PATIENT CARE Flashcards
WHAT IS A PATHOGEN?
WHAT IS A RESERVIOR? EXAMPLES?
WHY IS HUMAN BODY PERFECT HOST FOR PATHOGENS?
ANY DISEASE-PRODUCING MICROORGANISM, COMMONLY A VIRUS OR BACTERIUM
PLACE WHERE PATHOGEN CAN SURVIVE & BE TRANSMITTED
-SOURCES INCLUDE HUMANS, ANIMALS & INANIMATE OBJECTS
B/C ITS TEMPERATURE, PH AND NUTRIENTS
WHO MAKES A GOOD HOST FOR PATHOGENS?
WHAT ARE THE TYPES OF TRANSMISSION OF PATHOGENS?
HOW CAN PATHOGENS ENTER?
Those with reduced natural resistance to infection (impaired health,
fatigue, stress, low-grade infection)
DIRECT OR INDIRECT CONTACT
- PENETRATION 2. INHILATION 3. INGESTION
EXAMPLES OF DIRECT TRANSMISSION?
EXAMPLES OF INDIRECT TRANSMISSION?
DROPLET & DIRECT CONTACT
AIRBORNE, VEHICLE BORNE-FOMITE & VECTOR BORNE-MECHANICAL
EXAMPLES OF DROPLET TRANSMISSION:
EXAMPLES OF DIRECT CONTACT TRANSMISSION
EXAMPLE OF AIRBORNE TRANSMISSION
DROPLET = COUGH, SNEEZE, SPEAKING
DIRECT = HIV, SKIN INFECTION
AIRBORN = DUST IN AIR
EXAMPLE OF VEHICLE BORNE-FOMITE:
EXAMPLE OF VECTOR BORNNE-FOMITE:
OBJECT (TABLE, DOORKNOB, TECH’S HAND)
ANIMAL INFECTED (MOSQUITO, TICK, DOG W RABIES)
WHAT IS ASEPSIS?
WHAT IS EQUIPMENT DISINFECTION?
WHAT IS EQUIPMENT STERILIZATION?
means freedom from infection
use of a chemical procedure that eliminates virtually all
recognized pathogenic microorganisms but not all microbial forms
procedure used to prevent contamination by microbes and endospores before, during, and after surgery using sterile technique
WHAT IS MEDICAL ASEPTIC TECHNIQUE?
WHAT IS STERILE TECHNIQUE?
WHAT DOES IT INVOLVE (EXAMPLES?)
reduction in the numbers of infectious agents, which decreases the probability of infection
certain procedures to make sure no microorganisms contaminate a sterile field
- gowning, gloving, masking, assisting with sterile trays, preparing sterile syringes, etc.
What is the first line of defense in preventing the spread of disease?
WHAT IS STERILIZATION?
CAN YOU LEAVE A STERILE AREA UNATTENDED?
Medical aseptic technique
absolute killing of all life forms
NO, ONCE LEFT OR UNSURE - DISCARD / ASSUME CONTAMINATED
IN IV INJECTION, CLEANING THE SKIN IS EXAMPLE OF ______ & KEEPING NEEDLE & CONTRAST STERILE IS EXAMPLE OF ______-
STERILE TECHNIQUE VS MEDICAL ASEPSIS
EXAMPLES:
MEDICAL ASEPSIS / STERILE TECHNIQUE
Sterile technique is used for invasive procedures, such as surgery and inserting catheters,
medical asepsis is used for noninvasive procedures, such as measuring blood pressure and suctioning the oral cavity
WHAT IS CDC STANDARD PRECAUTIONS FOR?
IS EVERY PATIENT INFECTED? IS ALL BODILY FLUID?
EXAMPLES OF CDC ENGINEERING CONTROLS:
-precautions to prevent the transmission of disease by blood or body fluids
-an aggressive, standardized approach to infection control
EVERYTHING/ONE ASSUMED TO BE CONTAMINATED WITH HIV, HBV OR OTHER BLOOD-BORNE PATHOGEN
sharps containers, mouthpieces, ventilation bags
EXAMPLES OF CDC PPE:
EXAMPLES OF CSC WORK PRACTICE CONTROLS:
WHEN STERILE GLOVE/GOWN EXPLAIN WHAT PART IS STERILE / HOW TO PASS SOMEONE:
(gloves, masks, gowns, face shields)
(handwashing, do not recap needles)
WAIST UP / FRONT SIDE ONLY
- PASS BACK TO BACK
What is the single most important means of preventing the spread of infection?
WHEN SHOULD YOU WASH YOUR HANDS?
WHAT IS PPE?
HAND WASHING
hands must be washed before and after every procedure regardless of whether gloves were worn
Personal Protective Equipment (PPE) refers to wearable equipment that is intended to protect a Health Care Provider (HCP) from exposure to infectious agents
WHAT TECHNIQUE IS USED WHEN PREPARING / ADMINISTERING MEDICATION?
WHAT IS IMPETEGO? HOW TRANSMITTED?
WHAT IS MRSA? HOW TRANSMITTED?
ASEPTIC
impetigo (inflammatory skin lesions) - CONTACT
Methicillin Resistant Staph Aureus (MRSA) - CONTACT
WHAT IS STAPH? HOW TRANSMITTED?
WHAT PROTOCOLS FOR DROPLET PRECAUTION?
HOW CAN DROPLET INFECT?
staphylococcus (pathogenic bacteria) - CONTACT
Vancomycin Resistant Enterococcus (VRE) - CONTACT
wear surgical mask if within 3 feet of patient
the patient should be placed in a private room
patient wears surgical mask when transported to Radiology
drops expelled while coughing, sneezing, or talking
infected by contact with mouth, nasal mucosa, or conjunctiva
DISEASES WITH DROPLET PRECAUTIONS:
WHAT PROTOCOLS FOR CONTACT PRECAUTION?
EXAMPLES OF CONTACT DISEASES?
influenza (influenza A or influenza B virus)
meningitis
rubella (German measles)
wear gloves and gown if coming in contact with patient
the patient should be placed in a private room
patient wears mask and gown when transported to Radiology
while imaging the patient use the clean and dirty tech routine
impetigo (inflammatory skin lesions)
Methicillin Resistant Staph Aureus (MRSA)
staphylococcus (pathogenic bacteria)
Vancomycin Resistant Enterococcus (VRE)
WHAT PROTOCOLS FOR AIRBORNE PRECAUTION?
EXAMPLES OF AIRBORNE DISEASES?
wear respiratory protection that filters inspired air
negative-pressure isolation room
patient wears surgical mask when transported to Radiology
rubeola (measles)
tuberculosis
varicella (chicken pox)
WHAT DOES NEUTROPENIC MEAN?
WHAT IS IMPORTANT AB IT?
WHAT IS A NOSOCOMIAL INFECTION?
the level of white blood cells in their body is considered low
-HIGH RISK INFECTION / NEEDS TO STAY AWAY FROM INFECTED PPL
hospital-acquired infection (healthcare associated infections are spread from a hospital, nursing home infection, rehabilitation facility or clinic)
HOW MUCH NOSOCOMIAL INFECTIONS ARE PREVENTABLE?
BEST PREVENTATIVE FOR IT?
MOST COMMON NOSOCOMIAL INFECTION?
1/3
HANDWASHING
UTI
IS CHEMOTHERAPY WASTE HAZARDOUS?
WHAT IS A SAFETY DATA SHEET?
WHATS IT INCLUDE?
YES
SDS are required to be presented in a consistent user-friendly format
the SDS includes the properties of each chemical; the physical, health, and environmental health hazards; protective measures; and safety precautions for handling, storing, and transporting the chemical
WHAT IS MEDICAL RECONCILIATION?
WHAT IS EXAMPLE OF PREMEDICATIONS
WHAT PROCEDURE TYPICALLY GETS THIS?
CURRENT MEDICATIONS BEING TAKEN
antihistamine before the procedure to reduce risk
MYELOGRAM
WHAT IS IMPORTANT ABOUT METFORMIN & IV IODINATED CONTRAST?
WHAT IS A CONTRAINDICATION?
Glucophage (metformin) should be discontinued at the time of a procedure using IV iodinated contrast media and
withheld for 48 hours or until safe reinstitution can be assured in high risk patients
potential danger of serious adverse reactions to contrast media and the procedure should not be performed
SEQUENCE OF EXAMS:
B.E/LOWER G.I, UPPER GI, URINARY EXAM, SONOGRAM, THYROID EXAM, BILIARY EXAM, REGULAR X-RAYS,
SONO/U.S FIRST
XRAYS NOT INVOLVING CONTRAST
EXAMS OF URINARY TRACT
EXAMS OF BILIARY SYSTEM
LOWER GI / B.E.
UPPER G.I
THYROID ASSESMENTS BEFORE CONTRAST EXAMS
SONO/U.S. 2. SCOUT. 3. IVU. 4. B.E. 5. 6. UGI
(SO SUNNY IN BOLIVIA EXCEPT UKRAINE )
WHAT IS PARENTERAL MEAN? EXAMPLES?
WHAT IS TAKEN VIA ORAL ROUTE?
WHAT IS TOPICAL MEAN?
(other than G.I.), intramuscular (IM), intravenous (IV), subcutaneous
tablets, capsules, granules, and liquids
germicidal solution to cleanse the skin; nitroglycerin administered sublingually
HOW IS NITROGLYCERIN ADMINISTERED?
THE SMALLER THE GAUGE =
DIFFERENCE BTWN ML & CC?
nitroglycerin administered sublingually
THE LARGER THE LUMEN
SAME VOLUME / NO DIFFERENCE
WHAT IS AMPULE NEEDLE?
WHAT IS RADIOGRAPHERS ROLL IN VENIPUNCTURES?
WHAT VEINS IS CONTRAST INJECTED?
SNAP OFF GLASS TOP
supportive one - prepare medication (contrast), check patient I.D., reassure the patient, assist the physician, monitor patients’ progress after the injection
BASILLIC & CEPHALLIC VEINS
WHAT IS IODINATED CONTRAST?
WHAT IS WATER SOLUBLE?
WHEN IS IT TYPICALLY USED?
contains iodine and generally produces less contrast than barium
unlike barium, these will be absorbed into the blood stream and then excreted via the
urinary tract (urography, angiography [blood vessels, bile ducts], joint capsule)
WHAT IS BARIUM? WHEN IS USED?
IONIC VS NONIONIC:
barium sulfate, gastrointestinal tract only
ionic dissociates CHEAPER, several chemical reactions, less osmoltility
non-ionic (Isovue or Omnipaque), less toxic, less likely to stimulate anaphylactic Response and more comfortable for the patient (less heat and discomfort) - EXPENSIVE - high osmotility
contrast used for:
gastrointestinal tract
operative cholangiogram
T-tube cholangiogram
venogram
myelogram
IVU
retrograde pyelogram
choices: barium, omnipaque, isovue or cystografin
barium, air, gastrografin
Omnipaque
Omnipaque
Isovue Omnipaque
Isovue Omnipaque
Omnipaque
Cystografin
WHAT CONTRAST IF PERFORATED ULCER OR RUPTURED APPENDIX? WHY?
WEIGHT TO CONTRAST RATIO:
perforated ulcer, ruptured appendix, risk of barium impaction, neonates - use gastrografin instead of barium
.5 ml per pound of body weight not to exceed 100 ml
NORMAL BUN RANGE:
NORMAL CREATINE RANGE:
WHAT IF THEY ARE ABOVE NORMAL RANGE?
8-20MG/DL
.7-1.2 MG/DL
MAY INDICATE RENAL DISEASE / DR NEEDS APPROVE
TYPES OF REACTIONS TO CONTRAST:
EXAMPLES OF LOCAL EFFECTS:
EXAMPLES OF SYSTEMIC EFFECTS:
LOCAL OR SYSTEMIC
LOCAL = EXTRAVASTION, INFILTRATION OR PHLEBITIS
SYSTEMIC = MILD, MODERATE OR SEVERE
WHAT IS EXTRAVASITION?
WHAT IS INFILTRATION?
WHAT IS PHLEBITIS?
THESE ARE EXAMPLES OF WHAT?
-injection of contrast medium into the tissues surrounding the vein
-process of a substance passing into and being deposited within a cell, tissue or organ (IV’s infiltrate, whereas, injections extravasate)
-an inflammation of a vein;
LOCAL REACTIONS TO CONTRAST
EXAMPLES OF MILD SYSTEMIC EFFECT:
EXAMPLES OF MODERATE SYSTEMIC EFFECT:
EXAMPLES OF SEVERE SYSTEMIC EFFECT:
-FLUSHING OR NAUSEA
-HIVES, ITCHING
-HYPOTENSION, SHOCK OR ANAPHYLAXIS, DIFFICULT BREATHING
WHAT IS URTICARIA?
WHAT IS ATROPINE USED FOR?
WHAT IS ADRENALIN USED FOR?
HIVES / BLOTCHY REDNESS OF SKIN
BRADYCARDIA
ANAPHALAXIS / CARDIAC ARREST
WHAT IS BENADRYL USED FOR?
BETA-AGONIST INHALER?
DILANTIN?
LASIX?
NITROGLYCERIN?
ALLERGIC REACTION
ASTHMA
SEIZURE
PUMONARY EDEMA
CHEST PAIN
WHAT IS INFORMED CONSENT?
WHAT MUST BE INCLUDED?
EXAMPLES OF FORMS OF INFORMED CONSENT:
patient has been informed of the procedure, any
alternative procedure that could be performed, and the benefits and risks of those procedures; only then can a patient give an informed consent for a procedure
WRITTEN, ORAL & IMPLIED
WHEN IS WRITTEN/SIGNED CONSENT OBTAINED?
WHEN IS ORAL CONSET USED?
WHEN IS IMPLIED CONSENT USED?
INVASIVE = SIGNATURE
NONINVASIVE = ORAL
PATIENT FOLLOWING DIRECTIONS OF SIMPLE PROCEDURE = IMPLIED CONSENT
WHAT IS HIPAA STAND FOR?
WHAT IS HIPAA?
WHAT IS PHI?
VIOLATIONS OF HIPAA COULD RESULT IN:
Health Insurance Portability and Accountability Act
legislation that allows workers to continue their insurance even when they change employment; one part of the law affects health care by assuring a patient’s confidentiality
any patient information that identifies a patient is known as Protected Health Information (PHI)
FINES &/OR PRISON
_____________ ‘S ________________ STATES every human being of adult years and sound mind has a right to determine what shall be done with his/her own body
WHAT IS INCLUDED IN PATIENTS RIGHT TO PRIVACY?
WHAT IS DNR EXAMPLE OF?
American Hospital Association (AHA) Patient Care Partnership (Patient’s Bill of Rights)
right to receive notice of privacy practices, to amend medical or billing records, to restrict the use of Protected Health Information (PHI), to request confidential communications
EXTENT OF CARE
______________ States a patient has the right to consent to or refuse treatment; whether to be put on life support or not; whether to resuscitate or do not resuscitate (DNR)
what documents express a patient’s choices about his future care and to name someone to decide if he cannot speak for himself?
does a patient need to be informed about research participation?
extend of care
living will, health care proxy, advanced directives
a patient has the right to consent or decline to take part in research
WHATS INCLUDED IN PATIENT BILL OF RIGHTS?
WHAT IS ASSAULT?
WHAT IS BATTERY?
PRIVACY, EXTENT OF CARE, ACCESS INFORMATION, LIVING WILL/ HEALTHCARE PROXY & RESEARCH PARTICIPATION
assault - the threat of injury
battery - unlawful touching without consent
WHAT IS FALSE IMPRISIONMENT?
WHAT IS INVASION OF PRIVACY?
WHAT IS NEGLEGIENCE?
false imprisonment - detention of a person against his will
invasion of privacy - confidentiality of information has not been maintained
negligence - the neglect or omission of reasonable care or caution
WHAT IS MALPRACTICE?
WHAT IS BENEFICENCE?
WHAT STANDARD IS RADIOGRAPHER HELD TO?
malpractice - improper or negligent care that results in an injury to the patient
beneficence - an action that is done for the benefit of others
the radiographer is held to the standard of care and skill of the “reasonable radiographer” in similar circumstances
WHAT IS RESPONDEAT SUPERIOR?
(DEFINITION & TRANSLATION)
WHAT IS RES IPSA LOQUITOR?
(DEFINITION & TRANSLATION)
means “the master speaks for the servant”
the physician and/or the hospital may be responsible for the negligent acts of an employee, especially if they knowingly let an incompetent employee keep working
“the thing speaks for itself”;
this doctrine switches the burden of proof from the patient (plaintiff) to the health care worker (defendant), the health care worker has to prove he/she was not negligent
WHAT IS A RESTRAINT? CAN A TECH USE THIS?
WHAT IS AN IMMOBOLIZATION DEVICE? EXAMPLES? CAN TECH USE THIS?
any method of restricting a patient’s freedom of movement;
- a physician is responsible for evaluating the need for restraints and completing an order
used to maintain a position or temporarily immobilize a patient during a radiographic procedure
positioning sponge, velcro strap, sandbag
TECH DISCRETION
WHAT IS INCLUDED IN PROCESSING ALGORITHM?
WHAT IS VERBAL/WRITTEN COMMUNICATION?
WHAT IS NONVERBAL? EXAMPLES?
DIGITAL IMAGE AQUISITION, PROCESSING & DISPLAY
SPEAK, WRITE, LISTEN & OBSERVE
EVERYTHING OTHER THAN SPOKEN WORDS
- EYE CONTACT, PAT ON BACK, FROWN/SMILE & BODY LANGUAGE
WHAT MODALITY USES XRAY?
WHAT PRODUCES LARGEST DOSES?
WHAT DOES SONOGRAPHY USE?
CT, MAMMO, DEXA & XRAY
CT. & NUCLEAR MEDICINE
SOUND WAVES
WHAT DOES MRI USE?
WHAT DOES NUCLEAR MEDICINE USE?
CT?
DEXA?
WHAT IS XRAY TYPICALLY USED FOR COMPARED TO THESE?
MAGENTIC AND RADIO WAVES
GAMMA RAYS
XRAY
XRAY
SCREENING FOR MORE ADVANCED/EXPENSIVE EXAMS
WHEN MOVING PATIENTS, THE FOLLOWING SHOULD BE:
BASE OF SUPPORT:
CENTER OF GRAVITY:
LINE OF GRAVITY:
BACK INVOLVEMENT
BODY MOVEMENT:
BROAD FOR STABILITY
MID PORTION OF PELVIS / LOWER ABDOMEN
BACK STRAIGHT, HEAVY OBJECTS CLOSE TO BODY
BACK STRAIGHT, NO TWISTING
BEND KNEES, USE LEGS - PUSH OVER PULL HEAVY OBJECTS
EXAMPLES OF INFUSION EQUIPMENT:
TYPICAL OXYGEN FLOW:
WHAT DISEASE IS DIFFERENT? LESS OR MORE?
INFUSION CATHETER, INFUSION PUMP & IV
1-4 LITERS/MINUTE
EMPHYSEMA IS LESS
TYPES OF OXYGEN ADMINISTER
WHAT IS AN NG TUBE?
WHERE IS URINE CATHETER BAG? WHATS IMPORTANT ABOUT THIS?
NASAL CANNULA, NASAL CATHETER, FACE MASK, OXYGEN TENT, VENTILATOR
a nasogastric tube is inserted through the nostril and into the stomach and connected to a suction device
keep the urinary catheter and catheter bag below the bladder; never let the bag touch
the floor or the wheels of the wheelchair
WHERE IS CHEST TUBE / DRAINAGE KEPT? WHATS IMPORTANT ABOUT THIS?
WHAT IS A TRACHEOSTOMY TUBE?
keep the chest tube and drainage chamber below the chest; never let the tubes touch the floor or the wheels of the wheelchair
a tracheostomy tube is inserted into the trachea to improve respiratory function
TOP NUMBER IN BP:
BOTTOM NUMBER:
RANGES:
NORMAL PUSLE RATE:
BELOW RANGE =
ABOVE RANGE =
TOP = SYSTOLIC
BOTTOM = DIASTOLIC
90-140 / 60-90 = ACCEPTABLE
BELOW 90 / BELOW 60 = HYPOTENSION
ABOVE 140 / ABOVE 90 = HYPERTENSION
60-100 BEATS PER MINUTE
BRADYCARDIA BELOW 60
TACHYCARDIA ABOVE 100
NORMAL RESPIRATION RATE =
_______-DIFFICULT BREATHING
_______- RAPID BREATHING
WHAT IS CYANOTIC?
12-20 BREATHS PER MINUTE
DYSPENEA
TACHYPENEA
BLUEISH SKIN / LIE PATIENT DOWN
CPR COMPRESSION LOCATION & RATE:
CPR INHALATION RATE
WHAT IS SYNCOPE? WHAT CAUSES?
DEPRESS STERNUM 1.5 - 2 IN @ 100 TIMES PER MINUTE
2 INFLATIONS EVERY 30 COMPRESSIONS
FAINTING / CAUSED BY INADEQUATE BLOOD PRESSURE
WHAT IS PALLOR?
WHAT IS AN EMESIS BASIN?
DIFFERENCE BETWEEN HYPOGLYCEMIA & HYPERGLYCEMIA?
LACK OF COLOR
VOMIT BIN
HYPO = EXCESSIVE INSULIN / NEEDS GLUCOSE
HYPER = EXCESSIVE SUGAR / NEEDS INSULIN
- What to do if patient has abnormal vital signs?
- Are vital signs objective or subjective measurements?
- What vitals are used?
- Stop procedure, stabilize patient & call for help
- Objective
- Temp, Respiratory Rate, Pulse Ox, BP & Pulse
- Average Oral Temp?
- Tympanic
- Axillary
- Rectal - What is Tympanic mean
- Which is most accurate?
- Medical Term for fever?
- Oral Temp: 98.6* F
- Tympanic +1*
- Axillary -1*
- Rectal +1* - Tympanic = Forehead / Skin Surface
- Rectal Most Acc.
- Febrile
- What is respiratory rate?
- Average RR?
- What is Average Blood Pressure?
- What occurs during Systolic?
- Top or bottom #? - What occurs during Diastolic?
- Top or bottom #?
- Breath Cycles per minute (IN & OUT)
- 12-20 breathes/min
- 120/80
- Ventricles contract
- 100-120 / TOP # - Ventricles relax
- 60-80 / BOTTOM #
- What does pulse oximetry measure?
- What does hypoxia mean?
- Pulse is measured in:
- Average healthy pulse:
- Oxygen saturation in blood
- Oxygen level under 90%
- beats per minute - bpm
- 60-100 bpm
- Blood Flow Through The Heart:
12 STEPS TOTAL (6 ON R. SIDE, 6 ON L. SIDE)
- Remember “First Try, Before You Buy” (Tricuspid before Bicuspid)
- Remember A is before V in alphabet, like Atrium is above Ventricles
- Remember right sides goal: “Get blood RIGHT to heart for oxygen”
- Remember left side: “Oxygenated blood LEFT the lungs to feed body”
- Remember “To Venice, Away from Alaska” = IN through Vena Cava & OUT through Aorta
STEPS:
1. Unox. blood enters through Superior & Inferior Vena Cava
2. R. Atrium
3. Tricuspid Valve
4. R. Ventricle
5. Pulmonic Valve
6. Pulmonary Artery to Lungs
- From lungs to pulmonary veins
- Left Atrium
- Bicuspid Valve (Mitral)
- Left Ventricle
- Aortic Valve
- Aorta to Body
- What is BUN?
- Average Level:
- too much could mean:
- too little could mean: - Average Creatine Level:
- Blood Urea Nitrogen (urea in blood levels)
- 7-21 mg/dl
*REMEMBER BUNS IN OVEN FOR 7-20 MIN.
- 0.7-1.5
