Final Flashcards
1
Q
What are the 4 vital signs?
A
temperature
pulse
respiration rate
blood pressure
2
Q
What is body temperature?
A
measurement of the degree of heat of the deep tissues of the human body
3
Q
What is thermoregulation?
A
the body’s maintenance of heat production and heat loss
4
Q
What plays an important role by removing excess heat through ventilation?
A
the respiratory system
5
Q
How long should a thermometer be placed under the tongue when using a glass thermometer?
A
3 minutes
6
Q
When using an electronic thermometer, how long should it be placed under the tongue?
A
20 seconds
7
Q
What is normal body temperature?
A
98.6 F (37 C)
8
Q
How does the hypothalamus dissipate heat?
A
sweating and peripheral vasodilation
9
Q
How does the hypothalamus preserve heat?
A
Shivering to generate heat and vasoconstriction to conserve heat
10
Q
What are the four methods of measuring body temperature?
A
Rectal
Oral
Axillary
Tympanic
11
Q
How long should you wait before taking an oral temperature if the patient has ingested hot or cold liquids or foods or just smoked?
A
15-30 minutes
12
Q
What is the least reliable measure of temperature?
A
axillary
13
Q
What is the major muscle of ventilation?
A
diaphragm
14
Q
What does a single respiration consist of?
A
one inspiration and one expiration
15
Q
How may a respiratory rate be obtained?
A
by observing the rise and fall of the chest
16
Q
What is normal respiratory rate for an adult?
A
12-20 breaths per minute
17
Q
What is normal respiration rate for children under 10?
A
20-30 breaths per minute
18
Q
What is normal respiration for newborns?
A
30-60 breaths per minute
19
Q
What is tachypnea?
A
respiratory rate greater than 20 breaths per minute
20
Q
What are common causes of tachypnea?
A
exercise
fever
anxiety
pain
infection
heart failure
chest trauma
decreased oxygen in blood
central nervous system disease
21
Q
What is bradypnea?
A
decrease in respiratory rate
22
Q
What are common causes of bradypnea?
A
depression of respiratory center of brain
drug overdose
head trauma
hypothermia
23
Q
What is dyspnea?
A
difficulty breathing
24
Q
What is apnea?
A
absence of breathing
25
What is a pulse?
produced each time the left ventricle of the heart contracts and forces blood into the aorta and peripheral arteries
26
What is resting pulse rate in an adult?
60-100 bpm
27
What is normal pulse rate in children under 10?
70-120
28
What is tachycardia?
heart rate greater than 100 bpm
29
What are causes of tachycardia?
exercise
fever
anemia
respiratory disorders
congestive heart failure
hypoxemia
shock
30
What is bradycardia?
pulse rate less than 60 bpm
31
What are causes of bradycardia?
unrelieved severe pain
some drugs- such as a beta blocker
resting in supine position
32
What is a thready pulse?
weak difficult to count indicates poor blood flow
33
What are the locations of pulse?
temporal
carotid
apical
brachial
radial
femoral
popliteal
pedal
34
Where is the temporal pulse?
pulse on each side of the temple: temporal artery
35
Where is the carotid pulse?
the pulse felt along the large carotid artery on either side of the neck
36
Where is the apical pulse?
pulse taken with stethoscope and near the apex of the heart
37
Where is the brachial pulse?
the pulse felt in the upper arm
38
Where is the radial pulse
the pulse felt at the wrist
39
Where is the femoral pulse?
pulse of the femoral artery felt in the groin
40
Where is the popliteal pulse?
behind the knee
41
Where is the pedal pulse?
obtained on the top of the foot
42
What is blood pressure?
a measure of the amount of force that the blood places on the walls of blood vessels, particularly large arteries, as it is pumped through the body
43
What is systolic blood pressure?
pressure exerted on blood vessels when the heart is contracting
44
What is diastolic blood pressure?
pressure exerted on blood vessels when heart is at rest
45
What is blood pressure measured in?
millimeters of mercury
46
What is average adult systolic range?
100-140
47
What is average adult diastolic range?
60-90
48
What is hypertension?
high blood pressure
49
What is hypotension?
low blood pressure
50
What are factors that affect blood pressure?
age
gender
blood volume
stress
pain
exercise
weight
race
diet
medications
position
51
What is medical asepsis?
any practice that helps reduce the number and spread of microorganisms
52
What is surgical aspesis?
complete removal of microorganisms and their spores from the surface of an object
53
What are the 6 methods of sterilization?
steam under pressure
gas
chemical
dry heat
ionizing radiation
microwaves/nonionizing radiation
54
What are basic principles of sterile technique?
-If in doubt about sterility consider it unsterile
-Sterile persons should avoid unsterile areas
-Anything below table or waist is unsterile
-Gowns are sterile on sleeves and front from waist up
-Sterile persons pass each other back to back
-Sterile person only touches sterile things
-Unsterile person do not reach above or over sterile field
-Sterile materials must be kept dry
-Wet area should be redraped
-Sterile gloves kept above waist level
55
What is a peripheral angiography?
radiologic examination of the arteries of the legs and or arms after injection of contrast
56
What are indications for peripheral angiography?
-atherosclerosis disease
-vessel occlusion and stenosis
-trauma
-neoplasm
-embolus and thrombus
-arteriovenous malformations
-thoracic outlet syndrome
57
What is the recommended contrast dose for peripheral angiography for lower extremities?
30 ml unilateral
50-70 ml bilateral
at a rate of 8-10 ml per second
58
What is the recommended contrast dose for peripheral angiography for distal arm and forearm?
15-24 ml over a period of 2-4 seconds
59
What are complications of peripheral angiography?
increased rate of femoral thrombosis
upper extremity: arterial spasm, arterial thrombosis, injection of contrast into wrong vessel, local hematoma and nerve root damage
60
What is cerebral angiography?
study of blood vessels in the brain
61
What are pathological indications for cerebral angiography?
vascular stenosis and occlusions
aneurysms
trauma
arteriovenous malformations
neoplastic disease
tumors
62
What is the catheterizations approach for cerebral angiography?
femoral- catheter advanced into aortic arch and vessel to be imaged is selected
common carotid, internal carotid arteries, external carotid arteries and vertebral arteries
63
What are the 3 main branches off the aortic arch?
brachiocephalic trunk
left common carotid artery
left subclavian artery
64
What is the left common carotid artery?
originates at the highest point of the aortic arch ascends to the left sternoclavicular joint where it enters the neck
65
What are the common carotid arteries?
unequal in length with the left one being 4-5 cm longer than the right
66
What is the circle of willis?
formed by the anterior communicating and the posterior communicating arteries
67
What are complications of cerebral angiography?
hematoma at puncture site
hemiparesis
loss of vision
gangrene of lower extremity
68
What is angiography?
exam of vascular structures within the body after the injection of contrast
69
What are types of angiographic procedures?
arteriography
venography
angiography
lymphagraphy
70
What are indications for angiography?
verify presence of tumors
internal bleeding
stenosis
occlusions
aneurysms
heart disease
71
What are contraindications of angiography?
previous severe reaction to contrast
impaired renal function
impaired blood clotting factors
inability to undergo surgical procedure
72
What is seldinger technique?
needle punctures both walls of vessel
needle withdrawn until blood flow back
guidewire inserted through needle
needle comes out leaving guidewire in place
catheter inserted over guidewire into vessel
guidewire removed
73
What is pre-procedural care for angiography?
limited to liquid diet and routine medications
adequate hydration
history of vitals taken
informed consent
anticoagulant
lab tests to see kidney function
74
What is post procedural care for angiography?
catheter removed- compression applied
bed rest minimum 4 hrs
head elevated 30 degrees
vital signs
extremity watch
75
What are risks/complications for angiography?
bleeding at puncture site
thrombus formation
embolus formation
dissection of vessel
puncture site infection
contrast reaction
76
When was the first operative or immediate cholangiogram performed?
1932
77
When is an operative cholangiogram performed?
before or following surgical removal of gallbaldder
78
What are advantages of laproscopy?
performed as outpatient procedure
minimally invasive
reduced hospital time
reduced cost
79
Where is the cassette placed for operative cholangiogram?
14 x 17 top just below right axilla
80
What are indications for postoperative T-tube cholangiography?
residual calculi
strictures
81
What are contraindications for postoperative T-tube cholangiography?
hypersensitivity to contrast
acute infection of biliary system
elevated creatinine or BUN levels
82
What contrast media is used for postoperative T-tube cholangiography?
iodinated water soluble
83
What are diagnostic indications for ERCP?
stenosis dilation obstruction or small lesions within biliary or pancreatic ducts
post operative or postoperative procedure
inconclusive gallbladder studies
84
What are therapeutic indications for ERCP?
spincterotomy
stones removed
biliary duct stenosis dilation
pancreatic stones removed
85
What are contraindications for ERCP?
pancreatic pseudocytes
acute pancreatitis
septic cholangitis
86
What are different types of sedatives for ERCP?
demeral
valium
versed
87
What is narcan?
drugs that reverse the effectiveness of sedatives
88
What contrast media is used for ERCP?
water based iodinated
renographin- ionic
isovue- nonionic
89
What is hyterosalpinggraphy?
radiographic exam of female reproductive system
90
What are indications for hysterosalpingography?
-Infertility
-Habitual abortion
-Abnormal uterine bleeding
-Absence of mensus
-Suspected blockage of fallopian tube
-Intrauterine or pelvic masses
-Fistula
-Congenital abnormalities
-Pelvic pain
91
What are therapeutic indications for hystersalpingography?
-restore fallopian tubal patency by opening blocked tubes
-dilating narrowing tubes
-straightening kinked tubes
92
What are contraindications for hystersalpingography?
-acute pelvic inflammatory disease
- active uterine bleeding
-pregnancy
93
What contrast media is used for hystersalpingography?
water soluble iodine- singrafin
iodized oil- lipiodol
94
What are complications of hystersalpingography?
-hemorrhage
-spread of pre-existing infection
-peritonitis
95
What are abnormal findings in hystersalpingography?
-congenital abnormalities
-diverticula of fallopian tubes
-dilation of fallopian tubes because of partial obstruction
-peri tubal adhesions
-fibroid tumors or polyps
96
What is lymphangiophy?
study of the lymph vessels carried out within 1 hour of contrast
97
What is lymphadenography?
study of lymph nodes performed 24 hours after contrast
98
What are indications for lymphography?
-assess clinical extent of lymphoma
-staging of radiation treatment
-obstruction of lymphatic system
-locating nodes for biopsy or surgical removal
99
What are contraindications for lymphography?
-sensitivity to vital dye
-respiratory insufficiency
-concurrent radiation therapy to the lungs
100
What contrast media is used for lymphography?
oil based- ethiodol
101
What are the vital dye for lymphography?
-patent blue V
-evans blue
-brilliant blue
-direct sky blue
102
What is the setting on automatic injector for lymphgraphy?
0.1-0.2 ml/min
103
What are the routine radiographs for lymphography?
lower extremities
AP pelvis
AP abdomen
RPO/LPO abdomen
104
When is lymphography performed?
two different days, 24 hours apart
105
Ethiodol remains in lymph vessels, nodes, abnormal nodes for?
3-4 hours
3-4 weeks
several months
106
What is the total injection time for lymphography?
30-45 minutes
107
What are complications for lymphography?
contrast reactions
pain and possible vessel rupture
emboli
infection at injection site
108
What is athrography?
x-ray of joint taken after the injection of a contrast medium into the joint
109
What are indications of knee arthrogram?
tears of joint capsule, menisci or ligaments maybe caused by trauma
bakers cyst
110
What are contraindications of knee arthrogram?
allergy to contrast
111
How do you image for a knee arthrogram?
rotate leg 20 degrees for each picture; 9 exposures of each meniscus
112
How much contrast is given for dual contrast knee arthrogram?
5 ml low density positive medium
80-100 ml negative medium (air)
113
How much contrast is used for a single contrast shoulder srthrogram?
10-12 ml positive (omnipaque 300)
114
How much contrast is used for a double contrast shoulder arthrogram?
3-4 ml of positive
10-12 ml of negative
115
What is the routine positioning for a shoulder arthrogram?
Scout AP
internal
external
glenoid fossa
transaxillary
intertubercular groove
116
What is a myelogram?
study the spinal canal and its nerve roots through introduction of contrast
117
What are indications of myelogram?
-benign and malignant tumors
-lesions present in spinal canal or protrude into canal
-cysts
-herniated nucleus pulposus
-bone fragments
118
What are contraindications of myelogram?
-blood in CSF
-arachnoiditis
-increased intracranial pressure
-recent lumbar puncture
119
What kind of contrast media is used for myelogram?
-positive nonionic iodine based water soluble
-metrizamide/amipaque
-9-15 ml taking 1-2 min
-Oil soluble contrast
-pantopaque
-absorbed slowly if not removed; 1 cc per year
-negative
-air-pneumyelogram
-40-100 ml
120
Where are the two puncture sites for myelograms?
L3-L4
C1-C2
121
Where does the spinal cord end?
L1-L2
122
What are the three body positions for myelogram lumbar puncture?
prone
erect
left lateral with knee flex up and head bent down
123
CSF is sent to the lab to test for?
blood cell count
protein
sugar
vdrl
elevated WBC/RBC or protein
124
What are complications of myelogram?
headaches
nausea
injection of contrast into wrong areas
irritation to nerves
poor visualization
vomiting
125
How high above access site is the IV pole?
18-24 in
126
When do reactions happen?
5-20 minutes after injection
127
What is normal creatinine level?
0.6-1.5 ml/dl
128
What is normal BUN level?
8-25 mg/dl
129
What color is an 18 gauage?
green
130
What color is a 20 gauage?
pink
131
What color is a 22 gauge?
blue
132
What color is a 24 gauge?
yellow
133
What are the 5 patient rights?
contrast
amount
patient
time
route
134
What are signs and symptoms of infiltrates?
redness
swelling
pain or tenderness
135
What are mild contrast reactions?
nausea/vomiting
anxiety
light headedness
136
What are moderate contrast reactions?
tachycradia
bradycardia
hypertension
dyspnea
wheezing
137
What are severe contrast reactions?
convulsions
cyanosis
pulmonary edema
shock
cardiac arrest
laryngospasm
respiratory arrest
death
138
What is the treatment protocol for infiltrates?
elevate extremity
apply warm or cool compress
139
What patients are at higher risk for infiltrates?
1 patients unable to tell you where their problem is
2 patients with impaired circulation
3 patients receiving chemo through IV
