FINAL EXAM Flashcards
To whom is a health care worker’s primary responsibility to?
patient
If the image produced during a patient’s procedure is not diagnostic or lacking information the radiologist needs to make an interpretation, is it an acceptable practice to repeat the image?
Definitely
What is assault?
The threat of touching a person in a harmful manner
What is battery?
Touching someone without permission
Regarding the rights of patients, can a patient refuse an exam?
Yes, it is a tort if done after refusal
Regarding the rights of patients, can an RT add images to a procedure because the patient requests it?
no
Regarding patient’s rights, is the patient entitled to know the technologist’s name that is performing the procedure?
yes
Regarding patient’s rights, is the technologist supposed to tell the patient if there are risks associated with the procedure to be performed?
yes
Regarding ARRT sanctions, will they result from inadequate radiation protection by failing to shield the patient properly?
No, but it is unethical and a tort
Regarding ARRT sanctions, will they result if a student or RT is convicted of a felony?
yes
Regarding ARRT sanctions, if the RT attempts to interpret images or share any other information about the images to the patient?
No, but they could be fired because it is not in an RT’s scope of practice
What information is required on an image?
Patient name/ID, date of exam, right or left marker, and institution’s ID
What offense has an RT committed if s/he shares confidential information about a patient with a third party?
Invasion of privacy and a tort
What does respondeat superior mean?
Let the master answer
What are some of the common terms associated with the legal document that authorizes another to make health care decisions when the patient is unable to?
Advanced health care directive, living will, health care proxy
When may a fax (facsimile) containing health information legally be sent?
When urgently needed for patient care, third party payer hospital certification
What is slander and invasion of privacy categorized as?
Intentional misconduct
Regarding patient consent, can unnecessary blanks be left empty on consent forms the patient signs?
No
Regarding patient consent, must the physician who signs the consent form perform the procedure or can other physicians in the same practice perform the procedure too?
Only the physician who signs
Regarding patient consent, is it necessary for a patient to sign before receiving sedation?
yes
Accidents happen and sometimes an injury is just as much the fault of the patient as the health care provider, what is this called?
Contributory negligence
What could an RT be charged with if the wrong part of the body is imaged?
battery
An RT may be required to work under a variety of different circumstances and conditions that depend on their place of employment. One condition one must be ready for in this profession is working with all ___ and ___.
Cultures, religions
Diagnostic procedures and their diagnosis are considered to be ___ and ___.
Privileged, confidential
What type of consent occurs when a procedure that is necessary to save a life is performed without the patient’s agreement because the patient is incapable of giving permission?
implied
What defines the role of the radiologic technologist (RT) and establishes the criteria used to evaluate performance?
Practice Standards
What can a radiographer do to help maintain a high level of expertise in the health care profession?
Joining professional organizations
What is ethics?
A set of moral principles that govern one’s course of action
What would the mistake be considered if the wrong medication or contrast agent was administered to a patient?
Unintentional tort
When can a patient have restraints applied?
By physician order only
Which regulatory body is commonly referred by health care workers as that requiring evidence of a high quality of care?
Joint Commission
Is it an acceptable procedure for a patient to withhold information from the radiographer concerning previous treatment for communicable disease/s?
no
Name some of the aspects of a patient’s health assessed by a professional?
Cultural background, mental and physical state
Define channel communication
A written page or spoken word
Physiological needs are a person’s most basic needs according to what?
Maslow’s hierarchy
What are the stages of grief and what occurs during each stage?
Denial, Anger, Bargaining, Depression, Acceptance
Which stage of grief is a patient in when s/he begins to deal with the pain and other aspects of the illness?
Acceptance
An informed consent form is necessary for invasive procedures and those requiring sedation. What is an example of a procedure performed in the imaging department requiring informed consent?
angiograms
Barium sulfate is commonly administered for gastrointestinal procedures. It is a metallic salt suspension in water. The body will extract and excrete the water leaving the heavy metallic salt in the GI tract unless the patient receives proper instructions to follow. What are some of the common instructions?
Contact the physician if there is no bowel movement in 24 hours, changes in stool color will occur until all of the barium sulfate is evacuated, and increase fluid and fiber intake for several days
What type of communication precautions should be taken with an unconscious patient?
Reassure the patient about what is being done, refer to the patient by name, make only those statements that would be made to a conscious patient
What are the common elements of the patient’s medical chart apart from patient identification?
Medical history, diagnostic and therapeutic orders and results, informed consent
What is veracity?
Sincerity and truthfulness
What course of action should be followed if the imaging requisition differs from the patient’s description of the complaint or injury?
Verify with the referring physician
Does a patient have the right to see his/her chart while in the RT’s possession? The answer is no, so what is the best response?
Inform the patient that s/he has the right to see the chart but that s/he should request to view it with his physician so that it is interpreted properly
What is the difference between subjective and objective data?
Objective data is based on facts and concrete evidence and subjective data is based on judgment by an individual and personal opinion
What abilities are required for critical thinking?
Interpretation and evaluation
What is the first step in problem solving?
Collecting data
When performing tasks that have been successfully performed before, what is the mode of thinking used?
Recall
When does a radiographer consider the need for patient assistance for a particular patient?
During the implementation of a plan of care
When are a patient’s customs and values considered?
During patient assessment
What is an expectation a patient can have from his/her radiographer?
person who is attentive to the patient’s needs
What skill does a successful communicator possess?
Ability to listen
When a patient makes a verbal statement to a radiographer it is important to repeat the idea to the patient to make sure everyone understands what is going on. What is this?
Restating the main idea
A response to the patient that keeps the feeling and meaning of the patient’s verbal expression in mind is communicating in what manner?
Therapeutic manner
What is the correct response for a patient who has suffered a serious loss?
Be supportive and allow the patient to retain hope
Is there any action a radiographer should take if caring for a serious ill patient and there is no health care directive on the patient’s chart?
Yes, inform supervisor or patient’s physician
What is ambulatory mean?
Able to walk; walking
Which direction is a disabled patient turned on an x-ray table?
Turn the patient toward you
In reference to the spine, what is important to remember when lifting a patient?
Keep back straight
Describe the Fowler position.
Feet lower than head
Describe how to move a heavy object.
Pull or drag it
In addition to referring to a patient by name, how is the identity of a patient verified?
ID armband
What is the placement of a wheelchair in relation to the x-ray table when transferring a patient?
Close to the table at approximately a 45 degree angle
For a patient with a brain injury, what patient position should be maintained when being transferred?
Semi-erect
Describe the Trendelenburg position.
Head lower than feet
When assisting a patient from a wheelchair to the x-ray table and the patient has a stronger side, which side is closer to the table?
The stronger side is closer the table
What method of moving is used for patients with suspected spinal injury?
Logrolling
When assisting a patient in a wheelchair, what should be done with the footrests?
Move them aside, do not let the patient step on them or trip over them
What is orthopnea?
The sensation of breathlessness in the recumbent position
Describe the best way to reduce friction when moving a patient.
Place patient arms across chest and use a pull sheet
What must be done when a patient is transported back to the room and assisted back into the bed?
Place side rails up, place bed in low position, place call button close at hand
What is the best method to move a seriously ill and/or weak patient from a stretcher (gurney) to an x-ray table?
Move by smooth mover (smoothing board) and three assistants
In reference to proper undressing, How should a patient in the x-ray department for a procedure be directed?
Escort patient to dressing room and give proper undressing instructions
Is it necessary to know a patient’s HIV status in order to care for the patient?
No! we protect ourselves at all times using standard precautions all of the time
Patients are physically immobilized when necessary. What is the most effective form of immobilization?
Communication
Locate a person’s center of gravity.
Center of the pelvis
What types of infections are increasing in development due to the increased resistance of microorganisms to antibiotics?
Hospital-acquired (nosocomial) infections
What is the most common site of hospital-acquired infection to develop?
Urinary tract
What is the most successful method of infection control?
Handwashing
What were Standard precautions formerly known as?
Universal Precautions
What practice is based on the assumption that all patients are potential sources of infectious disease?
Standard Precautions
What is the institution that inspects work sites and protects employees and students from work-related injuries and illnesses?
OSHA
In what manner are all used needles and syringes treated?
Never recap a needle!
What precaution is acceptable to protect others in the area should a patient be coughing and sneezing in a waiting area?
Ask them to refrain from this near the others in the area
What personal protection is required to enter a strict isolation unit with a portable machine?
Cassette covers,
cap,
gown,
at least 2 pairs of clean exam gloves
What is the responsibility of a radiographer receiving a needle stick injury?
To repeat the injury and to receive treatment
Before entering a strict isolation room for an imaging procedure, what are some items the radiographer should prepare?
Extra gloves
A vascular access device may be the potential cause of what type of infection?
Nosocomial
What type of bacteria are Staphylococci as it relates to the body as a potential source of disease?
Normal flora
What causes influenza?
virus
What causes hepatitis A?
virus
What causes tuberculosis, streptococcal infections, Salmonella poisoning, gonorrhea, syphilis, staphylococci, bacilli, and tetanus?
bacteria
What causes malaria and giardiasis?
bacteria
What causes coccidioidomycosis and thrush?
yeast
What precautions must a health care worker who has cold symptoms take before entering the newborn nursery?
The worker is not allowed in the area!
The removal by mechanical and chemical processes of pathogenic microorganisms, but frequently not their spores is known as what?
Disinfection
What is the method of pathogen spread when a person is coughing or sneezing?
droplet
What method of disposal is used for discarded and disposable items after completing a radiographic procedure in a strict isolation area?
Discard items in biohazard bags
What is the establishment and growth of microorganisms on or in a host?
infection
What is the means of disease transmission when an animal or insect spreads pathogens?
vector
What type of container is used for the disposal of needles, syringes, and other sharp items?
Puncture-resistant containers
What means of disease transmission is kissing?
direct contact
What type precaution is necessary for droplet transmission?
mask
What types of precautions are used for a communicable disease?
Transmission-based precautions
What type of transmission involves the spread of disease through contaminated water or food?
vehicle
What is the term for any disease producing microorganism?
pathogen
What is the practice used to retard the growth of pathogenic bacteria?
antiseptic
An infectious agent and a reservoir of available organisms, an environment in which the pathogenic microbes can live and multiply a portal of exit from the reservoir, a means of transmission, and a portal of entry into a new host are all elements needed for the ___ of infection.
transmission
Are hand lotions an acceptable skin care regiment in a health care environment?
yes
___ contact occurs when a susceptible person actually touches and infected or colonized person’s body surface in an area where infectious microbes are present, such as bodily fluids.
direct
___ contact occurs when a susceptible person touches or comes into contact with an object that has been contaminated with infectious microorganisms, such as fomites and vectors.
indirect
What is the type of isolation that protects an immune deficient patient having such conditions as tuberculosis, burns, and leukemia?
Protective (reverse) isolation
Should contaminated areas be cleaned from the most contaminated to the least or the least to the most?
Least to most
Should contaminated areas be cleaned from the bottom up or the top down?
Top down
What are Clorox and Lysol examples of?
Disinfectants
Are gloves generally indicated when caring for those with droplet precautions?
yes
Are masks generally indicated when caring for those with MRSA precautions?
yes
Are masks generally indicated when caring for those with airborne precautions?
yes
Is isolation in negative pressure rooms generally indicated for MRSA patients?
no
What personal protection items are required when entering an area with contact isolation?
Gown and gloves
An angiogram is an invasive radiographic procedure requiring the introduction of contrast media via puncture and/or cutting into the skin and the vascular system. The splattering of blood and body fluids may occur. What type of protection should be in place for eye care?
Goggles or other special protective eyewear
Biopsies and procedures where blood and body fluids are likely to splatter require what type of protective eye care?
goggles/special eyewear
A common radiographic procedure involving the ingestion of barium or other contrast media is the upper gastrointestinal exam. What type of protective eye care is necessary for this type of noninvasive exam?
none usually
During portable radiographic exams in a strict isolation area, one team member is considered the clean person and one is considered the “dirty” or contaminated person. In this type of relationship which one makes the exposure?
clean person
What should occur if a health care worker has cracks or abrasions of the skin?
These should be properly cared for and kept covered
The stages of infection are the incubation stage, the prodromal stage, the full disease stage, and the convalescent stage. Which stage is when the disease reaches its fullest extent?
Full disease stage
The stages of infection are the incubation stage, the prodromal stage, the full disease stage, and the convalescent stage. Which stage is when the disease enters the body and may lie dormant for a short period and then begin to multiply?
Incubation stage
The stages of infection are the incubation stage, the prodromal stage, the full disease stage, and the convalescent stage. Which stage is when the disease begins to disappear?
Convalescent stage
The stages of infection are the incubation stage, the prodromal stage, the full disease stage, and the convalescent stage. Which stage is when the disease has the most specific symptoms?
Prodromal stage
What is the reduction of microorganisms in the immediate environment?
Medical asepsis
What should be done with cassettes after they are used for an isolation patient?
Disinfected before returning them to storage/use
What is an infection caused by physician intervention?
Iatrogenic infection
Is tuberculosis transmitted through blood infection?
no
What are the general classifications for yeasts and molds?
Fungi
What is considered to be the most effective medical aseptic technique?
Handwashing
What is the cause of the common cold?
virus
What response do white blood cells have to an invasion of the body by pathogens?
increase
What is an item to which microorganisms cling?
fomite
Mr. X received care from a radiographer who had respirtaory infection. Days after leaving hospital, he gets ill. what kind of infection is this?
nosocomial infection
Mrs. Mary was in an accident and is on broad-spectrum antibiotics and now has severe diarrhea and shows C. difficile. This is:
Community-aquired infection
First line of defense against infection:
hair, skin, acidic condition of the stomach
Aquired immunity
results from active production or receipt of antibodies
active aquired immunity
antibodies actually produced w/in a person’s body; usually long-term immunity
passive aquired immunity
antibodies are received from another person or an animal; usually short-term immunity
natural active acquired immunity
antibodies acquired by actually having anactual disease; reinfection may be short or long-term
Artificial active acquired immunity
antibodies formed by vaccination that enable one to form antibodies against that particular pathogen
natural acquired immunity
antibodies present in a mother’s blood or colostrum are passed to infant
artificail passive acquired immunity
antibodies are transferred from an immune individual to a susceptible individualto give temporary immunity - usually by adminstering hyperimmune serum from blood fo many immune people
incubation stage
pathogen enters the body and may lie dormant for a time then begins to produce nonspecific symptoms of disease
prodromal stage
more specific symptoms of the disease show, disease becomes highly infectious
full disease stage
disease reaches its fullest extent or in some cases, produces only vague sub-clinical symptoms, still highly infectious
convalescent stage
symptoms diminish and eventually disappear; some disappear, some go into latent stage
which infectious diseases go latent?
malaria
tb
herpes
What is a fenestrated drape?
A drape with one or more openings
The three zones of the surgical suite are Zone 1: An unrestricted zone, Zone 2: A semirestricted zone, and Zone 3: A restricted zone. In which zone must ALL persons wear scrub dress, shoe covers, and masks?
Zone 3
Why is catheterization considered to be an invasive procedure?
Sterile technique must be observed
What are Alcohol (70%), chlorine compounds, and glutaraldehyde considered to be?
Disinfectants
What is the practice that helps reduce the number and spread of microorganisms?
Medical asepsis
During the performance of radiographic procedures, everyone in the adjacent area (in the room) should be wearing protective radiation apparel, such as a lead apron. In the surgical suite during the operative procedure, which persons should be wearing protective radiation apparel?
Everyone who remains during x-ray exposures
Generally, when radiographer/s are in the operating room, they are not scrubbed-in, but must follow general Zone 3 dress and what else?
Handwashing for 3 minutes plus scrub suit, shoe covers, cap, and mask (gloves are not usually needed)
What is the complete removal of microorganisms and their spores?
Surgical asepsis
In regards to surgical asepsis, what are the responsibilities of a radiographer?
Maintain a sterile field and perform skin prep, and perform surgical scrub
What is the assumption when the sterility of an object is in question?
Do not use, it is considered contaminated
Which corner of a sterile pack is opened first?
The corner farthest away
When the sterile person begins placing the sterile drapes, which drapes are placed first?
The drapes closest to the sterile person
How is the skin prepped for a sterile procedure?
Begin at the inside of the site and scrub in a circular motion to the outside
A wet area on a sterile field is considered contaminated. If this occurs what should be done?
Place several thicknesses of sterile towels over the wet area
What is the most effective sterilization technique
Moist heat
When portable x-ray units are brought into the operating room, what is the essential preparation that must be performed?
Wipe the unit with disinfectant (just dusting it off is not enough)
When preparing to pour liquids into a container on a sterile field, precautions must be taken to prevent the solution from splashing and drips from landing on the tray, what are some of these precautions?
Place lid face upward and well above the sterile tray and pour off a small amount before pouring remainder into the sterile container
In designing an operating room, many possible hazards are considered and protections put into place, such as explosions and electrical shocks. What is the greatest hazard that cannot be placed into the physical design?
Contamination
How should persons in sterile dress pass each other?
Back to back
In order to prevent explosions in the operating room, what precautions are generally taken?
Use antistatic cleaners for equipment, use the specially designed electrical plugs, and wear apparel with antistatic/flame retardant materials (shoe covers and other garment have antistatic strips made in them
Generally, what areas are considered sterile in the operating room?
Draped patient, surgeon and scrub nurse, and instrument table and instruments
What is the complete removal of all microorganisms rom an object called?
Sterilization
What does an autoclave use to sterilize objects placed inside?
Steam under pressure
when entering a surgical suite and preparing to enter Zone 2, a radiographer must:
change into scrub suit, shoe covers and cover hair
Disinfectants are categorized depending on their ability to disinfect. Alcohol is considered an intermediate-level disinfectant. This means that
may be used to disinfect thermometers adn medication vials
the purpose of a surgical scrub is
to remove as many microorganisms as possible from the skin
when sterile drapes are placed by the sterile person the drape is placed:
in area nearest sterile person first
sterile technique must be used during a dressing change only if the dressing is not contaminated
true or false?
false: the changed dressing is always considered to be contaminated
list 3 responsibilities of the radiographer in the OR or special procedures room:
- for protecting everyone in the room from radiation exposure
- to be knowledgeable about the areas that are sterile
- to make sure any radiation equipment used is clean and dust free
list 3 things that contaminate a surgical suite or OR:
- contaminated gloves/surgical instruments
- wet/damp sterile field
- microorganisms blown onto a surgical site
What is the preferable site for taking a pulse?
Radial
Which vital signs assessment is being performed when the patient is seated or lying supine, the chest is observed for movement symmetry, and skin color is noted?
Respiration
A consistent diastolic reading greater than 90 mm Hg may be an indication for what condition?
Hypertension
How does medically induced hypothermia affect the body’s need for oxygen?
It is decreased
What is the highest point reached during contraction of the left ventricle?
Systole (systolic blood pressure)
Why must oxygen use be ordered by a physician?
It may be toxic
What is an abnfor adultsormally rapid heart rate over 100 beats per minute?
Tachycardia
Which pulse site requires the proper use of a stethoscope?
Apical pulse
Which device is used to measure the saturation of hemoglobin with oxygen?
Pulse oximetry
What forms of taking a temperature are considered to be convenient, but unreliable?
Temperature sensitive patches on the abdomen or forehead
Usually, if a patient’s pulse is rapid, then the blood pressure is ___.
low
Is the pulse rate for an infant faster or slower than that for an adult?
Much faster, approximately 115-130 beats per minute for infants and 70-80 beats per minute for adults
A consistent systolic reading greater than 140 may be an indication for what condition?
Hypertension
When writing blood pressure readings, which reading is the number on the top?
Systolic blood pressure (the contraction phase of the heart muscle)
When writing blood pressure readings, which reading is the number on the bottom?
Diastolic blood pressure (the relaxation phase of the heart muscle)
What is the normal average rate of respiration for an adult?
12-20 breaths per minute
What is the normal range of diastolic blood pressure for an adult?
60-90 mm Hg
What are the units of measurement for blood pressure?
Mm Hg (millimeters of mercury)
When taking a pulse, which blood vessels are best suited?
Superficial arteries
What do the symptoms retraction of the intercostal spaces, cyanosis, and dyspnea indicate?
Inadequate oxygen supply
Why is anaphylactic shock the type of shock most often seen in the diagnostic imaging department?
Water soluble iodinated contrast media is used for many of the imaging procedures
What is the medical term for fainting?
Syncope
What is an abnormally high amount of glucose in the blood called?
Hyperglycemia
What is the term that means a heart rate of greater than 100 beats per minute?
Tachycardia
What is the result of an exaggerated hypersensitivity reaction?
Anaphylactic shock
What is an occlusion of one or more pulmonary arteries by a thrombus or thrombi?
Pulmonary embolus
What causes can be associated with pulmonary embolus?
Usually deep vein thrombus associated with trauma, orthopedic and surgical procedures, pregnancy, congestive heart failure, prolonged immobility, hypercoagulable states
What is the body’s pathologic reaction to illness, trauma, or severe physiologic or emotional stress?
shock
Cold and clammy skin, pallor, nausea and dizziness, increased respirations from shortness of breath, anxiety level increases and possible uncooperativeness, blood pressure decrease, and pulse rate increase are indications of what disorder?
shock
Which condition is associated with the pain experienced by an individual whose coronary arteries are not conveying sufficient blood to the heart?
Angina pectoris
Which position should a patient experiencing fainting be placed in?
Dorsal recumbent with feet elevated (Trendelenburg)
Which type of shock is often associated with pulmonary embolism?
Cardiogenic shock
Which type of shock is often associated with myocardial infarction?
Cardiogenic shock
Severe hemorrhaging from an injury requires which type of immediate emergency response?
Call for assistance from the ER and apply pressure to the site of the bleeding
What does a patient need if s/he has taken insulin but not eaten and becomes weak?
Something with sugar
A defibrillator is the mechanical device used to correct what condition?
Ineffectual cardiac rhythm
What is the term associated with difficulty of swallowing?
Dysphagia
What condition is cerebral vascular accident (CVA) associated with?
stroke
When will brain damage begin to occur from a lack of oxygen?
1-3 minutes
What type of shock is associated with a loss of body fluids or blood?
Hypovolemic shock
What can be the result of a patient taking his/her regular dose of insulin when having food and water restricted for a radiologic procedure?
Insulin shock
What is a radiographer’s first response to a patient having a seizure in the diagnostic imaging department?
Prevent injury to the patient
What can insufficient blood supply to the brain from heart disease, hunger, poor ventilation, extreme fatigue, and emotional trauma cause?
Syncope
What immediate treatment can be given to a patient in insulin shock that is still conscious?
Something with sugar
What type of shock is associated with a failure of the heart to pOpen fracturesump enough blood to the vital organs?
Cardiogenic shock
When a mobile radiograph of the seven cervical vertebrae is performed in the lateral projection for a trauma patient how many of the cervical vertebrae must be included on the image?
All 7
Which diagnostic image is quite often performed as a routine oder for trauma patients?
Chest because it provides so much information
When performing trauma radiography of the bones, a minimum of two images is required with the images at what angle to each other?
90 degrees
What type of fracture has the bone fragments exposed?
Open fractures
What type of force results in traumatic injury?
External
What is a CVP?
Central venous pressure
Where should a CVP line be inserted?
Subclavian vein
What should be placed in the chest cavity to evacuate fluid from the pleural cavity?
Chest tube
What is the term describing the presence of blood in the pleural cavity?
Hemothorax
When involved with traumatic injuries that have the possibility of blood and body fluids spraying the face, in addition to the exam gloves needed for contact, what other PPE will be needed?
mask
When head and cervical spine injuries are to be treated for a trauma patient, what type of fracture must be ruled out before a patient may be allowed to move without immobilization?
Cervical spine, always at least a cross table lateral
What types of lines may be demonstrated by mobile chest images to verify proper placement?
PICC, Hickman, and CVP lines (catheters)
What is the most common type of mechanical ventilator used in hospitals?
Positive pressure ventilator
How is total parenteral nutrition (TPN) delivered to the patient?
Central venous route
Who should be called to perform emergency suctioning if profuse vomiting occurs in a patient who cannot voluntarily change position, if audible rattling or gurgling sounds coming form the patient’s throat, or if signs of respiratory distress occur?
The physician or RN
What might be the result of an endotracheal tube being placed too high in the trachea?
Air may enter the stomach
What might be the result of an endotracheal tube being placed too low in the trachea?
The tube may enter the right main bronchus which would result in the collapse of the the left lung
How is the proper position of an endotracheal tube confirmed?
Chest x-ray
What is the correct placement of an endotracheal tube?
5 to 7 cm above the tracheal bifurcation (carina)
What are some of the uses for central venous catheters?
Parenteral nutrition, frequent blood transfusions, hyperosmolar solutions, and long term medication administration
What are some of the more common types of nasogastric tubes?
Levin, Sump, Nutriflex, Moss, and Sengstaken-Blakemore
What is the purpose of nasogastric tubes?
Administration of medications and feeding
whatich are essential parts of the initial assessment of a patient who is in the diagnostic imaging department for an invasive procedure?
taking vitals: blood pressure pulse respiration rate temp
what range of breaths per minsute is the normal adult respiratory rate?
15-20
an adult patient is considered to be hypertensive or to have hypertension if the systolic blood pressure and diastolic blood pressure are consistently greater than:
140 systolic and 90diastolic
a patient may be considered to have tachycardia if the pulse rate is higher than:
over 100 beats/min
which of the following items must be in the diagnostic imaging dept and in working order?
oxygen delivery system
blood pressure monitoring equipment
name 2 of the most commonly used oxygen delivery systems
nasal cannula
face mask
measures apical pulse
stethoscope
point where the blood pressure is most often measured
brachial artery
measures blood pressure
sphygmomanometer
insufficient insulin (type 1) causes the liver to produce more glucose (results in hyperglycemia) and the kidneys attempt to compensate by excreting glucose with water and electrolytes. Excessive urination and dehydration
Ketoacidosis
True or False:
Never attempt chest compressions on a patient whose heart is beating.
true
True or False:
Attempting to do abdominal or chest thrust on a patient whose airway is not obstructed is ok.
false
strong, irregular pulse
respiration increased (shortness of breath)
skin is cold and clammy
mental status changes and could end up in coma
rapid heartbeat
general signs/indicators of shock`
labored noisy breathing, wheezing, use of neck muscles to assist with breathing
symptoms of partially obstructed airway
16 year old comes to DI ofr a CT scan. He is lying on table in supine position. He suddenly seems to lose consciousness and begins to move violently with jerking motions. You realize that he is having a generalized seizure. What is the most appropriate action to do?
call for help and make sure patient does not injure himself
16 year old comes to DI ofr a CT scan. He is lying on table in supine position. He suddenly seems to lose consciousness and begins to move violently with jerking motions. You realize that he is having a generalized seizure. What is the LEAST appropriate action to do?
Place patient on floor and begin CPR
Mrs. Glucose, age 35, had an open reduction of her left femur 3 days earlier and has been trasnported to the DI dept by gurney from her hospital room for radiographs. As you prepare her for it she suddenly begins to complain of pain in her midchest and appears to be out of breath. You stop and take her pulse/BP. You find out that her BP is 120/80 and her raidal pulse is 120/min and is very difficult to palpate b/c it is so weak and thready. You quickly notificy the physician and he directs you to call the emergency team (but not a Code Blue) You do this and make other emergency preperations.. You believe this may be:
pulmonary embolus
Fainting is a common medical emergency in the DI dept. If a patient appears to be fainting, what is the first thing to do?
assist the patient to a safe position and then call for help
difficult speech, severe headache, on sided, drooping eye and face, loss of consciousness
CVA aka stroke
choking, inability to speak, eventual loss of consciousness
airway obstruction
itching of eyes, apprehensiveness, wheezing, choking
anaphylactic shock
loss of consciousness, decreased blood pressure, weak, rapid pulse
hypovolemic shock
pallor; slow irregular pulse, cool, clammy skin, restlessness
cardiogenic shock
when called to the emergency room, supplies needed may include:
ALL:
gloves, mask, protective gown, goggles
This tube is inserted through the nasopharynx into the stomach, the duodenum, or the jejunum
Contains a radiopaque tip to allow its visualization on images and fluoroscopy
NG tube
To keep the stomach free of gastric contents and air
For healing purposes before or after surgery
For diagnostic examinations
Administration of medications, feedings, treat intestinal obstruction, and control bleeding
purpose of NG tube:
Most Commonly Seen NG Tubes
levin
sump
This tube passes into the duodenum and small intestine by means of peristalsis
Made up of the same material as NG tubes
Decompress the intestine
NE tube
True or false?
Radiographers are not responsible for inserting or removing NG or NE tubes
true
_____ is an opening into the stomach, usually through the abdominal wall
Gastrostomy tube
A wall outlet or a working portable suction machine
Adapters for wall outlets
Clean gloves
Tubing
Items Necessary for Suctioning
A tracheostomy is an opening into the trachea through the neck, created surgically to relieve _____distress caused by an obstruction.
respiratory
what ventilator is seen most often in the home
negative pressure
This is a tube inserted through the mouth into the trachea as a means of establishing or opening an airway on patients
Endotracheal Tubes
Fluid build up in the pleural cavity
Pleural Effusion
The trauma patient presents a wide variety of challenges for the radiographer:
Patient’s condition
Technical factors
Critical thinking
Quality images
true or false?
remove pneumatic anti-shock garments.
false, NEVER remove
what does Fx stand for?
fracture
what is a crash cart?
A cart that contains medications and equipment that are needed when a patient’s condition suddenly becomes critical.
Every department has one or more.
KNOW where they are located
abnormally low blood pressure occurring when a person stands up before the blood in the extremities has time to circulate to the upper body.
Orthostatic hypotension
what is another name for fever?
pyrexia
how many location to measure a pulse?
9
where is radial?
at the wrist at the base of the thumb
where is Carotid
neck
where is temporal?
front of ear
where is brachial?
groove of elbow
Most Common Locations for Pulse
radial
carotid
When a patient is using more than the normal effort to breathe
dyspnea
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 fearful of strangers?
Toddlers (1 to 3 years)
Which age group is not fearful of strangers?
Infants (1 to 12 months)
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
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
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
What type of immobilizer may be used for upright radiography of the chest and abdomen of an infant or small toddler?
Pigg-O-Stat
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
what is age of pediatric patient?
infant - 15
_____________ is a campaign dedicated to radiation protection for children
image gently
Elderly patients are burdened with _____ illness rather than acute
chronic
Symptoms of depression in the elderly person are often confused with “______.”
dementia
There are three categories of elder abuse:
- Domestic elder abuse
- Institutional elder abuse
- Self-neglect or Self-abuse
_____ is radiography of the bladder
Cystography
________ are catheters from the kidney to the bladder
Ureteral stents
Establish what type of catheter to use:
Straight
Indwelling
is a catheter which is inserted and left in place to allow continuous drainage of urine (most commonly used in radiology).
indwelling
Is used to obtain a specimen or to empty the bladder and then removed.
straight
Two common methods, could be temporary or permanent catheters:
Suprapubic catheter
Condom 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.
Suprapubic 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
condom catheter
Radiographic imaging of the bladder. Using fluoroscope and radiography, the urinary bladder is visualized as it fills with contrast media and empties
Cystography
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
Retrograde Pyelogram
There are two types of radiographic contrast agents:
Positive and Negative
decreases organ density to produce contrast
Negative
2 types of Negative:
Carbon dioxide
Air
Negative contrast gives a ____(like air) appearance on an image
black
increases organ density and improves radiographic visualization. Positive contrast agents create a density difference such as white or opaque appearance on the image.
Positive
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
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
What is the most commonly seen complication that occurs after hip arthroplasty in geriatric patients?
dislocation
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
When should elderly patients be scheduled for difficult diagnostic examinations?
early am
What is an abnormally increased convexity in the thoracic spine curvature?
kyphosis
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 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
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
What type of catheter is placed directly into the bladder by means of an abdominal incision?
Suprapubic catheter
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
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 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
What element is in contrast media used in radiology that is injected intravenously?
Iodine
What is the technologist’s response to swelling around an IV site in addition to calling for a nurse?
Clamp off the IV and apply warm compress to the site
What is administration of a drug by penetrating the skin?
Parenterally
How far above the vein should the solution for an IV infusion be kept?
18 to 20 inches
What is the usual flow rate for an adult’s IV?
20 drops per minute
What is it called when solution is leaking into the tissues?
Infiltration
Is nitroglycerin a vasodilator or vasoconstrictor?
Vasodilator
Where is the basilic vein located that is commonly used as the injection site for intravenous urography (IVU) or intravenous pyelography (IVP) studies?
Antecubital space
In what group of drugs is penicillin found?
Antibiotics
In what group of drugs is Dilantin found?
Antiepileptics
In what group of drugs is epinephrine found?
Bronchodilators
In what group of drugs is heparin found?
Anticoagulants
In what group of drugs is Demerol found?
Analgesics
What is the most common use for Aminophylline?
Asthma
What is the most common use for Digoxin?
Heart failure
How is nitroglycerin administered?
Sublingually
In what group of drugs is Benadryl found?
Antihistamines
What is one of the primary steps to take before administering drugs by IV?
Check patient identification
What is the escape of fluid from a vessel into the surrounding tissue?
Extravasation
What is an injection of a large amount of a pharmaceutical preparation?
Bolus
What is generally considered to be a low flow rate for a drip IV infusion?
10 to 20 drops/minute
What is the appearance of a negative contrast agent on a finished radiographic image?
A greater density than the surrounding tissue
What type of positive contrast agent does not dissolve into charged particles?
Non-ionic water-soluble iodinated contrast media
What does a high osmolality for water soluble iodinated contrast media mean in terms of adverse reactions?
has more particles in solution and increased adverse reactions
What is considered to be the reason allergic reactions to water soluble iodinated contrast media occur?
The release of histamine by the cells of the body
What is the term for the number of particles in solution per kilogram of water?
Osmolality
What must be included on the chart about drugs administered?
Time of day, drug name, dose, and route of administration
What are some of the more common patient factors to be considered before administering contrast media?
The history or presence of renal disease, presence of hypertension, age
What is the greatest disadvantage of oil based iodinated contrast media?
It is not water soluble so the body does not absorb it
What is the degree of angle for administering IM injections?
90 degrees
What does the abbreviation hs mean?
At bedtime
What does the abbreviation prn mean?
As necessary
What does the abbreviation qd mean?
Every day
What assessments must the radiographer make for the site of an intravenous infusion while it is in place?
Coldness and swelling
What are the primary parenteral routes of drug administration?
Subcutaneous, intramuscular, intradermal, intravenous
What is are enteral routes of drug administration?
Oral,
sublingual,
buccal,
rectal
What are the five rights of drug administration?
PDART- The right patient (P), the right drug (D), the right amount or dose (A), the right route (R), the right time (T)
What is hypotension?
Low blood pressure
What is dyspnea?
Shortness of breath (SOB)
What happens with many drugs that when combined with another drug can become inactivated or form a toxic compound or when two drugs are combined they increase the effect of each drug when given alone? An example of this is when a dose of heparin given with alcohol increases bleeding.
An additive reaction
After administration of iodinated contrast media, how are itching and difficulty breathing classified?
Adverse reactions
What determines the rate and extent of distribution of a drug to its intended site of action after it is absorbed into the body?
Adequate blood circulation
What are the actions of a drug on living tissues in the body?
Pharmacokinetics
Which drugs bear the legend “Caution: Federal law prohibits dispensing without prescription?
Those administered parenterally
What must the professional administering drugs know about the drug?
Potential side effects and adverse reactions to the drug
What is a venous device used for intravenous injections at frequent or regular intervals?
Heparin lock
What vasopressor drug is generally used for cardiac arrest or anaphylactic reactions?
Epinephrine
What drug is generally used to treat dysrhythmias?
Lidocaine
How does the gauge relate to the diameter of the needle?
The greater the gauge, the smaller the diameter
What are primary advantages of using non ionic water soluble contrast media?
Low toxicity and fewer adverse reactions
What is a primary disadvantage to using non ionic water soluble contrast media?
High cost
What is a quantity of medication introduced over a period of time?
An infusion
What is considered a normal range for blood urea nitrogen (BUN)?
8 to 25 mg/100 ml
What is used to relieve pain from angina pectoris?
Nitroglycerin
the extent to which a fluid resists a tendency to flow
Viscosity
What is the usual needle angle recommended for intravenous injections?
15 degrees
How is the best venipuncture site chosen?
The most distal site in which the desired size needle can be used and the amount to be administered
How should an IV for contrast media administration be discontinued?
Place gauze over injection site; quickly, smoothly, and gently remove the cannula from the vein, elevate extremity and apply pressure until all bleeding stops
What is the radiographic study that is still performed and oil based iodinated contrast is still used
Sialograms
what does ionic mean?
meaning they come apart in the bloodstream and fuse with other things
