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MRT Year 1 Semester 2 > Patient Care 2: Final > Flashcards

Patient Care 2: Final Flashcards

1
Q

Chest tube location

A

For air: anterior and superior

For fluid: posterior and inferior

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2
Q

3 main functions of a NE tube?

A
  1. Decompression
  2. Radiographic exams
  3. Feeding
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3
Q

Who can handle CVCs?

A

Only specially trained personnel or nurses who take additional training

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4
Q

What cause drug reactions? Radiographer’s response?

A
  • over-the-counter drugs, prescribed medications, parenteral administration of meds, or illicit drug use
    1. Radiographer’s response depends on the symptoms and severity of the reaction
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5
Q

Benefits of getting the patient history?

A
  • Builds a rapport with the patient
  • Builds patient trust and confidence
  • Patients have a chance to ask questions and tech can ensure consent is valid
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6
Q

Patient’s physical environment includes what?

A
  • Temperature
  • Humidity
  • Lighting
  • Ventilation
  • Colour of surroundings
  • Noise
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7
Q

Causes of diabetes insipidus?

A
  • hypothalamic injury (brain trauma, neurosurgery)
  • sickle cell anemia
  • hypothyroidism
  • adrenal insufficiency
  • inherited disorders of antidiuretic hormone production and sarcoidosis
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8
Q

Most common site for taking pulse? Where is the second choice?

A

Radial

Carotid

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9
Q

Steps of understanding information

A
  • Compare the info to existing knowledge of the situation
  • Critique the info collected and its integrity
  • Diagnose the info by considering its meaning and relevance
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10
Q

What is the glasgow coma scale?

A

A scale used to assess LOC and reaction to stimuli in a neurologically impaired patient based on performance in 3 categories:
1. Eye opening: score 1-4
2. Verbal response: score 1-5
3. Motor response: score 1-6
The scores are added up. Lower scored predict poorer outcomes

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11
Q

Physical evaluation is an ongoing process of what 3 things?

A
  1. Observation
  2. Assessment
  3. Measurement
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12
Q

What does an ECG do? What is the graph that it produces called?

A

Measured electrical activity of the heart and displays the info graphically in waves on paper or on a screen
-electrocardiogram

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13
Q

Function/purpose of CVCs?

A
  • Administer chemo or other long-term drug therapy
  • Provide total parenteral nutrition (bypassing alimentary canal)
  • Dialysis
  • Blood transfusion
  • Facilitate the drawing of blood for lab analysis
  • Allow venous pressure monitoring
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14
Q

10 communication barriers for situation awareness

A
  1. Hierarchy: the more people the message has to flow through, the more likely the message will get distorted
  2. Unexpected messages: if the message stuns the receiver, the brain can get bogged down and prevents new messages from being processed
  3. Multiple incoming cues: we can’t multitask listening, instead we interleave = single tasking in multiple succession
  4. Emotions: when something triggers a emotional memory you may zone out and miss some components of the current message
  5. Physical distance: the greater the distance between the sender and the receiver, the greater potential for miscommunications
  6. Conflicting messages: when a receiver hears 2 messages that are in conflict they have to device which one to believe, can be wrong
  7. Relationships: humans can favour messages communicated by people they have good relationships with
  8. Expected messages: when the message is expected, the receiver can tune out the message and the messenger
  9. Volume of information: the receiver can suffer from info overload, they then filter info and can filter out important points
  10. Source of information: we evaluate the trustworthiness of the sender and base whether we believe the info on whether we trust them
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15
Q

How does a PAC get through the heart to the pulmonary artery?

A

A balloon

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16
Q

Why is LOC noted?

A

To establish a person’s baseline

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17
Q

Normal body temp for adults?

A

36-38 degrees Celsius

96.8-99.8 degreed Fahrenheit

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18
Q

Pulse locations?

A
  • Radial
  • Carotid
  • Femoral
  • Brachial
  • Temporal: less common
  • Dorsalis pedal
  • Posterior tibial
  • Apical: less common
  • Popliteal: less common
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19
Q

What is hypovolemic shock? What is it caused by? Treatment?

A

Occurs when a large amount of blood or plasma has been lost, insufficient amount if fluid in circulatory system

  • external hemorrhage, lacerations, plasma loss form burns, internal bleeding, severe dehydration from vomiting, diarrhea, or extreme diuresis
  • fluid replacement for low volume shock, oxygen, medication to promote vasoconstriction
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20
Q

Diabetic coma vs. Insulin reaction?

A

Diabetic coma: too little insulin (hyperglycemia)

Insulin reaction: too much insulin (hypoglycemia)

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21
Q

How do you chart body temp?

A
  • Oral: O
  • Axillary: AX
  • Tympanic: T
  • Rectal: R

Put letter after temp

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22
Q

Location of non-tunneled CVCs?

A
  • Subclavian vein
  • Internal/external jugular vein
  • Femoral vein
  • Basilic or cephalic veins in arms (PICCs)
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23
Q

What is a CVA?

A

Cerebrovascular accident: (stroke) when blood flow to part of your brain in interrupted by a blockage or ruptured blood vessel
-signs include facial droop, arm weakness on 1 or both sides, slurred or difficult speech, extreme dizziness, sudden, severe headaches, muscle weakness or numbness, deviation of one eye, or temporary loss of consciousness

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24
Q

Respiration should be _______, ______, and _______?

A
  1. Quiet
  2. Effortless
  3. Uniform
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25
Q

Factors affecting pulse rate?

A
  • Age: infants higher, elderly lower
  • Gender: females higher
  • Emotions: stress, fear raises
  • Temperature: hot increases
  • Posture: standing/sitting up require more energy
  • Activity
  • Medication
  • Stimulants: caffeine and cigarettes
  • Alcohol: vasodilators lower blood pressure, increasing heart rate
  • Music
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26
Q

What are central venous catheters?

A

Tubes that are surgically inserted into a vein in the central circulation system
Provide access to the circulatory system on a repeated or continuous basis

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27
Q

What is septic shock? Phases? Causes?

A

When a massive infection occurs in the body

  • gram-negative bacteria (most common) or gram-positive bacteria and viruses
  • body releases chemicals that increase capillary permeability and vasodilation
  • First phase
  • Second phase
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28
Q

The purpose of taking an accurate and relevant history is to?

A
  • avoid an incorrect exam being performed on the patient
  • minimize the amount of radiation the patient receives
  • efficiently uses the equipment, contrast, etc. involved with the exam
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29
Q

What is the most frequently seen type of shock in the radiographic imaging department?

A

Anaphylactic shock

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30
Q

Types of NG tubes?

A
  • Dobbhoff: most commonly used, for feeding
  • Levin: for decompression, single lumen with holes
  • Salem-sump: decompression, double lumen
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31
Q

What are Swan-Ganz catheter used for?

A
  • measure cardiac output
  • measure right heart pressures
  • indirectly measure the left heart and lung pressures
  • diagnose right and left ventricular failure
  • monitor specific meds
  • assess effects of stress and exercise on heart function
  • measure core temps
  • reveal the amount of oxygen left in the blood after it has circulated through the body
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32
Q

What can happen if a patient moves during an ECG or if the electrodes become loose?

A

Movement: can falsely indicate an arrhythmia

Loose electrode: can flat line falsely indicating asystole

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33
Q

Common medical emergencies that occur in the DI department

A
  • Seizures
  • Vertigo/Orthostatic hypertension
  • Nausea and vomiting
  • CVA
  • Syncope/fainting
  • Drug reaction
  • Contrast media reaction
  • Shock
  • Diabetes
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34
Q

Radiographer’s response to syncope/fainting

A
  1. No physician order required if patient remains conscious
  2. Place patient in sitting or recumbent position, elevate the feet
  3. Provide food, sugar, or juice to patients who have fasted and may become hypoglycemic
  4. Reassure patient to alleviate stress
  5. Spirits of ammonia can be used to bring patient to consciousness
  6. Patient should be assed by physician if consciousness is lost for more than a minute or two
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35
Q

Location of leads?

A
  • white on right
  • black on left
  • green on side
  • left and right at 2nd intercostal space on soft tissue
  • side: level of 6th or 7th intercostal space
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36
Q

What is syncope?

A

Temporary loss of consciousness and postural tone caused by diminished cerebral blood flow, usually due to low blood pressure.

  • considered a mild form of shock
  • can occur when fear, pain, or an unpleasant event is beyond coping ability of patient’s nervous system
  • can also be caused by overheating, dehydration, exhaustion, sudden changes in body position, or resulting from meds
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37
Q

When observing respiration rate, observe the _______, _____, ______, and ______.

A
  1. Rate: how many breaths/min?
  2. Depth: shallow or deep?
  3. Quality: supplying the O2 needs of the patient?
  4. Pattern: rapid or staggered?
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38
Q

What is gestational diabetes?

A

Occurs during pregnancy, hormonal changes can lead to blood sugar elevation in genetically predisposed individuals, usually resolves once the baby is born

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39
Q

Characteristics of a PAC?

A
  • can be quadruple lumen depending on purpose
  • often seen in ICU or CCU patients who require intensive monitoring
  • considered a CVC or central line
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40
Q

Signs and symptoms of severe hypoglycemia?

A
  • sudden onset of weakness
  • sweating, tremors
  • hunger
  • cold, clammy skin, diaphoresis
  • tachycardia
  • headache
  • impaired vision
  • personality changes, agitated, and nervous
  • loss of consciousness
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41
Q

Another name for a Swan-Ganz catheter?

A

Pulmonary artery catheter (PAC)

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42
Q

Factors that may interfere with taking an accurate measure of pulse?

A
  • decreased sensation in fingers
  • not using the right amount of pressure
  • not finding correct site
  • using thumb
  • running or doing other rhythmic movements while trying to take pulse
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43
Q

When are disposable thermometers most often used?

A
  • children
  • ICU
  • isolation
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44
Q

What is the difference between and sign and a symptom?

A

Sign: objective evidence that could indicate disease or illness that can be observed by another person. Discovered by examining the patient
Symptom: a feeling or physical occurrence experienced by the patient

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45
Q

How to prevent shock?

A
  • avoid sudden changed in temp, keep patient warm
  • reduce pain and stress
  • reduce anxiety
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46
Q

Factors that affect body temp?

A
  • Environment
  • Time of day: cooler in morning
  • Infection/disease/injury
  • Age: decreases with age
  • Emotional status: increases with stress
  • Menstrual cycle: high during ovulation
  • Physical activity: increases, but plateaus
  • Site of measurement: oral vs. rectal
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47
Q

Patient who may require an NG tube for feeding?

A
  • trauma
  • disease
  • altered state
  • surgical procedure
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48
Q

3 main functions of NG tubes?

A
  1. Feeding
  2. Decompression
  3. Radiographic exams
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49
Q

Radiographer’s response to mild/moderate contrast reaction?

A
  • calm and reassure patient
  • identify allergen and avoid further contact
  • apply cool compress to itchy areas
  • observe patient for signs/symptoms of increased distress or changes
  • document details of reaction in patient’s profile, on the requisition, and in the chart
  • obtain medical assistance, consult with radiologist/physician/nurse to determine necessary observation of patient before discharging
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50
Q

What is the safest method of taking body temp?

A

Axillary

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51
Q

Match the terms with the definitions
Orientated, Lethargic, Medicated, Stupor, Fainting, Semiconscious, Confused, Unconscious
A. Reduced responsiveness
B. Knowledge of partial commands, can be woken up
C. Mentally dulled and altered by drugs
D. Aware of your surroundings
E. Lack of environmental awareness, non-responsive
F. Unsure what is happening, disorientated
G. Decreased awareness, low energy, lazy
H. Process of losing consciousness

A 
Orientated: D
Lethargic: G
Medicated: C
Stupor: A
Fainting: H
Semiconscious: B
Confused: F
Unconscious: E
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52
Q

Body temp locations?

A
  • Oral
  • Axillary
  • Rectal
  • Tympanic and temporal artery
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53
Q

Types of NE tubes?

A
  • Miller-Abbott: double lumen, drainage and balloon to act as a bolus and promote peristalsis to advance tube
  • Harris: single lumen
  • Cantor: single lumen
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54
Q

What techniques can you use when questioning a patient?

A
  • Open-ended questions
  • Facilitation
  • Silence
  • Reflection of reiteration
  • Clarification or probing, don’t lead on
  • Summarization
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55
Q

Signs and symptoms of second phase septic shock?

A
  • cool, pale skin
  • drop in BP
  • rapid heart rate and respiratory rate
  • anuria
  • seizures and organ failure
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56
Q

Average pulse rates for adults?

A

60-100 BPM

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57
Q

Key factors of situational awareness?

A
  1. Get information
  2. Understand the information
  3. Think ahead
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58
Q

What is the difference between passively and actively listening?

A

Passive: just listening
Active: listening and asking questions

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59
Q

How does a PAC get through the heart to the pulmonary artery?

A

A balloon

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60
Q

Respiration of fewer than 10 breaths/min may result in?

A
  • Cyanosis
  • Apprehension
  • Restlessness
  • Change in LOC
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61
Q

Classification of CVCs?

A
  1. Short or long term, non tunneled external catheters (PICC)
  2. Long term, tunneled external catheters (Hickman, Groshong, Raaf)
  3. Long term, implanted infusion ports (Port-a-cath)
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62
Q

What elements of a patient’s history should you consider?

A
  • Onset of condition/pain
  • Duration/frequency of condition
  • Location of pain/issue
  • Quality of pain (sharp or dull)
  • What aggravates it?
  • What alleviates it?
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63
Q

Most common patient with neurogenic shock?

A

Ones with spinal and head injuries

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64
Q

Signs and symptoms of severe hyperglycemia?

A
  • terribly thirsty
  • frequent and copious urination
  • breath smells fruity or sweet
  • decreased appetite
  • nausea, vomiting
  • weakness
  • confusion
  • coma
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65
Q

What is a partial (focal) seizure?

A
  • simple or complex depending whether patient loses awareness
  • can have motor, autonomic, sensory, or physiological symptoms
  • may cause sever uncontrollable tremors
  • often caused by extreme anxiety and hyperventilation
  • can last over an hour
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66
Q

What is diabetes insipidus?

A

Excessive urination caused by inadequate amount of antidiuretic hormone in the body of failure of kidney to respond to hormone

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67
Q

What are central venous catheters?

A

Tubes that are surgically inserted into a vein in the central circulation system
Provide access to the circulatory system on a repeated or continuous basis

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68
Q

Why is a chest tube inserted? What is its purpose?

A

To re-establish correct intrapleural pressure and allow the lungs to expand normally

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69
Q

When communicating with a patient who is drowsy or in a stupor what 2 things are important to remember?

A
  1. They can’t be relied upon to remember instructions

2. They are not responsible for their actions or answers

70
Q

What is vertigo?

A

Instead of feeling light-headed, patients feel like the room is spinning
-caused by an inner ear problem, lesion on the brain or spinal cord

71
Q

What does an ECG do? What is the graph that it produces called?

A

Measured electrical activity of the heart and displays the info graphically in waves on paper or on a screen
-electrocardiogram

72
Q

Having an RT present during the exam is an example of which type of element? Why?

A

It is a dynamic situation because the patient’s vitals may change quickly, thats why the RT is there

73
Q

What is situational awareness?

A

An individual’s perception of environmental elements within the volume and time of space, the comprehension of their meaning and the projection of the their status in the near future

74
Q

What are electrodes?

A

Electrical contacts that can receive electric signals produced by the patient’s heart

75
Q

What might a weak or absent pulse in the leg be a sign of?

A

-significant blood vessel disease in the leg

76
Q

What is orthostatic hypertension?

A

A form of low blood pressure that causes the patient to feel light-headed or dizzy when they sit or stand after prolonged bed rest.

  • blood pools in extremities and causes a lack of oxygen in the brain
  • common in elderly
  • sit up slowly, use support until it passes
77
Q

ECG equipment?

A
  • electrodes/leads
  • cables/wires
  • electronic display unit
78
Q

What can happen if a patient moves during an ECG or if the electrodes become loose?

A

Movement: can falsely indicate an arrhythmia

Loose electrode: can flat line falsely indicating asystole

79
Q

Radiographer’s response to vertigo

A
  1. Help patient lay down or sit until sensation passes
  2. Violent nausea us common so have a basin and cool cloth ready to go
  3. Report a sudden onset immediately to a physician as it can indicate a TIA or CVA
80
Q

When should physical assessments be done?

A

Before, during, and after the exam

81
Q

Severe contrast reaction signs/symptoms?

A
  • abrupt onset
  • bradycardia (<50BPM)
  • hypotension (drop in BP)
  • sever dyspnea
  • cardiac arrhythmias
  • laryngeal swelling
  • possibility of convulsions/seizures
  • loss of consciousness
  • respiratory arrest or cardiac arrest
82
Q

Signs and symptoms of neurogenic shock?

A
  • warm, dry skin
  • bradycardia
  • hypotension
  • diminishing peripheral pulses, cool extremities
  • *MONITOR PULSE, RESPIRATION, AND BP EVERY 5 MINS
83
Q

What are Swan-Ganz catheter used for?

A
  • measure cardiac output
  • measure right heart pressures
  • indirectly measure the left heart and lung pressures
  • diagnose right and left ventricular failure
  • monitor specific meds
  • assess effects of stress and exercise on heart function
  • measure core temps
  • reveal the amount of oxygen left in the blood after it has circulated through the body
84
Q

Which form of information delivery is the most productive?

A

Active: ex. checking vitals, asking questions

85
Q

2 types of diabetes mellitus?

A

Type 1: insulin dependent or juvenile diabetes, young, lean individuals before age 25, produce little or no insulin
-circulatory impairment of vision, kidneys, or extremities can occur, family history of minor importance, autoimmune, genetic, and environmental factors involved.
Type 2: non-insulin dependant or adult onset diabetes, still produce insulin, but inadequately for their body’s needs, obese people over age 40, oral hypoglycemic meds or changes in diet and lifestyle

86
Q

Indications for chest tube insertion?

A
  • hemothorax: blood in the pleural cavity

- pneumothorax: air in the pleural cavity

87
Q

Types of shock

A
  1. Hypovolemic
  2. Septic
  3. Neurogenic
  4. Cardiogenic
  5. Allergic or Anaphylactic
88
Q

Radiographer’s response to seizures?

A
  1. Do not move patient or attempt to restrain or restrict
  2. Notify physician, seek assistance, do not leave patient unattended
  3. Monitor rate and quality of respiration
  4. Monitor patient’s airway, but do not place anything in mouth o between teeth
  5. Do not attempt to grasp tongue
  6. When convulsions ends, turn patient on side into recovery position
  7. Protect patient’s modesty
  8. Allow patient to rest after
  9. Bladder control may be lost
  10. Patient should be evaluated
  11. Diazepam and lorazepam common treatments
89
Q

Hyperosmolar hyperglycemic nonketotic syndrome occurs when a type ______ diabetic becomes dehydrated and hyperglycemic?

90
Q

Definition of shock

A

Failure of circulation in which blood pressure is inadequate to support the oxygen perfusion of vital tissues and is unable to remove products of metabolism

91
Q

Signs and symptoms of first phase septic shock?

A
  • hot, dry, flushed skin
  • increased in heart rate and respiratory rate
  • fever, but possibly not in elderly
  • nausea, vomiting, and diarrhea
  • normal to excessive urine output
  • possible confusion
92
Q

What is a tonic-colonic seizure?

A
  • most common generalized seizure
  • involves the entire brain
  • patient may experience a premonitory sign
  • characterized by a horse cry, convulsions, and complete loss of consciousness
93
Q

Response to anaphylactic shock?

A
  • do not leave patient unattended, stop injection, maintain IV line
  • notify radiologist or ER physician
  • call code team if respiratory distress
  • place patient in semi-fowlers to facilitate respiration
  • monitor pulse, respiration, and BP every 5 mins
  • prepare oxygen, IV fluids, and meds (crash cart pr drug box)
  • always keep track of time and sequence of events in order to document
94
Q

Complications of CVCs?

A
  • clotting
  • local inflammation of phlebitis
  • systemic infraction
  • venous thrombosis
  • air embolus
  • extravasation of meds
  • migration of catheter
95
Q

Who can handle CVCs?

A

Only specially trained personnel or nurses who take additional training

96
Q

Signs of increased intracranial pressure?

A
  • Patient becomes irritable
  • Patient becomes lethargic
  • Patient’s pulse slows down and their rate of respiration decreases
97
Q

What is neurogenic shock? Causes?

A

The failure of arterial resistance causing a pool of blood in the peripheral vessels

  • injury to nervous system or reaction to medication
  • acute situation, demands immediate attention
98
Q

Radiographer’s response to a CVA

A
  1. Report symptoms even if only temporary
  2. Place patient in recumbent position with head elevated
  3. Seek assistance, but DO NOT leave unattended
  4. Have a crash cart and oxygen ready
  5. Monitor vital signs every 5 mins or follow physician’s orders
99
Q

If your patient is going into shock what do you do?

A
  • stop procedure, put in dorsal recumbent
  • elevate feet to increase blood flow to brain
  • obtain help, if in doubt call a code
  • check BP and assist the patient with oxygen
  • be ready to assist code team and document events
100
Q

What is PETT when referring to gathering information

A

PETT

  • Patient
  • Environment
  • Task
  • Time
101
Q

Radiographer’s response to severe contrast reaction?

A
  • maintain airway and call a code
  • calm and reassure patient
  • ensure integrity of IV site which may be used to give meds for treatment
  • prepare oxygen, suction, and crash cart
  • have patients history ready and available
  • be ready to assist physician
102
Q

Common characteristics of CVCs?

A
  • rigid material for placement that also lowers the incidence of blood clots
  • radiopaque strips at the distal end to allow verification of placement
  • single or double lumen
  • distal tips rest in vena cava near right atrium of heart
103
Q

4 types of thermometers?

A
  1. Digital/electronic: used for oral, axillary, and rectal
  2. Tympanic
  3. Temporal artery
  4. Disposable
104
Q

ECG equipment?

A
  • electrodes/leads
  • cables/wires
  • electronic display unit
105
Q

Why would a nurse postpone a mobile CXR until later for a patient with a Swan-Ganz catheter?

A

Because it would cause stress and exercise to the heart

106
Q

Location of non-tunneled CVCs?

A
  • Subclavian vein
  • Internal/external jugular vein
  • Femoral vein
  • Basilic or cephalic veins in arms (PICCs)
107
Q

What can hot and dry or moist skin indicate?

A

Hot and dry: fever

Moist: response to the environment

108
Q

Some mild contrast reactions may occur up to ______ mins post injection

109
Q

What is an absence seizure?

A
  • Generalized seizure
  • brief loss of consciousness where patient stares blankly and may lose balance and fall
  • patients unaware that they underwent loss of consciousness
  • no convulsions
  • common with children
110
Q

Caring for a patient with a chest tube

A
  1. Use gloves
  2. Drainage must remain below chest level
  3. Keep tubing as straight as possible
  4. All connections must be tightly taped
  5. Do not empty water-sealed chambers or raise them above insertion site
  6. Notify nurse if water is bubbling (should be a steady rise and fall)
  7. Keep tube long enough to allow free movement
  8. Disturbance of the tube at either end can result in a rush of air into the pleural space, reversing the intent of treatment
111
Q

There is a _______ risk associated with IV administration than with arterial injections?

112
Q

A patients whose temp is below normal limits is said to have what?

A

Hypothermia

113
Q

What medical procedure can cause and pneumo/hemothorax?

A

Thoracotomy: performed to diagnose or treat disease or injury to the lungs or pleura

114
Q

What do we take into account when checking the integrity of information?

A
  • Accuracy
  • Completeness
  • Source
  • Relevance
115
Q

What is diabetes mellitus?

A

Disease marked by alternating episodes of hypoglycemia and hyperglycemia

  • defects in insulin secretion
  • defects in action of insulin
  • defects in both secretion and action
116
Q

Types of NG tubes?

A
  • Dobbhoff: most commonly used, for feeding
  • Levin: for decompression, single lumen with holes
  • Salem-sump: decompression, double lumen
117
Q

How to record pulse rates?

A

Put a “p” beside the number

118
Q

Four levels of consciousness?

A
  1. Alert and conscious
  2. Drowsy, but responsive
  3. Unconscious, but reactive to painful stimuli
  4. Comatose
119
Q

List the information resources available

A
  • people
  • documents
  • tools
  • devices
  • environment
120
Q

3 main functions of NG tubes?

A
  1. Feeding
  2. Decompression
  3. Radiographic exams
121
Q

Types of NE tubes?

A
  • Miller-Abbott: double lumen, drainage and balloon to act as a bolus and promote peristalsis to advance tube
  • Harris: single lumen
  • Cantor: single lumen
122
Q

Factors that affect respiration?

A
  • Medication
  • Illness and pathologies
  • Exercise
  • Age
  • Emotion
123
Q

Which place for taking body temp provides the most accurate reading?

124
Q

What is cardiogenic shock? Causes?

A

Results from cardiac failure of heart to pump an adequate amount of blood to vital organs

  • can be slow or sudden to occur
  • most vulnerable patients: myocardial infarction, dysrhythmias, or other cardiac pathologies
125
Q

Why is a chest tube inserted? What is its purpose?

A

To re-establish correct intrapleural pressure and allow the lungs to expand normally

126
Q

Clinical manifestations of cardiogenic shock?

A
  • complain of chest pain that may radiate to jaws and arms
  • dizziness and respiratory distress
  • cyanosis
  • restlessness and anxiety
  • rapid change in LOC
  • irregular pulse, slow pulse
  • tachycardia, tachypnea
  • decreasing BP
  • decreasing urinary output
  • cool, clammy skin
127
Q

Why would a nurse postpone a mobile CXR until later for a patient with a Swan-Ganz catheter?

A

Because it would cause stress and exercise to the heart

128
Q

A patient whose body temp is above normal limits is said to have what?

A

Fever or pyrexia

129
Q

Names of CVCs and their characteristics?

A
  • Hickman: long term, med administration, withdrawing blood, measuring central venous pressure
  • Groshong: single/double lumen, med/fluid administration, withdrawing blood
  • Raaf: double lumen, dialysis
  • Port-a-cath: infusion or venous access port
  • PICC: short/long term use, inserted through vein in arm
130
Q

Patient who may require an NG tube for feeding?

A
  • trauma
  • disease
  • altered state
  • surgical procedure
131
Q

Names of CVCs and their characteristics?

A
  • Hickman: long term, med administration, withdrawing blood, measuring central venous pressure
  • Groshong: single/double lumen, med/fluid administration, withdrawing blood
  • Raaf: double lumen, dialysis
  • Port-a-cath: infusion or venous access port
  • PICC: short/long term use, inserted through vein in arm
132
Q

Adult and infant average respiration rates?

A

Adult: 12-20 breaths/min
Infant: 30-60 breaths/min

133
Q

How to treat hypoglycemia?

A
  • juice, pop, or pre-packaged dose of glucose (placed inside cheek)
  • 0.5 to 1mg of glucagon parenteral injection
  • IV infusion of dextrose solution if they don’t respond to glucagon
134
Q

Caring for a patient with a chest tube

A
  1. Use gloves
  2. Drainage must remain below chest level
  3. Keep tubing as straight as possible
  4. All connections must be tightly taped
  5. Do not empty water-sealed chambers or raise them above insertion site
  6. Notify nurse if water is bubbling (should be a steady rise and fall)
  7. Keep tube long enough to allow free movement
  8. Disturbance of the tube at either end can result in a rush of air into the pleural space, reversing the intent of treatment
135
Q

Signs, symptoms, and treatment of diabetes insipidus?

A
  • polyuria
  • thirst
  • dehydration resulting in fever, vomiting, and convulsions
  • fluid replacement is essential
  • is a side effect of drug therapy, the offending drug is withheld
  • can be treated with vasopressin (out of out scope)
136
Q

Another name for a Swan-Ganz catheter?

A

Pulmonary artery catheter (PAC)

137
Q

Complications of CVCs?

A
  • clotting
  • local inflammation of phlebitis
  • systemic infraction
  • venous thrombosis
  • air embolus
  • extravasation of meds
  • migration of catheter
138
Q

Common sensations felt by patient during a contrast injection?

A
  • feeling warm/flushed
  • metallic taste
  • voiding sensation
  • nausea/vomiting
139
Q

Diabetic ketoacidosis is most common with type ____ diabetes?

140
Q

Function/purpose of CVCs?

A
  • Administer chemo or other long-term drug therapy
  • Provide total parenteral nutrition (bypassing alimentary canal)
  • Dialysis
  • Blood transfusion
  • Facilitate the drawing of blood for lab analysis
  • Allow venous pressure monitoring
141
Q

Conditions that increase a patient’s resting heart rate?

A
  • fever
  • stress
  • hyperthyroidism/hypothyroidism
  • anemia
  • stimulants
  • asthma
  • medications
  • diet pills
  • various forms of heart disease
  • heart meds
  • fitness programs with aerobic exercise
142
Q

Potential challenges to satisfactory situational awareness?

A
  • increased workload
  • frustrations
  • stress
  • interruptions and distractions
143
Q

Location of leads?

A
  • white on right
  • black on left
  • green on side
  • left and right at 2nd intercostal space on soft tissue
  • side: level of 6th or 7th intercostal space
144
Q

What is a seizure? 3 types?

A

A sudden rush of electrical activity in the brain that can cause physical symptoms and convulsions

  1. Tonic-colonic (grand mal)
  2. Absence (petit mal)
  3. Partial (focal)
145
Q

A change in the glascow scale score could be caused by what?

A

Intracranial pressure

146
Q

Common characteristics of CVCs?

A
  • rigid material for placement that also lowers the incidence of blood clots
  • radiopaque strips at the distal end to allow verification of placement
  • single or double lumen
  • distal tips rest in vena cava near right atrium of heart
147
Q

3 different categories of “getting information”

A
  1. The nature of the information: patient, environment, task, time, static vs. dynamic
  2. Info Delivery: active vs. passive
  3. Source of information
  4. Collecting info
148
Q

Characteristics of a PAC?

A
  • can be quadruple lumen depending on purpose
  • often seen in ICU or CCU patients who require intensive monitoring
  • considered a CVC or central line
149
Q

What does a healthy blood vessel feel like compared to a normal one?

A

Healthy: soft
Unhealthy: hard

150
Q

Classification of CVCs?

A
  1. Short or long term, non tunneled external catheters (PICC)
  2. Long term, tunneled external catheters (Hickman, Groshong, Raaf)
  3. Long term, implanted infusion ports (Port-a-cath)
151
Q

What is the most important rule when it comes to crash carts?

A

Never borrow anything from a crash cart

152
Q

What is anaphylactic shock? Most common causes?

A

Result of an exaggerated hypersensitivity reaction, releasing histamine and bradykinin in the body = widespread vasodilation and peripheral pooling of blood

  • most common causes: meds, iodinated contrast, insect venoms
  • signs/symptoms depend on severity
  • more abrupt onset = more severe
  • contraction of nonvascular muscles (respiratory tract)
153
Q

Chest tube location

A

For air: anterior and superior

For fluid: posterior and inferior

154
Q

What is usually the first sign of respiratory distress?

A

Sudden onset of shallow, rapid breathing

155
Q

Radiographer’s response to nausea and vomiting

A
  1. Support the patient by sitting them up or placing in lateral recumbent, airway clear
  2. Reassure the patient by talking to them
  3. Don’t rush their recovery
  4. Provide simple breathing instructions
  5. Provide emesis basin and replace often with a clean one, give moist wash cloth to patient
156
Q

Why do we take a radiograph after tube insertion?

A

To ensure it has been correctly placed and did not go into the lungs

157
Q

Why do we “tunnel” the catheters?

A

Tunneling under the skin helps hold the catheter in place and prevent infection

158
Q

What are electrodes?

A

Electrical contacts that can receive electric signals produced by the patient’s heart

159
Q

Mild to moderate contrast reaction signs/symptoms?

A
  • itchy skin
  • development of urticaria (hives) or skin rash
  • nasal congestion, sneezing, watery eyes
  • coughing with possible laryngeal swelling
  • peripheral tingling
  • tachycardia (>100BPM) or bradycardia (<60BPM)
  • hypotension
  • feeling of fullness or tightness in chest, mouth, or throat
  • feeling of anxiety or nervousness
160
Q

What are the four ways to gather information you need

A
  1. Scan and search
  2. Pay attention
  3. Remain watchful
  4. Communicate
161
Q

3 main functions of a NE tube?

A
  1. Decompression
  2. Radiographic exams
  3. Feeding
162
Q

What is a weak pulse a sign of?

A
  • problems with the heart’s ability to pump as much blood as the body needs
  • shock
  • circulation problems (partially blocked, narrowed vessel)
163
Q

Why do we “tunnel” the catheters?

A

Tunneling under the skin helps hold the catheter in place and prevent infection

164
Q

Indications for chest tube insertion?

A
  • hemothorax: blood in the pleural cavity

- pneumothorax: air in the pleural cavity

165
Q

Physical evaluation includes assessing what?

A
  • Skin colour
  • Skin temperature
  • Breathing
  • Level of consciousness
166
Q

What medical procedure can cause and pneumo/hemothorax?

A

Thoracotomy: performed to diagnose or treat disease or injury to the lungs or pleura

167
Q

When you are getting information, what things should you consider?

A
  • The nature of the information: PETT, is it static or continuously dynamic
  • Information delivery: are you collecting it passively or actively, don’t rely on passive info-ask questions
  • Information source: people, tools, devices, and documents
  • Collecting information: scan and search, pay attention, remain watchful, communicate
168
Q

Why do we take a radiograph after tube insertion?

A

To ensure it has been correctly placed and did not go into the lungs

169
Q

Recognizing shock

A
  • sense of apprehension
  • may be restless
  • change in ability to think
  • change in skin appearance/colour
  • pallor accompanied by weakness
  • increased pulse rate
  • drop in BP of 30mm HG below baseline systolic pressure
  • decrease in urination
  • increased and shallow respirations
170
Q

Steps of collecting information

A
  • Scan and search
  • Pay attention
  • Remain watchful
  • Communicate

MRT Year 1 Semester 2 (11 decks)

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