Chapter 5: Medical Techniques and Patient Care Flashcards
True or Fase: Sonographers need to learn more than just how to obtain diagnostic quality ultrasound examinations?
True
What is the difference between Univeral Precautions and Standard Precautions?
Univeral Cautions is an OSHA term, while Standard Precautions is a term by the CDC
What is Universal Precautions?
This is defined y OSHA’s bloodborn pathogens standard. This is to prevent the spread or transmission of blood-borne pathogens to healthcare workers.
When was Universal Precautions first introduced?
1987
What is Standard Precautions?
This takes the idea of universal precautions by OSHA but expands it to include all body fluids.
When was Standard Precautions first established?
1996
What constitutes the primary strategy to prevent the transmission of infectious agents not only to healthcare personnel but also to patients and hospital visitors?
Standard Precautions
What are the components of Standard Precaution?
Mask, Gown, Gloves, and protective barriers.
What is the major difference between OSHA and the CDC?
OSHA is a regulatory agency meaning things defined by universal precautions are enforceable as regulations. While, the CDC is not a regulatory agency and they issue guidelines.
What term is the correct term to use?
Standard Precautions
What term does the Western world still prefer to use?
Universal Precautions
Fulfilling the role of sonographer requires responsibility to who?
Yourself, department/facility, patients, and the profession.
What is the most important facet of being a sonographer?
The patient as the primary focus of your efforts.
What is Patient-Focused Care?
A national movement to ensure that every patient receives the best possible medical care.
What is the key term when it comes to patient-focused care?
Listening
What is the Institue of Medicine define patient-focused care as?
Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.
When did the American Hospital Association adopt the patient’s bill of rights?
1973
What is a Patient’s Bill of Rights?
This is a list of guarantees for those receiving medical care.
What did the AHA replace the bill of rights with in 2004?
The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities.
What is “The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities”?
Informs patients about what to expect during their hospital stay regarding their rights and responsibilities.
When will a patient most likely refuse an examination or procedure?
Inpatient
What does CPT stand for?
Current Procedural Terminology
What is Current Procedural Terminology?
a standardized 5 digit code to document and bill for medical services.
What is CPT maintained by?
American Medical Association or AMA
What are some reasons a patient may refuse an ultrasound?
They have had tests all day and are waiting for a visitor
What are some reasons a patient may refuse and examination
They have had tests all day and are waiting for a visitor
They want to talk to their physician
They are feeling ill.
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
What is the Health Insurance Portability and Accountability Act?
National standards to protect the health insurance covering for workers and their families when changing or losing their jobs and to protect individual medical records and other personal information.
When did HIPAA first get signed into law?
1996
What marked the first comprehensive federal protection for privacy of health information?
The HIPAA Privacy Rule
When did HIPAA privacy rule become effective?
April 14, 2003
What does PHI stand for?
Protected Health Information
What is Protect Health Information?
Any information about patients that may limit to, the name, date of birth, the address, phone number, e-mail account, social security number, medical record number, health status, or health insurance information.
True or False: HIPAA is just for hospitals and does not apply to any other healthcare facility or organization.
False
What are the 6 emotions a patient may feel when being diagnosed with an illness?
Denial, Anger, Anxiety, Fear, Grief, and Guilt.
What types of physical changes can anxiety have on a body?
Rapid pulse, increased blood pressure, increased respiration, headaches, nervousness, excessive perspiration, or rapid speech.
What is grief?
The process of adjusting to the reality of a loss.
What percentage is non-verbal when it comes to comforting a patient?
80%
What are vital signs?
these refer to the patient’s temperature, pulse, respiration, and blood pressure.
What is pulse?
The beat of the heart that can be felt as a vibration within the walls of the arteries.
Where is the most convenient site for taking the pulse?
Radial artery which is located on the thumb side of the wrist or the brachial artery in the elbow.
What does pulse rate refer to?
The number of beats per minute (bpm)
What does rythm refer to?
The time interval between beats.
What is the strength of a pulse?
The force of the beat. Described as either bounding or weak and thready.
What substances can cause a heartbeat rhythm to become irregular?
Coffee, tea, tobacco, and certain drugs.
What can cause a weak, thready pulse?
Shock and hemorrhage
What is the normal pulse rate in an adult?
60 to 100 beats per minute.
What is the normal pulse rate in a newborn infant?
120 to 160 beats per minute.
What is arrhythmia?
Any variation of a normal rhythm, including premature beats or palpitations.
What is tachycardia?
Abnormally rapid pulse rate greater than 100 beats per minute.
What is bradycardia?
Abnormally slow pulse rate, lower than 60 beats per minute.
How do you feel for pulse?
Gently compressing the skin over an artery until pulsations are felt.
How do you take an arterial pulse?
- Explain to patient that you need to take their pulse
- Place patients arm in a comfortable resting position.
- Locate the artery and place your fingertips over the artery and press firmly enough you can feel the pulsation.
- Count the beats of the pulse for 30 seconds, then multiply by 2 to obtain beats per minute.
- Note any irregularities.
What is respiration?
Oxygen and carbo dioxide exchange that occurs in the lungs.
How is breathing defined?
the expansion (inspiration) and contraction (expiration) of the lungs
What is considered “normal breaths”?
Quiet, effortless, and regular in rhythm at a rate of 12 to 20 breathers per minute.
What is rate when it comes to breathing?
The number of respirations per minute.
What is depth?
The amount of air taken in with each respiration that is normal, shallow or deep.
What is character?
The quality of respirations. Can be described as quiet, labored, wheezing, and coughing.
What is dyspnea?
Difficulty is breathing.
What is Cyanosis?
Bluish discoloration to the skin
What is pallor?
Grayish or pale appearance to the skin caused by reduced amount of oxyhemoglobin or decreased peripheral perfusion.
What is 1 respiration?
One in-and-out breathing sequence.
What is blood pressure?
pressure that circulation blood exerts against arterial walls. (pumping of the heart.)
What is systolic pressure?
pressure of blood within the arteries is highest whenever the heart contracts. (top number) (when you first hear the heartbeat.)
what is diastolic pressure?
Lowest when the heart is at rest and filling with blood (you cant hear the heart beat anymore) (lowest number)
What is blood pressure measured in?
millimeters of mercury (mm Hg)
What is the average adult blood pressure?
No less than 120/80 or 110/65
What is the average blood pressure of a 1 year old?
95/65
What is the average blood pressure of a 6-9 year old?
100/65
What blood pressure is considered pre-hypertension?
120/80 and 139/89
What is the blood pressure for stage 1 hypertension?
140/90
What is the blood pressure for stage 2 hypertension?
160/100
What is the blood pressure for hypotension?
80/50
What factors can increase blood pressure?
Strong emotions, pain, exercise, and some disease conditions.
What factors can lower blood pressure?
Resting, depression, hemorrhage, and shock.
What happens if you deflate the cuff to slowly?
the reading will be to high
what happens if you deflate the cuff to fast?
the reading will be falsely low
What does pulse oximetry measure?
the oxygen concentration in arterial blood
What is the normal range of pulse oximetry?
95% to 99%
What do pulse oximetry measurements prevent?
Hypoxia and to evaluate the effectiveness of treatment.
Where can you attach the pulse oximetry?
patient’s finger, toe, nose, or earlobe.
What is the most common type of tubing?
Intravenous Infusion (IV), Nasogastric (NG) Suction, Urinary Catheters, and Nasal Catheters and Cannulae
What is intravenous infusion?
its a type of tubing connected to a plastic bag used to infuse fluids into the patient’s body via a needle or plastic catheter that is inserted into a vein.
What is a drip rate?
the amount of fluid over a period of time.
a clamp helps to regulate the flow.
Besides clamps, what else can help to regulate drip rates?
Computerized Infusion Pumps
What are nasogastric tubes?
Tubes used for feeding, obtaining specimens, treat internal obstructions, or to drain fluids from a patient’s stomach via suction.
Where can an nasogastric tube terminate (or stay at?)
The stomach or intestines
What is oxygen therapy?
to lessen a low-oxygen concentration in the blood and to decrease the workload of the respiratory system.
What are some delivery systems for oxygen therapy?
In-Room piping systems, oxygen tanks/cylinders.
What are large oxygen tanks used for?
for patients requiring high flow rates of oxygen use over extended periods.
What are small oxygen tanks used for?
for patient transportation or for short duration needs.
What are some examples of low-flow oxygen devices?
Nasal cannula/nasal prongs, nasal catheter, or simple oxygen masks.
What is a simple oxygen mask?
Transparent mask that fits over the nose, mouth, and chin.
What is a partial rebreathing or reservoir mask?
Its ust like the oxygen mask except it has a bag attached to it that remains inflated by 1/3.
What is a Venturi mask?
high-flow mask that provides reliable and consistent oxygen enrichment. Identified by the presence of hard-plastic adapters on each side.
Only oxygen mask that does not require humidification.
What is a nasal cannula?
used when a patient needs extra oxygen instead of a total supply. prongs are inserted into the patient’s nose, and held in place by a elastic band around their head. Connected to the oxygen source by a length of plastic tubing.
What is a nasal catheter?
tubing longer than a cannula, inserted through the nostril into the back of the patient’s mouth. used when the patient needs oxygen at all times. fastened to the patient’s forehead/cheek by adhesive tape.
What is a urinary catheter used for?
Provide temporary drainage of urine
What is the most common type of catheter used?
Foley
True or false: the foley balloon should be filled with air to prevent it from passing through the patient’s urethra.
False - it should be filled with fluid so it won’t cause artifacts and obscure the patient’s pelvic anatomy. If filled with air, ask the nurse to remove the air and fill it with fluid.
What is a wound drain?
Plastic tubes that provide a way for fluid, blood, or air to drain out of the body and aid in the healing process.
T or F: Sonographers may need to remove the dressing of a wound in order to perform a scan.
True
What patient would use a bedpan?
A female patient generally, however a male patient use them only during bowel movements.
True or False: when handling a bedpan, you should always follow standard precautions?
True
What type of patient would use a urinal?
A male patient
What is a colostomy?
An opening in the colon
What is a Ileostomy?
Opening in the ileum
What is an Emesis Basin?
collects vomit
What was the Joint Commission formerly called?
The Joint Commission of Accreditation of Healthcare Organizations
What did the Joint Commission issue of January 2003?
National Patient Safety Goals
What are NPSG’s?
Promote specific improvements in patient safety.
How often are National Patient Safety Goals evaluated?
Every Year
Who should sonographers anticipate the safety needs of?
Themselves, Coworkers, Patient’s and their Environment.
What is PPE?
Personal Protective Equipment
What are body mechanics?
the use of correct movements during the performance of any activity.
What is a gait belt?
Used to prevent a patient from falling when moving or transporting when they are weak.
What is infection?
The invasion and subsequent multiplication of microorganisms within the body, resulting in localized cellular injury.
What factors can lower the body’s natural resistance to infection?
Age, nutrition, stress, fatigue, medications, general health, and the presence of a disease.
What is a cycle of infection?
when a pathogen finds an environment in which it can grow.
What are the minimum standards for infection control called?
Standard Precautions
What are considered barrier devices?
Gloves, Gowns, Eyeglasses, Face shields, and Masks.
What are Nosocomial Infections?
Infections acquired during a hospital stay.
According to the CDC, every what in what patients will acquire and HAI?
1 in 25
What is the best way to stop the spread of infections?
Proper Handwashing Techniques.
What are some nosocomial infections?
Methicillian-resistant Staphylococcus (MRSA)
Vancomycin-resistant Staphylococcus (VRSA)
Vancomycin-resistant Enterococcus (VRE)
How long does the CDC recommend you wash your hands?
20 seconds, sing the happy birthday song 2x.
What is Clostridium Difficile?
A bacterial infection that can live 70-90 days outside of the body.
Commonly called C. Diff.
What is HPV?
Human Papillomavirus
What is HPV?
a group of more than 150 related viruses.
Transmitted through skin to skin contact
What is the goal of isolation?
To prevent the spread of communicable diseases in hospitals and microorganisms among patients, personnel, and visitors.
What are the 4 types of Isolation?
Strict, Respiratory, Enteric, and Reverse.
What is Strict Isolation?
Designed to protect others from patient’s germs.
Requires a private room, gowns, gloves, and masks to be worn before entry.
Protective eyewear may be required.
What is Respiratory Isolation?
Used to protect others from germs in the patient’s nose, mouth, throat, and lungs.
Used for diseases spread by droplets that are coughed, sneezed, or breathed into the air.
Masks are required.
2 patients with the same disease may be in the same room.
What is Enteric Isolation?
Used to prevent infections transmitted by direct or indirect contact with the feces, diarrheal viruses, hep A, and enteroviruses are included in this category.
Private room required - wash hands, wear gloves and masks.
Dispose gowns into special provided bags.
What is Reverse Isolation?
Used to protect patients with neutropenia, anticancer chemotherapy or steroid therapy, and severely immunocompromised patients.
Wash hands before entering
wear gloves, gowns, masks. (ensure sterile)
When should a sterile field be prepared?
Just before the procedure begins.
What is CPR?
Cardiopulmonary Resuscitation - a procedure involving repeated compressions on a patient’s chest to restore blood circulation and breathing of a person who suffered cardiac arrest.
