20 G +

Question 9

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

Answer 9

1.5 mL/sec

Question 10

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

Answer 10

1. large

2. 5- 6 mL/sec

Question 11

What is the difference between in intrathecal and intraarticular injections?

Answer 11

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

Question 12

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

Answer 12

It can be excreted in breast milk

Question 13

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

Answer 13

24 hrs

Question 14

Iodinated contrast crosses the blood brain barrier . True or False

Answer 14

True

Question 15

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

Answer 15

yes.

the decision to proceed is up to the referring physician

Question 16

List 3 contraindications to IV iodinated contrast

Answer 16

1. iodine allergy
2. Prior adverse rxn
3. Renal insufficiency

Question 17

Define a “breakthrough reaction”

Answer 17

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

Question 18

Premedication regimens usually consist of what two agents

Answer 18

Antihistamines & corticosteroids

Question 19

In what type of patients would premedication be a likely choice

Answer 19

Those with increased risk of having an adverse rxn

Question 20

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

Answer 20

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

Question 21

How do neutral contrast agents work in the GI tract ?

Answer 21

Distends bowel

Allows for clear visualization

Question 22

Name 3 negative contrast agents

Answer 22

water, air, gas

Question 23

3 advantages of using water as a negative contrast agent

Answer 23

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

Question 24

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

Answer 24

inspiration

Question 25

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

Answer 25

negative

Question 26

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

Answer 26

gas

Question 27

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 ?

Answer 27

- via Enema | - both

Question 28

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

Answer 28

- oral and rectal | - GI tract

Question 29

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

Answer 29

30 - 90 min

Question 30

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

Answer 30

- bowel perforation - scheduled surgery to the abdomen/ pelvis - aspirated into the lungs

Question 31

Describe the concept of osmolality

Answer 31

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

Question 32

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

Answer 32

Ionic and Non ionic

Question 33

2 Examples of High Contrast media

Answer 33

1. conray | 2. Hypaque

Question 34

3 Examples of Low Contrast media

Answer 34

3. Omnipause 4. Isovue 5. Optiray

Question 35

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

Answer 35

Non ionic LOCM

Question 36

What does HOCM stand for? LOCM? IOCM

Answer 36

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

Question 37

Name one example isomolar contrast media

Answer 37

Iohexal

Question 38

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

Answer 38

1. radiopacity | 2. concentration

Question 39

Iodinated radiocontrast media is water soluble. True or False

Answer 39

true

Question 40

What routes of administration can you use for Iodinated radiocontrast media

Answer 40

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

Question 41

What does the process of medication reconciliation involve?

Answer 41

reviewing patients medications at all points of care

Question 42

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

Answer 42

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

Question 43

What type of drug is coumadin ? | What is the generic name for it?

Answer 43

Anticoagulant Generic name: Warfarin

Question 44

What type of drug is Metformin? | What is the generic name for it?

Answer 44

Type 2 diabetic medication Generic name: Glucophage

Question 45

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?

Answer 45

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

Question 46

What is an anxiolytic drug? Name two classes.

Answer 46

drug that helps reduce anxiety Benzodiazepines and SSRIs

Question 47

What test is a measure of blood coagulation. What other lab value is used to asses the patients clotting ability

Answer 47

1. Prothrombin time | 2. Platelet count

Question 48

What test is used to detect abnormalities in blood clotting

Answer 48

Partial thromboplastin time

Question 49

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

Answer 49

D- timer

Question 50

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

Answer 50

Liver Function test

Question 51

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

Answer 51

GFR

Question 52

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

Answer 52

Bladder

Question 53

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

Answer 53

Straight type

Question 54

Whats the difference between Hypoxemia and Hypoxia?

Answer 54

Hypoxemia: low [C] oxygen in blood Hypoxia: low [C] oxygen in tissue

Question 55

Untreated hypoxia can lead to the patient becoming...?

Answer 55

cyanotic

Question 56

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

Answer 56

yes. it is considered a drug

Question 57

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

Answer 57

1. LPM 2. oxygen flow meter 3. liquid and gas

Question 58

Name 3 options for oxygen delivery What flow rate can be delivered using each device?

Answer 58

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

Question 59

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

Answer 59

Non-rebreather mask

Question 60

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

Answer 60

endotracheal tube: gets to trachea through the nose or mouth tracheostomy: gets to trachea through surgical opening

Question 61

List and describe the 4 levels of conscious states

Answer 61

Lethargic: drowsy but aroused Obtunded: depressed conscious, hard to wake, in a state of confusion Stupor: Semi comatose (near unresponsive) Coma

Question 62

What is the normal pulse rate for adults? | Is it lower or higher for children?

Answer 62

pulse rate: 60 -100 bpm higher

Question 63

What is the normal body temperature for adults

Answer 63

97.7 - 99.5

Question 64

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

Answer 64

Atrial Systole: P wave Ventricular systole: QRS complex Complete cardiac diastole: T wave