Patient Care Flashcards
Autonomy
Right to refuse medical treatment including a radiographic procedure
Who is responsible for determining patients chief complaint or most important issue
Physicians
Seven elements in producing complete history
1) localization
2) chronology
3) quality
4) severity
5) onset
6) aggravating or alleviating factors
7) associated manifestation
Scheduling of exams
1) non con first (KUB)
2) IVU
3) BE
4) UGI
Assault
Threat of touching in an injurious manner (tone of voice)
Battery
Unlawful touching of a person without consent (wrong pt, wrong part, took against will)
Libel
Defamation by written or printed words
Slander
Defamation by spoken words
Tort
Intentional or unintentional act resulting in injury to patient
Malpractice
When patient is injured due to error caused by health care provider
7 C’s of malpractice prevention
1) competence
2) compliance
3) charting
4) communication
5) confidentiality
6) courtesy
7) carefulness
Respondeat superior
Let the master answer
Res ipsa loquitur
The thing speaks for itself
5 steps of grief
1) denial
2) anger
3) bargaining
4) depression
5) acceptance
Pulmonary Artery (Swan-Ganz) Catheters
- used for diagnosis of R and L ventricular failure and pulmonary disorders, and to monitor effects of medications
- tip of catheter placed in pulmonary artery
Nasal Cannula
21% to 60% oxygen delivered using flow of 1 to 6 L/min for adults
IV levels above vein
Minimum 18 inches (45cm) to maximum 24 inches (60cm)
Adult pulse rate
60-100 bpm
Child pulse rate
90-100 bpm
Infant pulse rate
80-120 bpm
Most common site to take pulse when conscious
Radial
Most common site to take pulse when unconscious
Carotid
Hypertension
High arterial bp
Above 140 mmHg systolic
Above 90 mmHg diastolic
Hypotension
Low arterial bp
Below 95 mmHg
Below 60 mmHg
Adult Normal BP
Systolic 110-140 mmHg
Diastolic 60-80 mmHg
Children Normal BP
Systolic 70-112
Diastolic 26-70
Infants Normal BP
Systolic 60-105 mmHg
Diastolic 22-60
Repertory rate for adults
12 to 20 per minute
Repertory rate for children
30 to 60 per minute
Spinal injuries
Horizontal beam lateral view xray of the spine should be obtained and cleared of C and L spine before patient moved
Syncope
Fainting
Hyperglycemia
- High blood sugar
- Characterized by flushed, dry skin and mucous membrane, air hunger and fruity smelling breath, excessive thirst and urination
- occurs slowly
Hypoglycemia
- low blood sugar
- characterized by sweating, clammy, cold skin, nervousness and irritability, blurred vision
- occurs rapidly
Arterial blood
Compression directly to the site or proximal to site, between the site and the heart
Venous blood
Compression to the site or distal to the site away from the heart
Orthostatic hypotension
Lightheaded feeling after being recumbent for too long (ex. Trendelenburg)
Epistaxis
Bleeding from nose
ETT should no go past level of what
Carina
How far superior should ETT stop from carina
5-7 cm
At what level does carina bifurcate
T5
What anatomy is effected by blow out fracture?
Orbital bones
Smiths fracture
Hand displaced anteriorly
Fracture of distal end of radius
Colles fracture
Posterior displacement of hand in relation to forearm
Avulsion
Chip of bone pulled away from rest
Bennets fracture
Fx at base of thumb (1st metacarpal)
Jons fracture
Base of 5th metatarsal
What is Medical aseptic technique used for
Reducing the probability of infectious organisms being transmitted
How are microorganisms eliminated with medical aseptic technique
-microorganisms are eliminated through the use of soap, water, friction, and chemical disinfectants
What is surgical aseptic technique
-Complete removal of all organisms and their spores from equipment used to perform pt care
Sterile technique
Any procedure that involves catheterization of urinary bladder, tracheostomy care, dressing changes, penetration of skin
First level of medical asepsis
Cleanliness/Sanitation
Second level of medical asepsis
- Equipment disinfection
- Destruction of pathogens through chemical materials
Third level of medical asepsis
- equipment sterilization
- treating items with heat, gas, or chemicals to make them germ free
Fomites
Inanimate object that has made contact with infectious organism (food, water, gloves, equipment)
Vehicles
Transmission of infectious agent that is indirect by means of fomite that touches a person’s body of is ingested
Vectors
An arthropod (mosquito, flea, tick)
Nosocomial infection
Hospital acquired (UTI)
Nosocomial infection
Hospital acquired (UTI)
Iatrogenic infection
Physician caused
Ideopathic infection
Unknown cause
Chain of infection
Infectious agent Resevoir Portal of exit Mode of transmission Portal of entry Susceptible host
How long should hand washing last
20 seconds
How long should hand scrubbing last for sterile procedure
5 minutes
What should be removed when preparing syringes
Air bubbles
Operators dressed in sterile gowns pass how?
back to back
What is a common disinfectant used in radiology department
Bleach- mixed with water in a 1:10 ratio
Autoclaving
Steam sterilization
Alcohol is not a disinfectant but what?
Antiseptic- prevents the growth of microorganisms but does not kill them
Neutropenic Precautions (protective)
Reverse isolation
Sterilization
Complete killing of all microorganisms
Rectal IV height
No less than 18 inches (45 cm) and a maximum of 24 inches (60 cm) from site of introduction
Rectal contrast position
Sims position- pt lies on left side with right leg drawn forward in front of the left
Bolus injection aka
IV push
Infusion administration aka
IV drip
What is the single most commonly used contrast in rad?
Air
Negative contrast agents
Uses gas to reduce or decrease the attenuating ability of the structures filled with gas
Positive contrast agents
Increases the attenuating ability of the structures containing the positive contrast
Osmolarity
- Concentration of an osmotic solution
- increased osmolarity of contrast increases reaction risk
- ionic solutions have higher osmolarity than non-ionic
Viscosity
Thickness of contrast media
How to reduce viscosity of an ion?
Warm it up
How much kilovoltage for double barium study?
Above 90
How much kilovoltage for single contrast study?
100-125 kVp
Gastrografin
Water soluble, iodine based positive contrast
Creatinine values
0.7-1.3 mg/dL
Blood urea nitrogen (BUN)
8-25 mg/dL
Glomerular filtration rate (GFR)
90-120 mL/min/1.73 m sqaured
Estimated GFR
Best test to measure kidney function and determine stage of kidney disease
Hypovolemic shock
From external hemorrhage, lacerations, or plasma loss due to burns
Septic shock
Results from massive infection
Neurogenic shock
Patients that suffer head or spinal trauma resulting in a failure of arterial resistance
Cardiogenic shock
From cardiac failure
Anaphylaxis
From being injected with foreign protein, bee sting, or iodinated media
Symptoms of contrast reaction
Increase in pulse rate
A fall in bp (hypotension) accompanied with itching, flushing, and shortness of breath