Exam 2 Flashcards
Sterilization
complete destruction or elimination of all living microorganisms.
Medical asepsis
reduction in numbers of infectious agents, which, in turn, decreases the probability of infection but does not necessarily reduce it to zero.
Surgical asepsis
procedure used to prevent contamination by microbes and endospores before, during, or after surgery using sterile technique.
Chemical asepsis
The use of disinfectants or antiseptics to alter the environment available to the microbe.
Exogenous transmitted diseases
result from an encounter with a microbe in the environment.
Endogenous transmitted diseases
result of encounters with organisms already present in or on the body.
Nosocomial infection
hospital acquired condition. Generally occurring 72 hours after admittance.
iatrogenic infection
an infection that is the result of intervention with a physician.
Transmission based precautions:
Designed to place a barrier to the spread of highly infectious diseases between persons with such diseases ask the persons caring for them. Three routes: Air, Droplet, contact
Transmission based precautions: Airborne
Examples: tuberculosis, chicken pox and measles. Precautions: private room, standard precautions, mask for patient.
Transmission based precautions: Droplet
Spread by sneezing, coughing, talking, etc. Examples: influenza, rebel, pneumonias, meningococcal meningitis. Precautions: Private room, mask, standard precautions.
Transmission bases precautions: Contact
Direct contact: person actually touches an infected or colonized body surface. Indirect contact: person comes in contact with an object that has been contaminated. Precautions: private room, gloves, wear gown, standard precautions.
Standard precautions:
precautions used to prevent the transmission of disease by body fluids and substances.
Sterile field
the work area where sterile supplies are placed for procedures. It is considered free of microorganisms.
Exams using sterile technique:
Angiography Atrhrography Myelography Hysterosalpingography Exams in the operating room
Only ____ items are used in sterile fields.
sterile
If in doubt about the sterility of an object:
Consider it unsterile
Sterile field must be ______ to be considered sterile.
continually monitored
T/F: Create sterile fields as close to time of use as possible
True
Sterile persons should avoid:
unsterile areas
Anything below level of table or level of waist is considered:
unsterile
The undersurface of the drape is considered:
unsterile
Sleeves on gowns are considered:
sterile
Front of waist is considered:
sterile
Back of gown and below waist is considered:
unsterile
Persons in sterile gown and gloves must pass each other:
back to back
A sterile person may touch only:
what is sterile
Unsterile persons ________ reach above or over a sterile field.
cannot
T/F: Sterile materials are still considered sterile when wet.
False
If solution soaks through a sterile field to non sterile, then:
wet area may be redraped.
Sterile gloves must be kept _____ and ______ waist level.
in sight/above.
Sterile field is established using:
a sterile drape
How to confirm that the package containing the drape is sterile
Must be clean and dry
Check expiration date
Not opened
Opening a sterile package:
Place package on center of surface.
Open package away from you.
Do not let any unsterile object touch insides of package.
Drop sterile towels on sterile field while wrapping away from sterile field.
Drop approximately 6 inches above the field at a slight angle.
Use free hand to hold back wrapping from touching sterile field.
Neonatal Contact shielding:
placing lead directly on infant’s gonad
Neonatal shadow shielding
hanging a piece of lead in the beam to cast a shadow in the collimator light
Shadow shielding requires:
low levels of ambient light
Contact shielding has a greater potential for
cross-infection
What two things are major threats resulting significant morbidity and mortality each year in neonatal unit?
Sepsis and nosocomial infections
Nonaseptic
the use of equipment and exams where it is unnecessary to maintain a sterile environment.
NG tubes
plastic or rubber tubes inserted through the nasopharynx into stomach. Primarily used for decompression or removal of flatus (gas) and fluid from stomach.
When NG tubes are used for feeding, they are connected to:
an electronic pump that controls and measures intake as well as signals any interruption in feeding.
RT’s perform abdominal films on patients with NG tubes to:
confirm placement of these tubes
Be careful when moving patients with NG tubes….why?
Because you may dislodge the tube.
NG tubes are generally hooked to:
low pressure suction.
If patient is continually being suctioned then:
Dr’s orders are needed to stop in order to remove pt from room.
Removal of NG tube is usually performed by
a nurse
_____ are typically all that is needed to handle the end of an NG tube.
Gloves
During occasions when RT is assisting patient using urinal:
Provide privacy
Offer a washcloth
Do not discard urine if being monitored.
Describe process of emptying urinal when urine is not being monitored.
Wear gloves empty contents rinse with cold water place with soiled supplies remove gloves wash hands
Things to remember when using bedpans
Used for dedication and for urination for female
If necessary to move patient, use two people.
Fracture pan is lower to accommodate trauma patient.
Wear gloves/wash.
Hypotonic enema
uses tap water to cleanse colon.
Hypertonic enema
used when patient can t tolerate large amounts of fluid.
Barium enema is used for:
to diagnose pathology and conditions of colon or lower GI tract.
The most common complication of a barium enema is
damage to the rectal wall due to overinflation of the balloon catheter.
Double-contrast barium enema indicated for:
diarrhea high risk-cases polyps family history personal history of cancer rectal bleeding
Single-contrast barium enema indicated for:
gross pathology fistulas acute appendicitis or diverticulitis intussusception obstruction
What kinds of drugs are used with barium enema?
Glucagon is administered immediately before exam to relieve bowel spasm.
Post barium enema instructions
Lack of bowel movement 24 hours post procedure should prompt patient to contact physician.
Symptoms such as bleeding, weakness, constipation & abdominal pain should be brought to physicians’s attention.
What is a colostomy?
surgical creation of an opening between the colon and surface of the body, due to trauma, cancer, diverticulitis, colitis, etc. May be permanent or temporary.
Emergency
a situation in which the condition of a patient or a sudden change in medical status requires immediate action
General priorities during an emergency situation
Ensure open airway Control bleeding Prevent or treat shock Attend to wounds or fractures Provide emotional support Continually reevaluate and follow up appropriately.
Emergency cart
Emergency cart contains drugs and equipment needed to respond to life threatening situations
AED
Automatic External Defibrillator. Application of external electrical shock to restore normal cardiac rhythm and rate
PAD
Public Access Defibrillation. Can be fully automatic or semi-automatic.
Ventricular fibrillation
is a fluttering or ineffective cardiac rhythm that results in heart’s inability to pump blood. AED helps restore ventricular rhythm.
The simplest way to classify head injuries is
level of consciousness
Level of consciousness are
Alert & conscious
Drowsy but responds
Alert someone
Unconscious
Get help
Comatose & unresponsive
Call a codeSigns of Deteriorating Situations
Irritability
Lethargy
Slowing pulse rate
Slowing respiratory rate
Response by RT during medical emergency
Maintain open airway
Move pt as little as possible
Procedure stopped
Medical assistance obtained ASAP
Shock:
general term indicating a failure of the circulatory system to support vital body functions.
Types of shock
Hypovolemic
Cardiogenic
Neurogenic
Vasogenic
Hypovolemic
caused by loss of blood or tissue fluid
Cardiogenic
caused by variety of cardiac disorders
Neurogenic
caused by spinal anesthesia or damage to upper spinal cord
Vasogenic
caused by sepsis, deep anesthesia or anaphylaxis
What are the two types of shock that are most likely to be encountered in the x-ray department?
Hypovolemic or Anaphylactic. This is contributed to a result of reaction to contrast media.
What are the causes of shock?
Sudden change in body temp, pain, stress and anxiety.
Signs and symptoms of shock are:
Restlessness Apprehension/general anxiety Decreasing blood pressure Tachycardia Pallor Cold & clammy skin
RT’s reaction to shock:
Stop the procedure
Ensure maintenance of the patient’s body temperature
Call for medical assistance
Measure patient’s vital signs while waiting for assistance
Anaphylactic shock is a type of:
vasogenic shock
Re: Anaphylactic shock due to contrast media….Because the most severe reaction can result in death (due to cardiac arrest)….
contrast media should never be administered without first taking an adequate history
Regarding anaphylactic shock, the most severe reactions happen (how fast?)
quickly.
Mild reactions to contrast media:
Uticaria (hives)
Sneezing
Itching
Monitoring of the patient after the exam can identify
any unlikely delayed reaction
Although reactions to contrast media may be mild:
they may be an indication of the beginning of a more serious reaction
How is a reaction to contrast media treated?
Antihistamine is administered to counter the allergic reaction
Serious reactions to contrast media:
Laryngeal edema
Shock
Cardiac arrest
RT’s reaction to serious reaction to contrast media:
Physician notified ASAP & vital signs taken
What are some examples of radiological procedures that require that the patient be fasting and places diabetic patients in a compromised situation?
Upper GI, Sm Bowel studies, Barium Enema, etc.
Hypoglycemia
Condition where excessive insulin is present.
If patient has an insufficient amount of glucose they will go into insulin shock or insulin reaction.
Symptoms of hypoglycemia
Intensely hungry, weak, shaky, sweat excessively, confused, irritable, possibly aggressive and mildly hostile
Treatment of hypoglycemia
Glucose tablets
Orange juice
Sugared soft drink
Candy bar,any form of carbohydrate
Pt should sit quietly until food has taken effect (10-15 min.)
No food should be administered to an unconscious patient
Hyperglycemia
A condition where excess sugar is in the blood
Condition may develop gradually so may not be noticed by a technologist
Symptoms of hyperglycemia
rapid thirst & urination, dry mucosa, rapid and deep breathing, drowsiness and confusion
How to treat hyperglycemia
Patient needs to be treated with insulin
Seek medical help ASAP
If left untreated condition will lead to diabetic coma
Other terms associated with hyperglycemia are
hyperosmolar coma and ketoacidosis
Asthma or respiratory distress occurs in the radiology department since it seems to be brought on by
stressful situations
Symptoms of asthma
wheezing
Reaction of the RT to asthma attack:
Stop the procedure
Assist pt to sitting position
Maintain calm demeanor
If the patient cannot speak due to an airway obstruction:
the Heimlich maneuver would be appropriate.
RT’s reaction to choking:
Ascertain that the patient is choking
“Can you speak?”
Encourage patient to cough
Abdominal thrust (Heimlich maneuver)
How to perform the Heimlich on an unconscious patient:
Patient placed in supine position
Heel of hand on victim’s abd above navel, below sternum
Pressure applied in quick upward thrust
Heimlich maneuver for a pregnant patient:
Chest thrust used in place of abdominal thrust
Heimlich on infants
combination of back blows and chest thrusts
Cardiac arrest
Sudden stopage of cardiac output
If not treated leads to permanent organ damage or death
Symptoms of cardiac arrest
crushing chest pain, may also be readiating down left arm
RT reaction to cardiac arrest
CALL FOR HELP IMMEDIATELY
BEGIN CPR
Why must CPR be administered immediately for cardiac arrest?
Cerebral functions are generally impaired if brain is deprived of oxygen for 4 – 6 minutes.
What are the ABC’s of CPR?
Airway
Breathing
Circulation
Possible complications of CPR
Rib fractures Fractured sternum Pneumothorax Lacerated liver and spleen Fat emboli
What is a CVA?
Cerbrovascular Accident (stroke or brain attack.)
What are symptoms of a stroke?
paralysis on one or both sides Slurred speech Complete loss of speech Extreme dizziness Loss of vision Complete loss of consciousness
Does a stroke come on quickly, or over a number of hours.
Can be either.
What is a TIA?
transient ischemic attack (mini-stroke)
What are the symptoms of a TIA?
Same symptoms as a stroke, however they last less than 24 hours. paralysis on one or both sides Slurred speech Complete loss of speech Extreme dizziness Loss of vision Complete loss of consciousness
Some examples of minor medical emergencies are:
Nausea, epitaxis, vertigo, syncope, seizures, falls, wounds, burns.
RT’s reaction to nausea
Provide emesis basin and a cold wash cloth. Encourage patient to breathe slowly and deeply through mouth. Allow patient time to relax, position them upright or semi upright, and if that’s not possible, turn their head to the side.
Epitaxis
nosebleed.
RT reaction to nosebleed
Have patient lean forward and pinch nostril. If pressure fails, use moist compress. If bleeding does not stop within 15 minutes, medical assistance should be obtained.
What is vertigo?
Diziness
What is syncope?
Fainting. Temporary state of shock as result of lack of blood flow to brain
Vertigo and syncope are experienced by patients who have been:
bedridden or had limited mobility for an extended amount of time. Vertigo patients should be assisted to seated or recumbent position.
Patients arising from radiographic table will experience vertigo as a result of
orthostatic hypotension
Steps to increase blood flow to head following syncope:
Patient assisted to recumbent position with feet elevated
Tight clothing loosened
Most cloth applied to forehead
Characteristics of seizures
Caused by variety of factors
Range from mild to severe
Characterized by involuntary contraction of muscles
Last for a minute to several minutes
RT reaction to patient seizure
Prevent pt from injuring themselves Do not attempt to restrain patient Never place hand in mouth Move pt to floor, away from objects Place pillow under head Assure open airway Note where seizure began One-sided or two-sided Length of seizure
RT reaction to falls
RT should attempt to minimize physical impact of fall so as to minimize injury for both technologist and patient
Hemorrhage
bleed outside a vessel
RT reaction to hemorrhage
Apply pressure
May take 10 min. to clot
Dressing should not be removed
If necessary apply clean dressing
If extremity is bleeding, place above level of heart unless contraindicated
This will slow blood flow and result in less blood loss
How to handle a patient with burns
Care must be taken by RT to maintain proper infection control and minimize pain while positioning image receptors under patient during an exam
Burns are extremely painful injuries – extra gentle care is required when handling burn victim
Wound Dehiscence
Reopening of a wound/incision. Patient’s sutures separate
Abdominal contents come out of peritoneal cavity
RT reaction to wound dehiscence
Do not attempt to replace tissue into Abd
Cover area with sterile dressing
Seek medical attention ASAP
Beginning 20th century, what were the major causes of death in US due to infectious diseases
Pneumonia
TB
Diptheria
Infection
the establishment & growth of a microorganism on or in a host.
Pathogenic microorganisms cause
infectious diseases
Pathogens have ability to:
Multiply in large numbers
Cause tissue damage
Secrete exotoxins
Pathogens are divided into what 4 infectious agents?
Bacteria-
can remain viable for many years & then germinate
Viruses –
needs a host/unresponsive to antibiotics
Fungi-
ex. Athlete’s foot
Protozoan parasites
ex. malariaSix steps of Establishment of Infectious Disease
- Encounter
- Entry
- Spread
- Multiplication
- Damage
- Outcome
Encounters are numerous and span a lifetime.
Encounter
involves the infectious organism coming in contact with the host.
Congenital
microorganisms able to pass through placenta to create infection
ex: rubella and syphillis
Entry
Ingression: microorganisms adhere to the surface of the cell and excrete toxins Example: Digestive system Diarrhea Respiratory system pneumonia
Entry
Penetration involves microorganisms invading past the epithelial barrier
Example:
Cuts & Wounds
Mosquito bites
Spread
the propagation of infectious organisms
Spread of infection depends on the site of infection and type
Most important barrier of spreading disease is:
the immune system
Most important means of controlling spread of microorganisms is through
hand washing
Multiplication
Number of infectious agents need to multiply before impact is noticed
Incubation period
time frame in which the infection has set in until the time a substantial number of microbes has multiplied or increased
Direct damage
Cells are destroyed in the host by poisons secreted by the infectious agent
In a matter of hours enough organisms may be present to cause a complete obstruction in a major organ system
Ex: snake bite
Effects usually immediate
Indirect damage
The host is infected in such a way that their metabolism can be altered and it is just a matter of time before serious results take effect.
Ex. Botulism
Usually delayed effect
Three possible outcomes of infection:
The host gains control and eliminates the infection
The infection overcomes the host’s immune system.
There is a compromise and a coexistence.
Four factors are involved in the spread of diseases
- host
- infectious microorganism
- mode of transmission
- reservoir
Vector
carrier that transfers an infective agent from one host to another
Fomite
inanimate object able to harbor pathogenic microorganisms, serving as an agent of transmission
Reservior
The site where an infectious organism can remain alive
Transmission can continue to occur
Compromised patient
Patients who have weakened resistance to infectious organisms because of their admitting illness
Hospital patients have a greater sensitivity to infection
Sources of infection
Medical Personnel Patient Flora Contaminated hospital environment Blood-borne pathogens Invasive procedures
Infection from medical personel
Can be Direct or indirect, through Ingestion or inhalation from food handlers or surgeons.
Examples of patient flora
Skin
Gastrointestinal system
Genitourinay system
Respiratory system
Examples of contaminated hospital environment
Mildew
Improperly sterilized surgical equipment
Contaminated IV solution
Fomites
Blood-borne pathogens
Disease-causing microorganisms that may be present in human blood
Considered nosocomial infections
Invasive procedures
Any surgery & insertion of devices as needles, vascular catheters, endotracheal tubes & endoscopes
Defenses of the body
Mechanical, chemical, cellular
Mechanical defenses of the body
skin, handwashing
chemical defenses of the body
Sebaceous/sweat glands
Mucous membranes
Cellular defenses of the body
Acidity of the stomach
Chemotherapy
Treatment of a disease by chemical agents
Static chemotherapy
chemo drugs that inhibit growth but do not kill them off
Bacteriocidal chemotherapy
ability to kill susceptible microbes
Immunization
security against a particular disease
Vaccine
any preparation used as a preventive inoculation to confer immunity against a specific disease
Environmental control agencies
Department of Health and Human Services (DHHS), Center for Disease Control and prevention (CDC), US Dept of Labor’s Occupational Safety & Health Administration (OSHA), World Health Organization (WHO)
Responsibilities of Dept. of Health & Human Services (HHS) & Centers for Disease Control & Prevention (CDC)
make the recommendations and guidelines for environmental control of infectious disease in U.S.
Responsibilities of US Dept of Labor’s Occupational Safety & Health Administration (OSHA)
enforces policies.
Responsibilities of World Health Organization (WHO)
issues recommendations for infection control
Extravasation
Fluid leaking into the surrounding tissue.
