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Patient Care Flashcards

1
Q
  1. What must tech do prior to an exam?
  2. Why?
  3. How is this done?
A
  1. Ensure complete patient history
  2. Assist in diagnosis, document sxs & ROI, Identify recent procedures surgeries and traumas
  3. Allow patient to provide history in their own words.
    Avoid questions l may lead
    Practice active listening
    Repeat the information back
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2
Q
  1. When is communication important?
    - Why?
  2. Contrast side effects?
  3. Do you give instructions before, during or after exam
A
  1. Communication must take place prior to, during, and after the exam.
    - ensure patient compliant, = higher quality exams
  2. metal taste in mouth, warm sensation, feeling of urination
  3. ALL
    - Before = consent / explain
    - During = ensure compliant
    - After = Clear & Understand
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3
Q
  1. Informed Consent Includes;
  2. When is implied consent used?
  3. What are positioning aides used for?
    - Examples?
A
  1. Explaining the procedure, its benefits, and risks in a way that is easy to understand.
    - Answering patient questions before the procedure is started.
    - Obtaining the patient/legal guardian signature on a consent form.
  2. Patient can’t consent / assume they would
  3. Reduce motion / ensure good images
    - Straps, head holder, cushions
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4
Q
  1. Breath holds are used for what?
  2. Is tape used for immobilization?
  3. Wheelchair Transfer Steps:
A
  1. Reduce motion of breathing during image
  2. NO
  3. STRONG close table,
    Lock Breaks,
    Tech face patient,
    Patient stand & pivot to table
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5
Q
  1. Strong or Weak side closer to patient?
  2. How does tech assist in wheelchair transfer?
  3. Cart Transfer Steps:
A
  1. STRONG
  2. FACE PATIENT / Help Pivot
  3. Table & Bed level
    - Sliding mat or board used
    - Locked Breaks
    - 1 tech each side
    - Remove board after each transfer
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6
Q
  1. What should be done BEFORE patient goes on to table?
  2. Normal patient appears:
  3. First signs of abnormality:
A
  1. Table & Stretcher Locked
    - Proper patient prep / dressed
    - Asses patient see their abilities
    - Use cushions for patient comfort
  2. Awake, Alert, & Responsive
  3. Lethargy, Stupor, Unconscious
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7
Q
  1. Vitals to be monitored:
  2. What is the cardiac cycle?
    - Determines?
  3. How is Cardiac Cycle Monitored?
A
  1. Temp, Pulse, Blood Pressure, & Respiration
  2. way in which the heart beats and moves blood through the body is known as the cardiac cycle.
    - frequency of cycle determines the heart rate.
  3. electrocardiogram (ECG). An ECG produces a graph of the patient’s heart activity.
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8
Q
  1. What is ECG?
    - Monitors what?
  2. Average Body Temp?
  3. Normal Adult Pulse?
    - Child?
A
  1. electrocardiogram (ECG). An ECG produces a graph of the patient’s heart activity / heart rate
  2. 97.7 - 99.5 F
  3. Adult = 60-100 BPM
    Children = 70-120 BPM
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9
Q
  1. Normal Blood Pressure?
  2. Top Number = ________
    - Means:
  3. Bottom Number = ________
    - Means:
A
  1. 120/80 (Systolic over diastolic)
    - LESS THAN 120
    - LESS THAN 80
  2. Systolic
    - Pressure in arteries as heart beats
  3. Diastolic
    - Pressure against arterial walls as heart rests
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10
Q
  1. Hypotension means?
    - Hypertension?
  2. Normal Repiration Rate?
    - How monitored?
  3. Where is above monitor placed?
A
  1. Hypo = low
    - Hyper = High
  2. 95-100%
    Adult = 12-20 BPM
    Child = 20-30 BPM
    - Use of pulse ox / measured blood oxygen levels
  3. EARLOBE FINGER OR TOE
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11
Q
  1. Heart contraction =
    - Heart Relax / Resting =
  2. Stages of Cardiac Cycle:
    - Name
    - What Occurs
    - ECG Corresponds
A
  1. Systolic
    - Diastolic
  2. Atrial Systole = Contract R & L Atria
    - P Wave
  • Ventricle Systole = Contract R & L Ventricle
  • QRS
  • Complete Cardiac Diastole = Atrial & Ventric Heart Rest
  • T
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12
Q
  1. ECG WAVES:
    - T =
    - P=
    - QRS=
  2. Monitoring Cardiac Cycle used in what exam?
    - Why?
  3. Desired part of cycle for these exams?
A
  1. T = Distole, P= Atrial Systolic, QRS= Ventricle Systolic
  2. Cardiac CT
    - Reduce motion
  3. Diastole / Rest / T
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13
Q
  1. Desired HR for Cardiac Exams?
  2. What can help achieve this HR?
  3. Type of scanners needed for Cardiac Exams?
A
  1. 65 BPM or lower
  2. Beta Blockers
  3. 65 Slices or Higher
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14
Q
  1. Beta Blockers used for?
  2. Nitcroglycerin used for?
  3. Oxygen measured in?
A
  1. Lower HR
  2. Sublingual med to dilate coronary vessels
  3. Liters Per Minute LPM
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15
Q

1 Types of oxygen administration?
- LPM for each?

  1. How is oxygen stored?
  2. What is mechanical ventilator?
    - Functions?
A
  1. Nasal Cannula = 1-5LPM
    - Nonrebreather / Mask = 6LPM+
  2. Gas or Liquid
  3. Replace function oxygen and co2 exchange at steady rate
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16
Q
  1. Hypoxia vs Hypoxemia?
  2. Where is chest tube placed?
    - function & restore pressure (USED FOR PNUEMOTHORAX)
  3. What is in-dwelling catheter?
    - Example?
A
  1. Hypoxia = insufficient oxygen in TISSUE
    - Hypoxemia = insufficient oxygen in ARTERIAL BLOOD
  2. intraplueral space
    - drain fluid
  3. Replace function
    - Urinary catheter
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17
Q
  1. What is something placed in patient to replace a function?
  2. What condition may a chest tube cure/help?
  3. ___A____ = insufficient oxygen in TISSUE
    - _____B____ = insufficient oxygen in ARTERIAL BLOOD
A
  1. in dwelling catheters
  2. Pnuemothorax / restore pressure and remove fluid
  3. Hypoxia = tissue
    - Hypoxemia = arterial blood
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18
Q
  1. Foley vs Straight Cath?
  2. Where is drainage bag kept?
    - Why?
  3. A patient’s renal function is indicated by the levels of:
A
  1. Both for urinary function / In Dwelling
    Foley has balloon / in place longer
    Straight no balloon / temp use
  2. Below patient to prevent back flow
  3. blood urea nitrogen (BUN) and creatinine present
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19
Q

Common Lab Values Chart
1. BUN =
Creatinine =
PT (Prothrombin Time) =
PTT (Partial thromboplastin time) =
INR (International Normalized Ratio) =
Platelet Count =

A

Common Lab Values Chart
1. BUN 8-22mg/dL
Creatinine 0.6-1.2mg/dL
PT (Prothrombin Time) 11-16 seconds
PTT (Partial thromboplastin time) 25-38 seconds
INR (International Normalized Ratio) 0.8-1.2
Platelet Count 150,000-350,000µL

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20
Q
  1. Is creatine or BUN sufficient by itself for renal function evaluation?
  2. A more accurate measure of renal function is:
    - Two types?
A

1 CREATINE
- BUN IS NOT

  1. GFR (Glomerular filtration rate).
    - eGFR (estimated GFR) is an estimation of the rate in which the bloodstream filters creatinine.
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21
Q
  1. Is creatine or BUN sufficient by itself for renal function evaluation?
  2. A more accurate measure of renal function is:
    - Two types?
  3. Average BUN level?
    - Creatine?
A

1 CREATINE
- BUN IS NOT

  1. GFR (Glomerular filtration rate).
    - eGFR (estimated GFR) is an estimation of the rate in which the bloodstream filters creatinine.
  2. BUN = 8-22 mg
    - Creatine = .6 - 1.2
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22
Q
  1. What is GFR eGFR?
  2. Factors to calculate eGFR?
  3. Normal GFR Range?
    - Abnormal?
A
  1. estimated GFR is an estimation of the rate in which the bloodstream filters creatinine.
  2. Creatine + Patient Age/Sex/Race
  3. Greater than 90 but usually >60
    - Abnormal is below 60
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23
Q
  1. How is blood coagulation measured?
    - Normal Calue?
  2. What is INR?
    - How does it work?
  3. Normal INR?
A
  1. Prothrombin Time
    - 11-16 sec
  2. international normalized ratio
    - is calculated to help standardize PT results.
    - PT time compared to control in ratio form
  3. .8-1.2
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24
Q
  1. Blood Clotting Abnormalities monitored by?
    - Normal Level?
  2. Clotting abilities determined by?
    - Normal level?
  3. Elevated D Dimer indicates?
    - CT to help dx?
A
  1. PTT (Partial thromboplastin time).
    - 25 to 38 seconds is normal range for clotting time.
  2. platelet count.
    150,000-350,000µL of blood is normal platelet count.
  3. blood clot / DVT
    - Pulmonary Angiography
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25
Q
  1. What is patient’s medication record reviewed during admission, imaging procedures, as well as at discharge referred to as?
  2. What must be present on medication record?
  3. Explain Metformin & IV CONTRAST interaction?
A
  1. medication reconciliation.
  2. Dosage
    Patient name
    Frequency
    Method of administration
  3. NOT CONTRAINDICATED
    - Just indicates they may be high risk for contrast induced nephropothy
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26
Q
  1. Is claustrophobia contraindicated?
  2. IV Contrast needle gauge?
  3. Two types needles/dofferences?
A
  1. patient needs medication / extra watch but NOT contraindicated
  2. 18-22g
  3. Angiocath = needle inserted, Cath advanced & needle removed while cath stays
    - Butterfly = needle stays
27
Q
  1. Typical IV contrast dose range?
  2. What is exact amount depend on?
  3. In order for there to be sufficient iodine opacification during a CT examination, there must be ________ of iodine in the patient’s bloodstream.
A
  1. 50ml - 120ml
  2. Radiologist protocol
    Patient weight, age and renal function
    Body part being imaged
    Method in which body part is being imaged
  3. 2-8 mg/mL
28
Q
  1. Common common types of central venous catheters are:
    - Can we inject through them?
  2. Oral contrast is used to image?
    - Typical dose range?
  3. Barium Ename used to visualize ?
    - Typical Dose?
A
  1. Subclavian lines
    Implanted ports
    Peripherally inserted central catheters (PICC line)
    - YES BUT BASED OFF MANUFACT. @ 2-6 rate
  2. GI TRACT
    - 750-1500 mL of oral contrast 60-90 minutes prior to the CT examination.
  3. Lower GI
    - 150-300ml
29
Q
  1. Rate for induction through central venous catheter?
    - What is required before?
  2. What is Intrathecal Injection?
  3. What is Intraarticular Injection?
A
  1. 2-6ml/s
    - Saline flush to check viability
  2. Iodinated contrast is administered into the space surrounding the spinal cord.
    - CT myelogram.
  3. Iodinated contrast is administered directly into the joint space.
    - CT arthrogram of hip, wrist, ankle, etc.
30
Q
  1. Type of injection in Myelogram?
    - Anthrogram?
  2. Function of contrast?
  3. Two types:
    - differences?
A
  1. MYELO = intraethical
    - Artho = intraarticular
  2. allow for structures with similar densities to be imaged by separating out the structures, so they can be distinguished from one another.
  3. positive: iodine & barium / white
    negative: air gas / black
31
Q
  1. Positive Contrast:
    - Examples
    - Appearance:
  2. What is Intravascular contrast media?
  3. As time passes, contrast moves from _______ to _______
A
  1. Barium & Idoine
    - Radiopaque
  2. opacify the blood vessels and allow for them to differentiated from the surrounding tissues and structures.
  3. inside vessels to extravascular space
32
Q
  1. Is barium or Iodinated contrast media water soluble?
  2. Which is injectable?
    - Which is orally administered?
  3. Where is iodine contrast excreted?
A
  1. iodine contrast = water-soluble
  2. Iodine = Injection & Oral
    - Barium = Oral
  3. through kidney ureter & bladder
33
Q
  1. Ionic vs Nonionic:
  2. Examples of nonionic contrast:
  3. What is Osmotility?
A
  1. IONIC: 3 Molecules when injected to blood become 2 charged ions.
    *More likely reaction /
    - NONIONIC: 3 Atoms that do not become charged when injected
    * Less likely reaction,
  2. Iohexol, iopamidol, and iopromide
  3. How likely the iodinated contrast is to make water move from outside the blood vessel to inside the blood vessel
34
Q
  1. what is how likely the iodinated contrast is to make water move from outside the blood vessel to inside the blood vessel
  2. What is iso-osmolar?
  3. What is enteral contrast?
A
  1. Osmotility
  2. same osmolality as blood. These contrast media reduce the likelihood of an adverse effect, and reduce the side effects a patient may feel with iodinated contrast media as well.
  3. orally or rectally to opacify the GI tract. In most cases
    - a water-soluble iodine solution or a barium sulfate.
35
Q
  1. Why is barium more often used for
  2. Typical time Barium moved through Gi?
  3. Is water soluble contrast high or low osmolar?
A
  1. Barium is the most frequently used enteral contrast media because of its high attenuation level.
  2. GI tract in 30 to 90 minutes.
  3. can be both
36
Q
  1. Contraindications for Barium?
    - Iodine?
  2. Which typically better?
    - Why?
  3. Negative contrast examples:
A
  1. B= perf or pre surgery
    I = Allergy
  2. Iodine
    - Easier on patient GI
  3. air gas & water
37
Q
  1. Why use negative contrast?
  2. Effervescent granules are:
  3. Examples of air used in CT?
A
  1. Increase tolerance and patient comfort
    - improve enhancement bowel walls
    - limit artifacts from radiopaque
  2. are another form of negative contrast that add gas to the stomach and upper GI tract.
  3. Breathhold in Chest
    - Enema Air in Colonography
38
Q
  1. What is neutral contrast?
    - Typical exam that uses it?
  2. Intravenous contrast injections considered what type administration?
  3. Sites of injection/IV?
A
  1. Distending GI and visualize bowel
    - Enterography
  2. parenteral (route other than mouth)
  3. antecubital forearm
    - radial aspect wrist
    - anterior forearm
    - posterior hand
39
Q
  1. When placing an IV, ____ precaution &. _________ technique used
  2. Angle of needle to patients arm?

3.

A
  1. standard precaution & aseptic technique
  2. 15*

3.

40
Q
  1. Aseptic Technique Consist of:
  2. What is sterile technique?
  3. What’s required in sterile fields?
A
  1. Handwashing between patients
    - gloves
    - Clean site with alcohol, circle motion, begin center move out
    - Gentle pressure in removal of catheter/needle
  2. process that is followed to maintain a sterile microorganism free environment during invasive procedures
  3. area is kept free of microorganisms for the duration of the procedure, and only sterile tools and supplies are used.
41
Q
  1. What is bolus injection?
  2. How is bolus injection administered?
    - why?
  3. What is rate of injection based on?
A
  1. entire quantity of iodinated contrast is injected at a steady and fast rate, over a set amount of time
  2. Automatic injector
    - Inject large volumes of contrast media.
    - Inject at high rates (5 or 6 mL/sec).
    - Inject at a steady and constant pressure.
  3. depends on the protocol, location of the IV, and the gauge of the IV.
42
Q
  1. 22 g IV injection rate?
    - 20 g?
  2. What is crucial prior to contrast injection?
  3. What is another method of injection besides bolus?
    - when used?
A
  1. 22 gauge = rate of equal or less than 3mL/sec
    - 20 gauge = an injection rate of above 3mL/sec
  2. check for air bubbles
    - air embolus can occur
  3. Drip infusion
    - Slow gravity injection used in older slower ct
43
Q
  1. Single vs Multi Phase?
  2. Which phase being imaged depends on?
  3. Two important functions of injector machines?
A
  1. Single phase- imaging occurs during a specific phase of contrast enhancement.
    - either during or after the injection of contrast media.
    -Multi = Imaging occurs during multiple phases of contrast enhancement.
    - prior to, during, or after the injection of contrast media.
  2. The specific phases that are imaged are dependent upon departmental protocols and the desired phase of enhancement.
  3. Bolus tracking = image at peak pacification / phase
    - Dual syringe = easy saline and contrast injection
44
Q
  1. Why flush with saline?
  2. What is Extravasation
  3. How is above prevented?
    - Treated?
A
  1. -Reduces the overall contrast volume needed
    - Reduces the streaking artifact from high concentration of contrast
    - Saline can also be injected prior to IV safe for use
  2. occurs when the contrast media goes outside of the vein, instead of flowing through the vein properly.
  3. Check backflow blood, test flush/bolus
    - Treat: stop injection
    - IV needs to be removed.
    - Pressure needs to be applied to the area with a warm, damp compress.
    - must be documented in the patient’s chart & Ordering physician must be notified of the incident.
45
Q
  1. What must be included in post exam instructions?
  2. Do low-osmolar or high-osmolar contrast reduce reactions?
  3. Severe reactions occur with?
A
  1. should inform patients of what normal and abnormal after effects of the procedure are, and if needed, when to consult a physician.
  2. low-osmo
  3. 20 minutes
46
Q

Mild Reactions:

A

Hives (urticaria)
Sneezing or a Stuffy nose
Itchy throat
Nausea
Vomiting
Sweating
Hypertension
Vasovagal reaction

47
Q

Moderate Reactions:

A

Hives
Erythema
Tightening of the throat
Wheezing
Nausea
Vomiting
Vasovagal reaction
Tachycardia

48
Q

Severe Reasctions

A

Laryngeal and pulmonary edema
Anaphylactic shock
Severe erythema
Hypotension
Wheezing or bronchospasm
Cardiac arrhythmia
Seizure
Cardiopulmonary arrest
Death

49
Q
  1. The CT technologist should be aware of any changes in the patient’s?
    - Examples each
  2. Delayed reactions include:
A
  1. appearance (hives, erythema), behavior (scratching, clearing throat, sneezing), or any mention of unusual feelings or sensations by the patient that are abnormal.
  2. Hives
    Itchiness (pruritus)
    Nausea
    Vomiting
    Drowsiness
    Headache
    Chills
50
Q
  1. What is Contrast induced nephrotoxicity?
    - Results in?
  2. People at higher risk of this:
  3. Ways reduce this risk?
A
  1. is a delayed reaction that can have potentially serious effects for the patient.
    - causes a decline in renal function, which results in an elevated serum creatinine level
  2. Patients with an increased baseline serum creatinine level
    - Diabetes
    - Multiple Myeloma
    - Age
    - Cardiovascular disease
  3. Hydrated before and after contrast
    - Ensure creatine levels good
51
Q
  1. When a patient receives contrast media it should be documented in their chart. The information that is documented should include:
  2. Is Providing care for patients undergoing a medical emergency a radiographers scope?
  3. Staff must be aware of what for emergencies?
A

1.CT exam performed
- Quantity and type of contrast
- If an adverse reaction occurred.
- If so, patient outcomes must be documented by a healthcare provider.

  1. is outside of the scope but must know how to provide basic support and what the appropriate course of action may be for each emergency.
    • location of crash carts, and the items or equipment that can be found within them.
52
Q
  1. What is anaphylactic reactions?
  2. Latex allergy consideration?
A
  1. Severe reaction
  2. Know equipment in room that is safe and not
53
Q
  1. Cardiac Arrest vs. Heart Attack
  2. Signs of Cardiac Arrest
  3. First step when patient begins
A
  1. Arrest = sudden loss of heart function in an individual / heart stop
    - Heart attack = blood flow to a portion of the heart is stopped.
  2. loss of consciousness, loss of pulse, and cessation of breathing.
  3. Call Rapid THEN CPR
54
Q
  1. What is Respiratory arrest?
    - Causes?
  2. Rule for trauma patients?
  3. What are important consideration for trauma?
A
  1. is the sudden loss of breathing in an individual.
    - results from respiratory distress or failure, or traumatic incidents.
  2. Do no further harm
  3. Minimal moving
    - Assume internal injury
    - Be ready to alter way images obtained
55
Q
  1. Shock results from:
  2. What may help from patient in shock?
  3. What is a Seizure?
A
  1. decreased circulating blood volume, leading to decreased oxygen in the tissues, and general hypoxia.
  2. may benefit from being placed in the Trendelenburg position.
  3. are the uncontrolled firing of neurons in the brain, and can present in a variety of ways
56
Q
  1. Two types seizures?
    - Differences?
  2. What to do when seizure occurs?
  3. Prior to contrast admin, what must be done?
A
  1. Petit mal seizures = common in children and often go unnoticed. - Grand mal seizures = loss of consciousness and muscle contraction.
  2. clear a space on the floor and attempt to lay the patient down on their side, ensuring any potentially harmful objects are out of the way.
  3. Thorough history (incl. allergy and contrast history)
    - Patient hydrated
    - Be prepared for reactions
    - Consistent monitor and communicate
    - Premeds?
57
Q
  1. Premed Protocol?
    - Consist of? Example?
  2. Breakthrough reaction?
  3. Conditions increase likelihood reaction?
A
  1. consist combination medications 12 to 24 hours prior to the CT
    - Antihistamine such as diphenhydramine.
    - Corticosteroid such as prednisone or methylprednisolone.
  2. Rare reaction after premed
  3. Asthma
    Environmental allergies
    Multiple Myeloma
    Diabetes Mellitus
    Pheochromocytoma
    Sickle Cell Anemia
    Hypothyroidism
    Cardiac disease
    Anxiety
58
Q
  1. Contraindications to IV contrast?
  2. Renal Failure Patients should receive after contrast?
  3. IV contrast & Pregnancy?
A
  1. Iodine allergy
    Prior adverse reaction to iodinated contrast
    Renal insufficiency or failure
  2. Dialysis within 24 hours
  3. No harm to fetus known
    - Discard milk for 24 hours
59
Q
  1. What is Standard Precaution?
  2. What factors are included?
  3. Modes of Transportation?
A
  1. standard precautions = treat all bodily fluids as if they are infectious and capable of spreading disease.
    - assume that every patient has the potential to be infectious.
  2. PPE, Dispose one time use & properly disinfect multi use equipment, blood = bleach, Sharps = Container, Resuc/Mouth Piece available
  3. Airborne, Contact, Droplet
60
Q
  1. Airborne Transmission:
    -PPE?
  2. Droplet Transmission:
    -PPE?
  3. Contact Transmission:
    -PPE?
A
  1. Droplets remain in air
    -Respirator/N95
  2. Droplets from coughing talking sneezing
    - Regular Mask
  3. Contact from direct or indirect contact w pathogens
    - Gown&Gloves
61
Q
  1. Neutropenic Precautions?
  2. Nosocomial Infection?
  3. Medical Asepsis requires
    - Why
A
  1. Reverse isolation / weak immune system
  2. Hospital Acquired
    - UTI most common
  3. -wash their hands before, and after each interaction with a patient. *reduces the transmission of microorganisms
62
Q
  1. Are Alcohol based sanitizers sufficient for medical asepsis?
  2. Surgical Asepsis requires:
  3. Sterile Technique is utilized during
A
  1. YES - sufficiently remove microorganisms.
  2. removal of microorganisms and their spores.
  3. Invasive procedures
63
Q
  1. Sterile fields must:
  2. Spiral/helical CT:
    a. Takes much longer than conventional
    b. Requires a great deal of power to operate
    c. Collects data by starting and stopping the scanner each time the table moves an increment
    d. Involves continuous scanning around the patient and table
  3. The recommended maximum slice thickness for display of CT scans of the abdomen and pelvis is ______
    mm.
A
  1. waist up, never unattended, not wet, no turning back to
  2. D-Involves continuous scanning around the patient and table
  3. 6-7
64
Q
  1. ________ is/are the smallest of the cranial bones:
    a. Nasal bones.
    b. Inferior nasal conchae
    c. Zygomatic bone
    d. Lacrimal bones
A
  1. D - Lacrimal

CT (6 decks)

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