Chapter 7, 8, 11, 12 Flashcards
Which age group is not fearful of strangers?
Infants (1 to 12 months)
Which age group is the “age of initiative”?
Preschooler (3 to 6 years)
Which age group is the “age of identity”?
Adolescents (12 to 19 years)
Which age is not fearful of strangers?
Toddlers (1 to 3 years)
When should immobilizers be used?
Only when no other means are safe or logical
When performing radiographic procedures for pediatric patients, who’s help may be enlisted to assist the technologist performing the procedure?
Parents, nurses, other health care workers, another technologist
How may a sheet be used as a form of immobilization?
Properly folded or as a mummy-style wrap
How might sandbags be used as a form of immobilization?
Place beside the area to prevent movement towards the sides; do not place on the patient or in the field to be x-rayed
Besides checking for the possibility of pregnancy and the proper use of lead aprons and other radiation protection equipment, what is necessary to use the mother of a child for immobilization purposes?
Communication and detailed instructions
What is the usual length of time for handwashing before entering the NICU?
At least 2 minutes or the hospital’s protocol
What is the best method of making a child feel at ease and establishing communication before an imaging procedure?
Make eye contact at the child’s level if possible
Due to the fact that the cells in the body of a child are rapidly growing, rapidly changing, easily damaged, and very radiosensitive, what precautions should be strictly adhered to?
Radiation protection
When child abuse is suspected by the behavior of a child having a radiographic procedure, who should be notified of these suspicions?
The person at the institution who makes these types of inquiries and required reports. Notifying the wrong person/s could be catastrophic!
Regardless of the type of examination being performed, what should be communicated to a child if the procedure will be painful or very uncomfortable?
Tell the truth but also reassure the patient by being honest, concise, and friendly
When should pediatric patients be restrained?
Only when necessary
What is the recommended tone to be used with pediatric patients?
Communication should be nonthreatening and age appropriate
What type of immobilizer may be used for upright radiography of the chest and abdomen of an infant or small toddler?
Pigg-O-Stat
When a technologist returns a pediatric patient back to his or her room and into a crib, what safety precaution is required?
Make sure the side rails are up on the crib
Which age group should be allowed to confirm his or her own identity, have the procedure explained directly to him or her, and have a concern for the patient’s privacy?
Adolescents
All patients are to have maximum radiation protection used for them. What is a major concern that must be addressed with adolescent patients?
Addressing the possibility of pregnancy for female patients
Is it appropriate for the radiographer to inform preschool children of the disease that may be diagnosed by the procedure being performed?
No, it is not age appropriate
What age group may be given the results of images by the radiographer for the radiographs taken?
At no age for child or adult
what is age of pediatric patient?
infant - 15
Infants age?
Birth to 12 months
Toddlers
1 to 3 years
Preschooler
3 to 5 years
School age
6 to 12 years
what to transfer infants/children in:
Portable incubator
Crib
Gurney
Wheelchair
types of immobliizers:
Commercial
Sheet Immobilizers
Mummy-Style Sheet Wrap Immobilizer
Commercial Immobilizers and Other Positioning Aids
type of Commercial immobilizers
Pigg-o-stat, Papoose
Commercial Immobilizers and Other Positioning Aids
Posi-tot
Tam-em board
Infantainer
Sandbags
_____________ is a campaign dedicated to radiation protection for children
image gently
Child abuse includes the following
Physical abuse and neglect
Emotional abuse
Sexual abuse
Elderly patients are burdened with _____ illness rather than acute
chronic
Symptoms of depression in the elderly person are often confused with “______.”
dementia
true or false:
The skin of the geriatric patient is fragile and thus more easily traumatized
true
Normal Changes of Aging in Pulmonary System:
Lung capacity diminishes
The cough reflex becomes less effective
The normal respiratory defense mechanism lose effectiveness
Normal changes of aging in Cardiovascular System:
Coronary arteries calcify, lose elasticity Aorta and branches dilate, elongate Heart valves thicken Decline in coronary blood flow Baroreceptors become less sensitive
Normal Changes of Aging
in Gastrointestinal System:
Gastric secretion, absorption and motility decreases
The abdominal muscles weaken
Many patients are edentulous (without teeth), have dentures or partial plates
Esophageal motility declines
Normal Changes of Aging of Hepatic System:
Liver size decreases
Enzyme activity and synthesis of cholesterol decrease
Bile storage is reduced
Normal Changes of Aging: Women in Genitourinary System:
Muscle tone and bladder capacity decrease
Pubic hair becomes sparse
Vaginal atrophy occurs
Involuntary bladder contractions increase
Normal Changes of Aging: men in Genitourinary System:
Prostate gland enlarges
Tone of bladder neck increases
Urinary bladder capacity decreases
Size of penis and testes decreases
Normal Changes of Aging in Musculoskeletal System:
Bone mass is reduced; bones become weaker
Muscle mass decreases; replaced by fibrous connective tissue
Muscle strength decreases
Intervertebral discs shrink, vertebrae collapse
Articular cartilage erodes
Normal lordotic curve of lower back flattens
Flexion and extension of lower back diminished
Placement of neck and shaft of femur changes
Posture and gait change
Men: gait narrows and becomes wider based
Women: legs bow and gait is somewhat waddling
Normal Changes of Aging in Neurological System:
Brain weight changes; reduced size of neurons Possible short-term memory loss Sensorimotor function decreases Decreased reaction time Need more time to perform activities Decreased postural stability Decreased proprioception; spatial relation problems Loss of sensitivity to deep pain
what is elder abuse?
neglect, mistreatment or exploitation of anyone age 65 or older (or any disabled dependent adult).
There are three categories of elder abuse:
- Domestic elder abuse
- Institutional elder abuse
- Self-neglect or Self-abuse
Catheterization of the urinary bladder refers to the insertion of a ___,____, ____tube through the urethral meatus into the urinary bladder
plastic, silicone, or rubber
_____ is radiography of the bladder
Cystography
________ are catheters from the kidney to the bladder
Ureteral stents
Catheterization is performed:
To drain
To instill contrast for pathological findings
Post surgery
Establish what type of catheter to use:
Straight
Indwelling
Indwelling :
is a catheter which is inserted and left in place to allow continuous drainage of urine (most commonly used in radiology).
Straight :
Is used to obtain a specimen or to empty the bladder and then removed.
what kind of lumen does indwelling have?
has a double lumen with an inflatable balloon at one end. One lumen is attached to the urinary bag and the other lumen is for instilling sterile water into the balloon.
The balloon holds the catheter in place after inserting it into the bladder and filling with sterile water
what kind of lumen does strait have?
Single lumen, no balloon
true or false?
Keep the drainage bag below the level of the urinary bladder to maintain gravity flow and prevent contamination due to back flow of the urine.
true
Two common methods, could be temporary or permanent catheters:
Suprapubic catheter
Condom catheter
Suprapubic Catheter
Catheter placed directly into bladder through abdominal incision.
Reduce risk of infection as a long-term method of bladder drainage and facilitate normal urination after surgery.
Condom Catheter
Externally applied drainage used for males who are susceptible to UTIs or are incontinent or comatose
A soft rubber sheath that is placed over the penis and secured with adhesive material
Cystography
Radiographic imaging of the bladder. Using fluoroscope and radiography, the urinary bladder is visualized as it fills with contrast media and empties
Retrograde Pyelogram
Radiographic technique performed to visualize the proximal ureters and the kidneys after injection of an iodinated contrast agent through the ureter. This is done with a scope by a urologist
There are two types of radiographic contrast agents:
Positive and Negative
Negative
decreases organ density to produce contrast
2 types of Negative:
Carbon dioxide
Air
Negative contrast gives a ____(like air) appearance on an image
black
Positive
increases organ density and improves radiographic visualization. Positive contrast agents create a density difference such as white or opaque appearance on the image.
2 types of Positive:
Barium
Iodinated contrasts
true or false?
All exams that do not require contrast media should be imaged first
true
true or false?
Ultrasound should not be imaged prior to any GI studies
false: should be b/c of the contrast blocking views
true or false?
BE study should be imaged first then the UGI to follow
true
The most frequently used cleansing enemas are:
Saline enema Hypertonic enema Oil-retention enema Tap water enema Soap suds enema Self-administered enema
Hyperosmolar:
can create dehydration
Hyposmolar
can create fluid toxicity
A ____is created by bringing a loop of bowel to the skin surface of the abdomen.
stoma
____is Named by the Area of Surgery
Ostomy
If the opening is from the colon =
colostomy
If the opening is from the ileum =
ileostomy
How does aging affect the absorption of vitamin B12?
Increases
How does aging affect the size of the liver?
Increases
How does aging affect enzyme activity?
Increases
How does aging affect bile storage?
Reduced
What is the most commonly seen complication that occurs after hip arthroplasty in geriatric patients?
Dislocation
If a geriatric patient finds lying on the hard radiographic table uncomfortable and painful what can be done to improve this?
Place a radiolucent pad on the table
What may a lack of affection towards an elderly patient by a caregiver indicate?
Elder abuse
What may answering questions for an elderly patient by a caregiver indicate?
Elder abuse
What may inappropriate sexual behavior by a caregiver around an elderly patient indicate?
Elder abuse
What may unconcern for an elderly patient’s comfort indicate?
Elder abuse
Because dislocation is the most common complication of arthroplasty, what should every technologist be aware of when caring for a patient after this corrective surgery?
Movement restrictions
What may the appearance of a new “best friend” assisting with bill paying in secret for an elderly patient indicate?
Financial abuse
Are symptoms of dementia, including disorientation, confusion, gross memory deficits, paranoid ideation, hallucinations, and depression part of the normal aging process?
No
Which site is the most common for athroplastic surgery?
Hip
Hypertension, arthritis, diabetes mellitus, pulmonary disease, and visual and hearing impairments are common conditions requiring what type of care?
Long term care
Heart diseases, strokes, and cancer are common conditions associated with what type of result?
Death
When should elderly patients be scheduled for difficult diagnostic examinations?
Early morning
Why are additional or warm blankets helpful to prevent discomfort or hypothermia during radiographic examinations?
Decreased circulation is a normal cardiovascular system problem of elderly patients
What is an abnormally increased convexity in the thoracic spine curvature?
Kyphosis
Nails losing their luster with yellowing and thickening, areas of the skin losing their pigment with possible appearance of purple macules and senile purpura, and skin on the back of the hands and forearms becoming thin and fragile are all normal changes of the aging in which system?
Integumentary system
Why is it recommended to use a barium enema tip with an inflation cuff for elderly patients undergoing a barium enema examination?
A normal loss of sphincter control
Esophageal motility declines, abdominal muscles weaken, and gastric secretion, absorption, and motility decreases are all normal changes of aging of which system?
Gastrointestinal system
Muscle strength decreases, flattening of the normal lordotic curve of the lower back, decreasing muscle mass, and changes in posture and gait are all normal changes of aging of which system?
Musculoskeletal system
What type of catheter has one lumen for continuous urinary drainage and one lumen for instilling sterile water into the balloon?
Indwelling catheter with double lumen
What is a radiographic technique performed by a radiologist or urologist to visualize the proximal ureters and the kidneys for obstruction after injection of an iodinated contrast medium?
Retrograde pyelography
What is a radiological procedure used to visualize abnormalities of the urinary system, including the kidneys, ureters, and bladder?
Intravenous pyelography (IVP)
What is radiography of the urinary bladder and urethra?
Cystourethrography
What is radiography of the urethra studied as the patient voids upon removal of the catheter?
Voiding cystourethrography
What is the sign used to determine that the introduction of a urethral catheter into the bladder has been placed properly?
A flow of urine
The drainage of urine, the instilling of medication, and the insertion of contrast into the bladder are all reasons to perform what procedure?
Catheterization of the urinary bladder
What should be done before cleansing a patient for catheterization?
Warn the patient
What type of catheter is used after surgery to allow the patient urinary emptying?
Indwelling catheter
Which catheter is used to obtain a specimen or to empty the bladder and then removed?
straight catheter
Which type of catheter is inserted and left in place to allow for continuous drainage of urine?
Indwelling catheter
Why is a strict surgical aseptic technique In maintained during catheterization of the urinary bladder?
To prevent urinary tract infections
In what patients is cystography generally contraindicated?
Pregnancy
When performing cystography on patients with UTIs, why must special considerations be made?
The possibility to spread the infection to other pelvic organs
What type of catheter is placed directly into the bladder by means of an abdominal incision?
Suprapubic catheter
What are the considerations required for proper scheduling of diagnostic examinations?
a. Procedures that require fasting must be done in the morning.
b. All examinations or procedures that do not require contrast media should be scheduled first.
c. Ultrasonagraphy and nuclear medicine procedures must be scheduled prior to contrast studies, so that the contrast will not interfere with these examinations.
d. Iodinated contrast studies must be performed prior to barium studies
e. When a patient is scheduled for both upper and lower GI systems with barium, the lower GI series should be scheduled first,
What are some of the conditions that may be treated by the creation of a stoma through which the contents of the bowel can be eliminated?
Cancer, diverticulitis, and ulcerative colitis
What procedure is performed to find the reason for abdominal pain, a change in bowel habits (constant diarrhea or constipation), or to diagnose cancer, or to determine the location of parasites, or why blood, mucus, or pus is found in the stool?
Barium enema
What type of soap is the only safe type for soapsuds enemas?
Castile soap
Why may soap be added to tap water or to normal saline for soapsuds enemas?
To increase irritation of the intestine to promote peristalsis and defecation before a barium enema
What are the two types of positive contrast media?
Iodinated contrast and barium
When does barium have the most potential for an adverse effect to occur?
If there is a break in the gastric mucosa caused by injury or disease, the barium sulfate may pass into the respiratory tract into the peritoneal cavity or into the bloodstream
What is the most frequently chosen contrast medium for radiologic examination of the GI tract?
Barium sulfate
How does a negative contrast agent affect organ density?
Decreases it
Is a negative contrast agent radiolucent or radiopaque?
Radiolucent
How does a positive contrast agent affect organ density?
Increases it
Is a positive contrast agent radiolucent or radiopaque?
Radiopaque
What are examples of negative contrast agents?
Air and carbon dioxide
What are the two contrast agents used in a double-contrast radiographic study of the gastrointestinal system?
Barium and air
Which positive contrast agent is contraindicated when a patient has a suspected bowel obstruction?
Barium
