Final L Flashcards
1
Q
What are the 4 vital signs?
A
body temperature
respiration rate
pulse
blood pressure
2
Q
What are the four methods of measuring body temperature?
A
oral
axillary
tympanic
rectal
3
Q
What is normal respiration rate for adults?
A
12-20 breaths per minute
4
Q
What is normal respiration rate for children under 10?
A
20-30 breaths per minute
5
Q
What is normal respiration rate for newborns?
A
30-60 breaths per minute
6
Q
What is resting pulse rates in a normal adult?
A
60-100 per minute
7
Q
What is normal pulse for children under 10?
A
70-120 per minute
8
Q
What are the methods of sterilzation?
A
-Steam under pressure
9
Q
What are the methods of sterilization?
A
-Steam under pressure
-gas
-Chemicals
-DrY heat
-Ionizing radiation
-Microwaves/nonionizing radiation
10
Q
What are a few basic principles of sterile technique?
A
-If in doubt of an object, consider it unsterile
- Sterile persons should avoid unsterile areas
-Gowns are considered sterile on the sleeves and the front from the waist up
-A sterile person touches only what is sterile
-Sterile materials must be kept dry
-Hands covered in sterile gloves should be kept in sight and above waist level
-A sterile person does not lean over an unsterile area
11
Q
How high above the access site does the IV pole need to be?
A
18-24 inches
12
Q
What color is an 18 gauge?
A
green
13
Q
What color is a 20 gauge?
A
pink
14
Q
What color is a 22 gauge?
A
blue
15
Q
What color is a 24 gauge?
A
yellow
16
Q
How long does it take for reaction to show?
A
5-20 minutes
17
Q
What are mild drug reactions signs and symptoms?
A
-Nausea
-Vomiting
-Cough
-Warm feeling
-Headache
-Dizziness
-Shaking
-Itching
-Strange taste in mouth
-Pallor
-Flushing chills
-Sweats
-Hives
-Nasal stuffiness
-Swelling about the eyes and face
-Anxiety
18
Q
What are moderate reaction signs and symptoms?
A
-Tachycardia
-Bradycardia
-Hypotension
-Pronounced cutaneous reaction
-Hypertension
-Dyspnea
-Bronchospasm
-Wheezing
-Laryngeal edema
19
Q
What are severe reaction signs and symptoms?
A
-Laryngeal edema
-Convulsions
-Profound hypotension
-Cardiac arrhythmias
-Unresponsiveness
-Cardiac arrest
20
Q
What is negative contrast media?
A
composed of low-atomic number elements; appears radiolucent on image(black)
21
Q
What is positive contrast media?
A
composed of higher-atomic number elements; appears radiopaque on image (white)
22
Q
What are advantages of nonionic, LOCM?
A
-Lower osmolality
-No ionic breakdown and less toxic at cellular level
-More water soluble in blood plasma
-Warmed to decrease viscosity
-Less likely to cause patient reaction
-More tolerable by patients
-High contrast effect resulting from number of iodine atoms per molecule
-Reduced injection volumes
23
Q
What are signs of IV contrast medium infiltration?
A
redness, swelling, and/or tenderness at the IV site
24
Q
What are symptoms of IV contrast medium infiltration?
A
Burning or tingling sensation during contrast medium injection
25
What is treatment for IV contrast medium infiltration?
-Stop contrast infusion
-Elevate the extremity above the heart
-Notify the radiologist
-Attempt to aspirate any contrast from the tissue using the IV access device
-Apply dry ice packs or dry hot packs per radiologist
-Massage tissue area to distribute contrast and allow it to be absorbed
-Assess extremity for redness, skin blisters, or ulceration..
-Plastic surgeon consulted for infiltrates over 30 cc
-Incident report completed to assist with Quality Improvement monitoring
26
What is lymphadenography?
Radiographic study of the lymph nodes performed 24 hours after the injection of contrast media
27
How long after injection is a lymphadenogram performed?
24 hours
28
What are indications of Lymphography?
-Assess the clinical extent of lymphoma
-Staging of radiation treatment
-Obstruction or other impairment of the lymphatic system
-Locating nodes for biopsy or surgical removal
29
What are contraindications of lymphography?
-Sensitivity to the vital dye, contrast media or local anesthetic
-Respiratory insufficiency
-Concurrent radiation therapy to the lungs
30
What is injected for lymphography?
vital dye (blue)
31
What are the 4 vital dyes?
-Patent Blue
-Evans Blue
-Brilliant Blue GFF
-Direct Sky Blue
32
What contrast media is used for lymphography?
Iodized oil- Ethiodol
33
What is the recommended rate of injection for lymphography?
0.1-0.2 ml/minute
34
How long is total injection time for lymphography?
30-45 minutes
35
What are the routine radiographs for lymphography?
-Lower extremity
-AP Pelvis
-AP Abdomen
-RPO/LPO Abdomen\\
36
What are indications for knee arthrography?
-Tears of the joint capsule, menisci or ligaments maybe caused by trauma; Baker's Cyst
37
What are contraindications for knee arthrography?
Known to be allergic to an iodine based contrast medium or local anethetics
38
What is an Arthrostress?
Helps position the knee
39
What contrast media is used for knee arthrography?
radiolucent medium or radiopaque water-soluble medium or a combination of both
40
What type of study is the method of choice for knee arthrography?
dual contrast
41
How much contrast media is injected for knee arthrography?
5 ml of relatively low density positive medium along with 80-100 ml of a negative medium(carbon dioxide, oxygen or room air)
42
What do you do after the contrast media is injected for knee arthrography?
The knee is flexed which produces a thin even coating of the soft tissue structures with the positive medium
43
How much contrast media is used for
single shoulder arthrography?
10-12 ml of positive contrast (Omnipaque 300)
44
How much contrast media is used for double contrast shoulder arthrography?
3-4 ml of positive and 10-12 ml of negative contrast
45
Which exam is believed to be the exam of choice for shoulder arthrography?
Double
46
What are the routine images for shoulder arthrography?
Patient upright or supine
Suggested:
-Scout AP projections (Internal & External)
-Glenoid Fossa
-Transaxillary or Tubercular groove projection
47
How many times do you take images for shoulder arthrography?
Before and After contrast injection
48
What happens if the patients radiographs appear normal after contrast is injected for shoulder arthrography?
The patient is directed to exercise the shoulder and the radiographs are repeated
49
What are indications of myelograms?
-Benign or malignant tumors
-Lesions that may be present within the spinal canal or may protrude into the canal
-Cysts
-Herniated nucleus pulposus (HNP)
-In case of trauma- bone fragments
-Most pathology occurs in the cervical or lumbar spine
50
What are contraindications of myelograms?
-Blood in CSF
-Arachnoiditis (inflammation of the arachnoid membrane)
-Increased intracranial pressure
-Recent lumbar puncture (within 2 weeks of the current procedure)
51
What contrast media is used for myelogram?
Positive nonionic iodine based water soluble or oil soluble contrast media
52
What is the positive nonionic iodine based water soluble contrast used for myelogram?
Metrizamide/amipaque
53
How much Metrizamide/amipaque is used for myelogram?
9-15 ml slowly injected over 1-2 minutes
54
How long does it take for absorption to begin for a myelogram using positive nonionic iodine based water soluble contrast?
within 30 minutes after injection with good radiopacity up to one hour after injection
55
What is the name of the oil soluble contrast used for myelogram?
Pantopaque
56
How long does it take for Pantopaque to be absorbed for myelogram?
Absorbed slowly if not removed- at a rate of 1cc per year
57
Where is the most common 2 puncture sites for myelogram?
L3-L4
C1-C2
58
Where does the spinal cord end?
The interspace between L1-L2
59
What are the 3 body positions for lumbar puncture?
-Prone
-Erect
-Left lateral with knees flexed up to the chest and head bent down
60
What test are CSF sent to the lab for?
-Blood cell count-WBC/RBC
-Protein
-Sugar- Low sugar levels-meningitis
-VDRL- syphilis
-Elevated RBC/WBC or protein
61
What ae complications of myelograms?
-Any spinal puncture may procedure headaches and nausea
-Injection of contrast media into the inappropriate space
-Spinal needle positioned to cause irritation to nerves
-Inadequate filing of the subarachnoid space can result in poor visualization of structures or pathology
-Contrast media complications- headache; nausea and vomiting
62
What are indications for hysterosalpingograms?
-Infertility
-Habitual abortion
-Abnormal uterine blocking
-Absence of menses
-Suspected blockage of the fallopian tubes
-Identifying intrauterine and pelvic masses
-Fistula
-Congenital abnormalities
-Pelvic pain
63
What are therapeutic indications for hysterosalpingogram?
-restore fallopian tube patency by opening blocked tubes
-Dilating narrowed tubes
-Straightening kinked tubes
64
What are contraindications for hysterosalpingograms?
-Acute pelvis inflammation disease
-Active uterine bleeding
-Pregnanacy
65
What contrast media is used for hystersalpingogram?
-Water soluble iodine- Sinografin
-Iodinized Oil- Lipidol
66
Why is water soluble iodine (Sinografin) used for hysterosalpingogram?
-quickly absorbed ( approx. 1 hour)
-Radiopacity moderate
-Demonstrates mucosal pattern well
-No possibility of embolic formation
67
What are complications of hysterosalpingogram?
-Hemorrhage
-Spread of a pre-existing infection
-Peritinitis
68
What are the radiographic findings of hysterosalpingogram?
-Congenital abnormalities- single fallopian tube
-Diverticula of the fallopian tubes
-Dilation of the fallopian tube because of partial obstruction
-Peri tubal adhesions
-Fibroid tumors or polyps
69
What are indications for ERCP?
Diagnostic-
-Stenosis, dilation, obstruction or small lesions within the biliary or pancreatic ducts
-Pre-operative or postoperative procedure
-Inconclusive gallbladder studies
Therapeutic-
-Spinecterotomy may be performed to repair a stenosis of the sphincter of oddi or the facilitate stone removal from the bile ducts
-Stones can be removed either by threading a balloon catheter beyond the stone, inflating the balloon and then with drawing the balloon and stones into the duodenum or by using a basket catheter to retrieve the stone
-Biliary ducts stenoses can be treated by dilation with a balloon catheter, by stent placement or by balloon dilation along with stent placement
-Pancreatic stones can also be removed by using either a balloon catheter or a stone basket for retrival
70
What medications are used for hysterosalpingogram?
-Xylocaine- local anethestic
-Sedatives- Dermel valium
71
What is narcan or mazicon?
drugs that reverse the effectiveness of the sedatives
72
What contrast media is used for hysterosalpingogram?
Water based iodinated contrast
-Renographin M60- ionic
-Isovue 300- nonionic
73
Where is the cassette for mobile chloangiogram?
14x17- top of the cassette just below right axilla
74
What are the advantages of laparoscopic cholangiogram?
-It can be performed as an outpatient procedure
-Minimally invasive procedure
-requires reduced hospital time over other procedures with reduced cost
75
What are clinical indications for Post Operative T-Tube Cholangiogram?
-Residual Calculi
-Strictures
76
What are contraindications for Post operative T-Tube cholangiogram?
-Hypersensitivity to iodinated contrast media
-Acute infection of the biliary system
-Elevated creatinine or blood urea nitrogen (BUN) levels
77
What contrast media is used for Post operative T-tube cholangiogram?
-Iodinated water soluble contrast medium
-Might be diluted concentration to prevent obscuring a small calculi
78
What are indications for angiograms?
-Verifying the presence of tumors
-Internal bleeding
-Stenosis
-Occlusions
-Aneurysms
-Heart Disease
79
What are contraindications for angiograms?
-Previous severe reaction to contrast
-Impaired renal function
-Impaired blood clotting factors
-Inability to undergo surgical procedure
80
What is a biplane c-arm injector?
81
What is an automatic injector?
-Maintain flow rates
-Includes heating device
-Contrast must be administered at a consistent speed
82
What is pressure injectors?
-Warms contrast- improve viscosity
-Piston- motor driven plunger
-Flashing light- audible tone- message
-prevents excessive pressure
83
Where is the seldinger technique used
femoral artery
84
What is preprocedural care for angiograms?
-Liquid only diet
-Adequate hydration
-Iv line placed
-history taken
-Informed consent
85
What is postprocedural care for angiograms?
-Catheter removed- compression applied
-bed rest- minimum 4 hours with head elevated 30 degrees
-Vital signs
-Extremity watch
86
What are risks/complications of angiograms?
-Bleeding at puncture site
-thrombus formation
-Embolus formation
-Dissection of vessel
-Puncture site infection
-Contrast reaction
87
What are pathologic indications for cerebral angiogram?
-Vascular stenosis and occlusions
-Aneurysms
-Trauma
-Arteriovenous malformations
-neoplastic disease
-Tumors
88
Where is the catheter placed for cerebral angiogram?
femoral approach
89
What are the 3 major branches of the aorta?
-Brachiocephalic
-Left Common carotid
-Left Subclavian
90
What are complications of cerebral angiogram?
-local ,neurologic or systemic complications
-Common- hematoma, extravasation of the contrast media at the puncture site
91
What are indications for peripheral angiogram?
-Arthrosclerosis disease
-Vessel occlusion and stenosis
-Trauma
-Neoplasm
-Embolus and thrombus
-Arteriovenous malformation
92
How much contrast is used for peripheral angiogram?
20-30 ml unilateral
50-70 ml for bilateral
at rate of 8-10ml/s
