Patient Care Flashcards
Consent may be given these 3 ways
Informed, oral or implied
What type of procedure would need informed consent
Anything that creates a new entrance into the body (IV contrast)
What Act is responsible for confidentiality
HIPAA
Right to refuse medical treatment including radiographic procedure applies to patient _____
Autonomy
In what sequence should exams be ordered
- Anything no requiring contrast media
- Lab studies for iodine uptake
- Urinary Tract exams
- Biliary Tract exams
- Lower GI (BE)
- Upper GI
In what order should patient waiting times be prioritized
- Emergency pts
- Fasting pts
- Peds & Geriatrics that are NPO
- Diabetics putting off insulin due to NPO
What needs to be in the order
- Pt name
- Exact part
- Pt diagnoses
- Ordering physician
- Date of requisition
The threat of touching in an injurious manner
Assault
An unlawful touching of a person without consent
Battery
When the confidentiality of the pt is not maintained
Invasion of privacy
An injustifiable detention of a person against their will
False imprisonment
The neglect or omission of reasonable care and caution
Negligence
Defamation by written or printed words
Libel
Defamation by spoken words
Slander
An intentional or unintentional act resulting in injury to a pt
Tort
When a pt is injuried due to error caused by the health care provider
Malpractice
The doing of goodness, kindness or charity, including all actions to benefit others
Beneficence
Let the master answer
Respondeat superior
The thing speaks for itself - requires the defendant to prove their innocence
Res ispa loquitur
Do you need a physicians order to use restraints
Yes
Mandatory standards of minimally acceptable professional conduct for all present RTs & Candidates
Rules of Ethics
Modes of communication
Verbal & non verbal
Attitudes, tone, volume
Eye contact, touching, facial expressions, appearance
A sensitivity to the needs of others that allows you to meet those needs in a constructive manner
Empathy
A calm firm expression of feelings or opinions, good to use whenever working with a reluctant pt
Assertiveness
5 steps of grieving
Denial, Anger, Bargaining, Depression & Acceptance
DABDA
Uses an xray beam to record predetermined planes in the body
CT
Uses radio frequency and a magnetic field to produce sectional images of the body
MRI
Uses an xray beam to produce images of the breast
Mammo
Uses ultrasonic waves directed into tissues to visualize deep structures of the body
Ultrasound
Introduces radioactive substances into the body for diagnostic as well as therapeutic purposes
Nuc Med
Uses dual energy xray absorption to detect osteoporosis
DEXA - bone densitometry
Rules of Body mechanics - how to lift
- Wide stance
- load balanced
- avoid twisting
- back straight & bend at knees
- push rather than pull a heavy object
- pull a pt onto a table tho
Swan Ganz Catheter
Catheter used to diagnose right and left ventricular failure and pulmonary disorders, & to monitor the effects of specific medications - tip places in the pulmonary artery
What is the flow rate of O2 through a nasal cannula
21-60% O2 with a flow of 1-6 L/min
O2 flow rate w oxygen mask
Greater than 5 L/min
Non rebreather mask
Plastic reservoir bag should never be completely flat
O2 tent
Used on Pediatrics
Uses weights to apply a mechanical pulling or traction for therapeutic reasons, long bones, lumbar and cervical spine injuries
Orthopedic traction
Surgical opening cut in the trachea to create an airway
Tracheostomy
Tube used for feeding or gastric suction
NG Tube
Tube that goes into the intestine for purpose of aspirating gas and fluid in the intestinal tract following surgery
Nasoenteric Tubes
Used to remove fluid or free air from the pleural cavity
Closed chest drainage
Used for the drainage and collection of urine
Urinary catheters
How high does the IV bag need to be hung above the vein
At least 18 inches
Sphygmomanometer and stethoscope
BP equipment
Pulse rate
60-100 bpm
Pulse palpation sites
Temporal artery
Carotid artery
Radial artery
Femoral artery
Dorsal pedis artery
Fast heart rate - greater than 100 bpm
Tachycardia
Slow heart rate - less than 60 bpm
Bradycardia
that Represents pressure created during contraction of ventricle
Systolic
representing pressure with heart at rest
Diastolic
Hypertension
High BP - above 140 systolic or 90 diastolic
Hypotension
Low BP - below 95 systolic or 60 diastolic
BP range
110-140/60-80
Adults respiration
12-20/min
Child Respiration
30-60/min
Tachypnea
Rapid breathing
Bradypnea
Slow breathing
Apnea
Cessation of breathing
Closed fracture
Not broken the skin
Open fracture
Penetrated the skin
Displaced fracture
Not anatomically aligned
Nondisplaced fracture
Still in normal alignment
Compression fracture
In vertebra only
Impacted fracture
Driven into one another
Overriding fracture
Weight bearing bones only (EX Colles)
Comminuted fracture
More than 2 fragments
Incomplete fracture
Greenstick
Transverse fracture
Angled
Compound fracture
Open fracture
Linear fracture
Running down the bone
Depression fracture
Skull
Subluxation
Dislocation
Apple core appearance
Appearances in colon cancer
Padgetts disease
Areas of bone breakdown, bone enlargement & deformity
Boxers fracture
Fracture in the neck of the 5th metacarpal
Avulsion fracture
Bone is pulled away by soft tissue that it’s attached to
Colles fracture
Distal radius/ulna fracture with fracture pushed in front of hand
Smith fracture
Distal radius/ulna fracture with fracture pushed behind hand
Cardiac vs respiratory arrest
Cardiac - blood flow stops
Respiratory- breathing stops
CPR steps
- determine unresponsive
- call 911
- get AED
- send for assistance if possible
- if no pulse, 30 compressions & 2 breaths
- if pulse, one breath every 5-6 seconds
Syncope
Fainting
What is the most common medical emergency encountered by technologists
Fainting
Hyperglycemia
High blood sugar
Hypoglycemia
Low blood sugar
Onset of hyperglycemia and hylpoglycemia
Hyperglycemia- slowly
Hypoglycemia- rapidly
Petite mal seizure
May not be apparent to the technologist
Grand mal seizure
Major motor seizure
Arterial blood - apply compression where
On site or proximal to the site between it & heart
Venous blood - apply compression where
At site or distal to the site away from heart
Orthostatic hypotension
Faint or lightheaded feeling when a pt is moved into an upright position
Epistaxis
Nose bleeds
Sensation of a loss of balance
Vertigo
Breathing disorder characterized by wheezing and difficulty breathing
Asthma
Steps for fire Evacuation
Race
Rescue
Alarm
Contain
Extinguish
Steps for putting fire out
Pass
Pull
Aim
Squeeze
Sweep
Deals with reducing the probability of infectious organisms being transmitted to a susceptible individual
Medical asepsis - clean
Complete removal of all organisms and their spores from the equipment used to perform pt care or procedures
Surgical asepsis - sterile
First level of medical asepsis
Cleanliness/Sanitation
2nd level of medical asepsis
Equipment Disinfection
Third & highest level of medical asepsis
Equipment sterilization
An inanimate object that has made contact with an infectious organism
Fomite
Transmission of an infectious agent that is indirect by means of a fomite that touches a persons body or is ingested
Vehicles
Typically an arthropod - mosquito, flea, tick
Vector
Hospital acquired infection
Nosocomial infection
Physician caused infection
Iatrogenic infection
Infection from an unknown cause
Ideopathic infection
Chain of infection
Infectious agent - reservoir- portal of exit - mode of transmission - portal of entry - susceptible host
For a sterile procedure, how long do you hand wash for
5 minutes
Bleach ratio mixture for disinfectant use
1:10 ratio with water
Opening a sterile tray - flaps
Open furthest one away from you first to avoid leaning over the tray once it’s open
Methods of sterilization - boiling
12 minutes
Methods of sterilization - dry heat
1-6 hours at temps 329-338°F
Methods of sterilization - gas sterilization
Used on electric, plastic & rubber items
Autoclaving
Steam sterilization
Chemical sterilization used where
On items that cannot withstand heat
Ionizing radiation sterilization
Used in commercial sterilization
Microwaves/Non ionizing radiation sterilization
Uses low pressure steam and microwaves to produce heat
Is alcohol a disinfectant
No - it’s a antiseptic which prevents the growth but does not kill them
Acid-Fast Bacilli protocol
Used for TB pts with positive sputum culture - N95 required on top of gown & gloves
Neutropenic precautions
Reverse isolation - used on pts w compromised immune systems which are very limited
Responsibilities when working with pts in isolation (Clean Tech/Dirty Tech)
One tech works the equipment while the other the IR/pt. Clean equipment immediately outside pt room
Material Safety Data Sheet
MSDS - tells everything about the product - handling precautions, safe uses of product, cleanup & disposal
The best predicator of a possible reaction to contrast is what
A history of previous allergic reaction
What percent of pts experience some type of reaction
5% - 5% of that 5% have sever or life threatening reactions
IV push injection is also called what
Bolus injection
Six rights of drug administration
Right:
Patient
Drug
Amount
Route
Time
Documentation
Infusion administration is also called
An IV drip
Steps for IV
- Wash hands
- Verify pt ID
- explain process
- get supplies
- put on gloves
- find vein & clean
- tourniquet
- stabilize the vein
- insert needle & check backflow
- remove tourniquet & inject
- properly dispose of needle
- chart
Maximum allowable volume of Iv iodine is what
300 mL
If a pt has renal insufficiency, IV contrast should not exceed what
5 x weight in kg/creatinine/mL
How to convert lbs to Kg
1 kg = 2.2046 lbs
Sites for venous catheters or needles
Antecubital vein (most common)
Basilic vein (back of the hand is second most common)
What does positive contrast do to the body in terms of X-ray
Alters the selected organs ability to attenuate the xray beam - affects subject contrast
What does negative contrast do to the body in terms of X-ray
Uses gases to reduce the ability of the structures to attenuate the beam
Water soluble contrast
May be ionic or nonionic
Oil based contrast
Not commonly used - is slowly absorbed into the body
Kvp when using iodinated contrast
Usually 80 or less in order to not penetrate the contrast
Ionic vs non ionic contrast
Ionic dissociates into two molecules & non ionic doesn’t.
Nonionic decreases the chance of reaction.
Osmolarity vs risk
The increase in osmolarity = an increase in risk or reaction. Ionic has a higher osmolarity than nonionic
Thickness of contrast media
Viscosity
Barium used when
Doesn’t need to be absorbed by the body - cannot be used if bowel perf is suspected
Kvp range for barium usage
100-125 kvp for single contrast
Above 90 for double contrast
Gastrografin
Used whenever bowel perf is suspected - water soluble iodine based contrast that can be administered orally or through NG tube
Considerations or factor that would alter the type or amount of contrast used
Pt condition (EX perforated bowel)
Age
Weight
Medication
Renal function
Creatinine normal range
.7-1.3 mg/dL
BUN normal value
8-25 mg/dL
GFR normal value
90-120 mL/min/1.7 m squared
Do diabetics have compromised kidneys
Yes
When fluid infuses the tissue surrounding the venipuncture site
Infiltration AKA extravasation
Drug capable of causing tissue necrosis
Vesicant
Inflammation of the veins
Phlebitis
Introduction of air into a vein
Air embolism
A general term used to describe a failure of circulation in which blood pressure is inadequate to support oxygen perfusion of vital tissues and is unable to remove the by products of metabolism
Shock
Shock resulting from external hemorrhage, lacerations or plasma loss due to burns
Hypovolemic
Shock resulting from massive infection
Septic
Shock resulting from a pt suffering head or spinal trauma ending in a failure of arterial resistance
Neuogenic shock
Shock resulting from cardiac failure
Cardiogenic shock
Results from being injected with a foreign protein, stings or iodinated media
Allergic or anaphylaxis
Urticaria AKA
Hives
Symptoms of contrast reaction
- Restlessness
- Increase pulse
- Pallor, weakness &/or change in thinking ability
- cool clammy skin
- drop in BP (can be with itching, flushing, & shortness of breath)
Examples of mild reactions
Nausea, vomiting, hives, itching, sneezing, extravasation, vasovagal response such as fear, exhibited by weakness, dizziness, sweating and feeling of passing out
What to do for extravasation
Provide a warm towel
Examples of moderate reaction
Excessive hives, tachycardia, giant hives, excessive vomiting - call for medical assistance
Examples of severe reactions
Any reaction involving life threatening situation - very low BP, convulsions, arrest, cyanosis, profound shock - call for immediate assistance
Xylocaine use
Arrhythmias
Decadron use
Allergic reaction
Benadryl use
Allergic reaction
Atropine use
Bradycardia
Dilantin use
Seizures
Lasix use
Edema
Epinephrine use
Cardiac arrest & anaphylaxis
Sodium bicarbonate use
Metabolic acidosis
Nitroglycerin use
Angina - chest pain
Glucagon use
Smasmatic colon
Heparin use
Anticoagulant
Warfarin use
Anticoagulants
Coumadin use
Anticoagulants
Insulin use
Hyperglycemia
Metformin use
Hyperglycemia
Glucophage use
Hyperglycemia
