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MRT Year 1 Semester 1 > Patient Care > Flashcards

Patient Care Flashcards

1
Q

What should you do to increase the sensitivity of the palpating finger?

A

Swab the finger with alcohol

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2
Q

How high should the IV bag be above the vein?

A

18-20 inches

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3
Q

What is charting?

A

Any records you expect to add to a patient’s chart

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4
Q

What role does the hospitalist play?

A

The doctor in charge of the hospital patients

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5
Q

Factors to consider when choosing the appropriate cannula size?

A
  • Purpose of the infusion
  • Viscosity of the contrast to be administered
  • Condition/availability of the exam
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6
Q

When should an incident report be filled out?

A
  • Accident/injury to patient, staff, or visitor
  • Loss of/damage to property of patient, staff, visitor, or hospital
  • Incorrect drug or procedure administration
  • Incorrect events that occurred during procedure (incorrect injection)
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7
Q

Systems of the body that experience physiological changes when IV contrast medium is injected

A
  • cardiovascular
  • respiratory
  • urinary
  • GI
  • neurologic
  • integumentary
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8
Q

When should side rails be used?

A

When a patients state of consciousness is altered due to:

  • sedation
  • intoxication
  • shock
  • senility/reduced awareness of surroundings
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9
Q

Purpose of consent forms

A
  • Provide patient with information about procedure, risk, and benefits
  • Establish a positive relationship with the patient
  • Legal implications
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10
Q

Things that should be on the first page (quick access) to chart

A
  • allergies

- DNR

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11
Q

What can you do if you know the patient may react to the contrast media?

A

Administer and antihistamine before the procedure, find out if another procedure can be performed

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12
Q

Prevention of extravasation

A
  • Check for backflow of blood to be sure the catheter location is correct
  • Immobilize catheter at the injection site
  • Stop injection immediately if patient complains of discomfort
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13
Q

Areas susceptible to ulcers

A
  • Scapulae
  • Knees
  • Heels of feet
  • Sacrum
  • Trochanters
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14
Q

Concepts of Body Mechanics

A

Base of support: stability for body position/movement
Center of Gravity: center of body weight
Line of Gravity: vertical line passing through center of gravity

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15
Q

What is the purpose of a cervical collar?

A

Maintain alignment of the spine and prevent further spinal injury, paralysis, or death

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16
Q

What group of patients might have a gown with snaps?

A
  • ICU

- cardiac for quick access

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17
Q

Purpose of restraints

A
  • Ensure patient safety
  • Prevent undesirable motion
  • Prevent disengaging therapeutic devices
  • DO require a physician’s order
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18
Q

What helps increase arterial blood flow to the area when looking for a vein?

A

Warming the puncture site with a towel for 3-5 mins OR the arm may be left to dangle to increase blood flow

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19
Q

Mechanical factors that contribute to the formation of ulcers

A
  • Immobility: extended time in one position
  • Pressure: inadequate protection of skin or moving too rapidly
  • Friction: movement back and forth on a rough surface
  • Dampness: urine on gown or sheet, irritates skin
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20
Q

Common body positions…

A
  • Sim’s or Lateral recumbent
  • Trendelenberg
  • Fowler’s
  • Semi-fowler’s
  • Prone or supine
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21
Q

Purpose of administrating contrast agents

A
  • expand collapsible organs
  • provide and outline of the surrounding tissue
  • enhance presentation of organ
  • differentiate closely located organs with similar composition
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22
Q

Advantaged of E-charting

A
  • Legible
  • Accessible
  • Easily stored
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23
Q

Factors to consider when choosing an IV device?

A
  • Size/location of vein
  • Condition/age of patient
  • Purpose of venipuncture
  • Viscosity of contrast media to be delivered
  • Department protocol/physicians orders
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24
Q

What is a tracheostomy?

A

A surgical procedure that creates an opening into the trachea tp provide and temporary or artificial airway

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25
Q

What is the piggyback method?q

A

When meds are administered through an already existing IV

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26
Q

Who’s responsibility is it to bring the patient’s concerns to the radiologist/physician in charge?

A

The tech’s

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27
Q

What factor is considered when deciding between a powder, liquid, or paste contrast?

A

Transit time: how long it will take to travel through the organ

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28
Q

Most common replacement fluids

A
  • Normal Saline: an isotonic solution of 0.9% sodium chloride in water
  • 5% dextrose solution in water
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29
Q

What is hypervolemia? What are its symptoms?

A

An abnormal increase in the volume of circulating blood

-causes pain due to dilation of the vessels, flushing, red cell changes, nausea, vomiting, and dehydration

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30
Q

Patients most at risk of developing ulcers

A
  • Elderly
  • Malnourished
  • Chronically ill
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31
Q

Patients most prone to falls

A
  • Frail and elderly
  • Weak
  • Neurological deficits
  • Head trauma
  • Sedated or confused
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32
Q

Equipment used for immobilization

A
  • Sponges
  • Tape
  • Sand bags
  • Compression bands
  • Velcro straps
  • Sheets
  • Lead shields
  • Specialty devices
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33
Q

5 rules of body mechanics

A
  1. Provide a base of support
  2. Work at a comfortable height
  3. Bend knees and keep back straight when lifting
  4. Keep load well balanced and close to body
  5. Roll or push heavy objects
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34
Q

The ________ of a contrast media is directly related to its viscosity

A

Concentration, because the more particles present in a drop of solution, the slower that drop is going to move

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35
Q

7 Rules of Immobilizers and Restraints

A
  • Must be allowed as much mobility as safely possible
  • Must be padded to prevent injury to skin beneath
  • Normal anatomic position must be maintained
  • Must use knots that will not become tighter with movement
  • Circulation and respiration must not be impaired
  • Must be easy to remove quickly
  • no 2 point restraints, always 4
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36
Q

What is a physiochemotoxic reaction?

A

Result from the ability of the contrast to upset the homeostasis of the body, especially regarding the blood/circulatory system

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37
Q

What is an idiosyncratic reaction?

A

A reaction that cannot be related to any particular property of the contrast media
-random and unpredictable

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38
Q

How do tourniquets make the veins more prominent and easier to puncture?

A

Venous filling

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39
Q

What two test results are VERY IMPORTANT to consider before administering contrast?

A

Creatinine level and GFR

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40
Q

What is the most effective way to avoid using restraints

A

Therapeutic communication

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41
Q

Why is it important to know if a patient is diabetic before administering contrast media? What about asthma?

A

-predisposed for renal complications
-could be taking other meds that may react with contrast
Asthma: 3x more likely to have a reaction, meds

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42
Q

Size of needles

A

Gauge: size of bore

Increasing gauge = decreasing size

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43
Q

Advantages of small bore needles

A
  • can access smaller veins

- smaller hole, less bleeding

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44
Q

Steps to deal with infiltration

A
  • remove needle
  • assure patient that pain is only temporary
  • maintain pressure on vein until bleeding stops
  • apply a cold pack for 20-60 mins and repeat 3 times a day until swelling gone
  • have injection site check by radiologist
  • fill out incident report
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45
Q

Rules of injection

A
  • never borrow meds/equipment from emergency cart
  • read label of drug 3 times before administering
  • remove all air bubbles prior to injection
  • surgical asepsis required
  • know correct procedure and notice extravasation/infiltration
  • do not administer meds via specialty IV catheters such as PICC lines
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46
Q

Ionic vs. Non-ionic contrast agents

A

Ionic: breaks down into positive and negatively charged particles (cations and anions), for every 3 iodine molecules there in 1 cation and 1 anion (3:2 compound)
Non-ionic: do no dissociate into charged particles when places in a solution, for every 3 iodine molecules there is 1 neutral molecule (3:1 compound)

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47
Q

Majority of injections in the DI department require what type of needle?

A

Angiocath needle

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48
Q

In order to be valid, consent must be…?

A
  • Voluntarily given
  • Informed
  • Given specifically for the act performed (minor modifications and extensions implied)
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49
Q

What should be documented in the chart when they come for an x ray?

A
  • Patient condition upon arrival
  • track regular monitoring during patient’s stay in radiography
  • Patient condition upon discharge
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50
Q

What is loss of autonomy?

A

Loss of self. Most likely with inpatients because they don’t get to make decisions for themselves anymore. The hospital staff make decisions for them (what to eat, when to eat, etc.)

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51
Q

When immobilizing a child…

A
  • Use a sheet or commercial immobilizer
  • 1-2 assistants if they have proper protections (lead gowns)
  • Inform parent and child (simply) as to the purpose of immobilization
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52
Q

Which patients require a bolster?

A

-those that are arthritic, kyphotic, and post-operative (abdomen or spinal surgery)

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53
Q

Contraindications for not using the patient’s arm veins

A
  • burned/scarred areas
  • cast on arm
  • thrombosed veins
  • edematous arms
  • partial or radical mastectomy on one or both sides, (lymph nodes are often removed and without lymph vessels to removed fluid, swelling occurs)
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54
Q

What is the purpose of Bolsters?

A

-Relieve lumbosacral stress by straightening the lumbar curve (lordosis)

55
Q

Patients requiring assistance

A
  • Stroke
  • Lower extremity fractures
  • Post surgery
  • Paralyzed/immobilized
  • Joint replacements
  • Spine trauma
56
Q

Purpose of a requisition

A
  • provide a work order that provides legal protection and proves a reason for a radiologic procedure
  • includes patient history
  • gives tech info about whether modifications need to be made to procedure and why
  • part of a patient’s medical records
57
Q

Types of needles

A
  • Angiocath: flexible and used for long-term insertion

- Butterfly: inflexible and more apt to injure the vein and cause infiltration, should not be in longer than 2-3 hours

58
Q

Routes of medication administration

A
  • Topical: to surface of skin
  • Sublingual: placed under tongue
  • Buccal: placed in cheek
  • Parenteral: injected directly into body to bypass GI system
59
Q

Main things to take into consideration when assessing a patient’s mobility

A
  • Deviations from correct body alignment (poor posture, trauma, muscle damage)
  • Range of joint motion (stiffness, instability, swelling, pain)
  • Ability to walk (rhythm, speed, and characteristics)
  • Respiratory, cardiovascular, metabolic, and musculoskeletal problems (impaired circulation)
60
Q

What is traction?

A

The use of weights, pulleys, and ropes to treat bone and muscle disorders or injuries, parts are pulled into alignment

61
Q

2 Phases of skin breakdown

A
  • Ischemia: blanching and feeling of coldness

- Reactive Hyperemia: heat and redness

62
Q

Handling of casts

A
  • keep casts elevated and supported
  • support above and below injury site
  • do not use fingers to lift the cast
63
Q

Classifications of parenteral injections

A
  • Intradermal: between layers of skin
  • Subcutaneous: under the skin
  • Intramuscular: into the muscle
  • Intravascular: into vein, also intra-arterial
  • Intrathecal: into spinal canal
64
Q

What is a pulse oximeter?

A

Device that monitors the pulse rate and oxygen in blood levels

65
Q

Types/Ways to infuse of inject

A
  • Bolus: large amount, short time

- Infusion: slow introduction of substance over a long period of time

66
Q

Which patients do we allow to come in beds and not stretchers?

A

ICU patients

67
Q

Routes used to administer contrast agents

A
  • oral
  • rectal
  • intravenous
  • intra-arterial
  • intrathecal
  • intra-articular
68
Q

What side of a patient with a lower extremity fracture should you support?

A

The affected side

69
Q

What is included on a requisition?

A
  • name, age, gender
  • ID #, provincial health info
  • name of requesting and attending physicians
  • clinical history that supports request
  • allergy history
  • accession #
  • location of patient
  • date procedure should be performed
  • which x rays need to be performed
  • urgency of exam
  • OXYGEN INFORMATION
  • ISOLATION INFORMATION
  • time patient was called for exam (tech adds)
70
Q

How does the presence of contrast media in the body affect water in the body?

A

Causes water found in the body tissues to move into the vascular system in an attempt to maintain the concentration equilibrium

71
Q

Spinal trauma: when changing from recumbent to upright what should you do?

A

Patient should sit in lateral recumbent position first

72
Q

What can you do to a patient’s positioning to decrease apprehension and increase cooperation?

A

Elevate their head so they can see what is going on

73
Q

What is a hyperosmolar solution?

A

Any contrast media solution that has a greater number of osmoles per litre than blood

74
Q

How many drops per minute on an IV line is normal?

A

15-20 drops per min = 60ml/hr

75
Q

What does nosocomial mean?

A

A hospital acquired infection

76
Q

What causes a patient to move during the x-ray?

A

Pain
Discomfort
Lack of understanding

77
Q

Charting must be…?

A
  • Accurate
  • Legible
  • Objective
  • Pertinent
  • Complete
  • Consistant
78
Q

Types of traction

A
  • Skin: attached to skin using tape/straps, short-term, less invasive
  • Skeletal: long/term, attach directly to bone, invasive
79
Q

Which routes of contrast administration require a general consent form and which require a contrast consent form?

A

General consent form: intrathecal, intra-articular

Contrast consent form: intravenous, intra-arterial

80
Q

Complications/risks of venipuncture

A
  • fainting
  • failure to insert needle successfully
  • not inserting needle deep enough
  • over-inserting the needle through the vein
  • holding the bevel against the vein wall
  • hematomas (needle completely through vein)
  • excessive bleeding
  • edema
  • infection
  • ruptured red blood cells from probing the needle in obese patients
  • damaged, sclerosed, occluded veins
  • collapsed veins
  • allergies
81
Q

Types of casts

A
  • Plaster of paris: heavy, white material with lots of water in the material, must increase technique
  • Fiberglass: lighter, radiolucent
82
Q

What kind of questions require more than a “yes or no” answer?

A

Open-ended or feedback questions

83
Q

What kind of consent overrules in certain situations?

A

Double Dr. Consent

84
Q

What is the most common cause of urinary tract infections with catheterized patients?

A

The back flow of urine, if collection bag is held above bladder level

85
Q

Advantages of oral reporting

A
  • Quick
  • Easy
  • Good in an emergency
86
Q

HOCM

A

High Osmolar Contrast Media

-usually ionic contrast media

87
Q

Signs of poor circulation

A
  • finger and toes cold, numb, lack of normal colour
  • pain/burning in distal extremity
  • absence of pulse in distal extremity below cast site
88
Q

Physical properties of contrast media

A
  • chemical breakdown of contrast media when mixed into a solution
  • number and size of the iodine compounds
  • number and size of additional chemical compounds
89
Q

Factors to consider when choosing an IV site?

A
  • Duration of therapy: choose distal veins in unaffected/non-dominant arm, avoid areas of flexion and overused veins
  • purpose of infusion: largest appropriate gauge
  • condition of skin: choose soft skin and round straight veins, avoid previously damaged areas and crooked hardened or inflamed veins
  • patient age: avoid small and/or distal veins in elderly patients
  • other: avoid lower extremities as a physicians order is usually required
90
Q

Characteristics of contrast media

A
  • negative/positive
  • ionic/non-ionic
  • water soluble/non-water soluble
91
Q

Where should you be located when speaking to a patient on a bed/stretcher?

A

At the side, never at the head end

92
Q

How many techs does a log roll for a known or possible spinal precaution patient require?

A

5

93
Q

Other health care providers who might be involved in a transfer

A
  • Nurse
  • Orderly
  • Porter
  • LPN
94
Q

Other names for ionic and non ionic contrast

A

Ionic: 3:2 compound

Non-ionic: 3:1 compound

95
Q

What is infiltration?

A

When the IV fluid leaks into the surrounding tissue

96
Q

X-ray procedure that require a parenteral-route injection must have a ______

A

Informed consent

97
Q

Examples of info techs would chart

A
  • Date/time
  • Exam performed
  • Post procedural care
  • time called for patient
98
Q

Steps after an incident occurs

A
  • Take care of yourself and/or patient
  • Notify physician and assist with medical intervention
  • Fill out incident report
  • Evaluate situation
99
Q

What is osmolality?

A

Measure of concentration that considers the number of osmoles per litre in a solution

100
Q

What side should you position yourself on of a stroke patient when assisting them?

A

Their weak side

101
Q

Oxygen equipment

A
  • method of delivery
  • flow meter
  • portable oxygen tank
  • tracheostomy
  • ventilator
  • pulse oximeter
102
Q

Is consent transferrable from one physician to another?

A

No

103
Q

What determines the radiopaqueness of the media?

A

The amount of iodine present

104
Q

How many people does a spinal precaution patient require for a slide?

A

5

105
Q

What are normal oxygen level percentages?

A

95%-100%

106
Q

Purpose of charts?

A
  • Accurate records of the patient’s care during hospitalization
  • Means of communication between patient’s health team
  • Aid in treatment and care of patient
  • Educate patient
107
Q

Fall prevention equipment

A
  • safety straps
  • side rails
  • compression bands
  • brakes on equipment
108
Q

Types of catheters

A
  • Straight catheter: used to obtain a specimen or to empty a bladder, short-term
  • Retention/Indwelling catheter: (foley most common): long-term, has small balloon at tip to keep in place
109
Q

“Six Rights Rule”

A
  1. The right dose
  2. The right medication
  3. The right patient
  4. At the right time
  5. By the right route
  6. With the right documentation
110
Q

How to verify patient identification? Inpatient vs. Outpatient

A

Inpatients: compare requisition info with ID band info
Outpatients: double ID (spell name, DOB, body part to be x-rayd)
-Use open ended or feedback questions

111
Q

Methods of delivering oxygen

A
  • nasal prongs/cannula: 1-3L
  • oxygen mask: at least 5L
  • non-rebreathing mask: mask with bag on it
  • high-flow mask
112
Q

What is viscosity?

A

The thickness of a liquid and its resistance to flow

113
Q

LOCM

A

Low Osmolar Contrast Media

-usually non-ionic contrast media

114
Q

How is the concentration of iodine in a solution determined?

A

By the number of iodine molecules present in a litre of solution (mol/L)

115
Q

Rules to prevent falls

A
  • Learn condition of patient
  • Keep floor clear of objects
  • Store equipment in proper locations
  • Keep side rails up when patients are on a stretcher
  • Lock wheelchair if a patient is in it
116
Q

Principles of body mechanics

A
  • Alignment
  • Balance
  • Movement
117
Q

Injection contrast examples

A
  • visipaque
  • optiray
  • conray
118
Q

Typical length of IV needles

A

-2.5 inches

119
Q

How up to date must blood work be before administering contrast?

A

In the past 3 months

120
Q

Why is a relevant to ask a patient if they have had an injection of contrast before and whether they had a reaction?

A
  • patient history: common sensations felt

- determines likelihood of a reaction

121
Q

Types of consent

A
  • Implied: emergency situations when it is not possible to obtain consent from patient, guardian, or legal representative
  • Expressed: when a patient does not stop the procedure (walking into x-ray clinic)
  • Informed: for any invasive procedures (must sign form)
122
Q

Is oxygen considered a medication? Do you need permission of a physician?

A

Oxygen is considered a medication, no you don’t need permission

123
Q

Why do we get patients to open and close hand and make a fist when doing IVs?

A
  • restrict circulation and enlarges veins

- makes veins easier to identify and penetrate accurately

124
Q

The difference between extravasation and infiltration?

A

Extravasation: fluid is outside the vessel
Infiltration: fluid has diffused into the surrounding tissues

125
Q

What is orthostatic hypotension?

A

When a person stands up too fast and their blood pressure drops = fainting

126
Q

What would you do if an inpatient came with no ID band

A

Check with their nurse or somebody in charge of that particular patient to confirm identity

127
Q

Disadvantages of oral reporting

A
  • Can be easily misunderstood
  • Easy to make mistakes
  • Can be paraphrased
128
Q

Purpose of immobilizers

A
  • Various devices to keep a patient from moving during the exam (tape, sand bags, lead shields)
  • DO NOT require a physician’s order
129
Q

Oral contrast examples

A
  • barium
  • gas granules
  • telebrix
  • hypaque
  • gastrofin
130
Q

Variables that affect viscosity of contrast

A
  • temperature: higher temp = lower viscosity
  • size of particles: increased size = increased viscosity
  • inner catheter diameter
  • catheter length
  • number of catheter holes (lumen)
131
Q

What amount is classed as “high flow” oxygen?

A

8L or more through mask/min

132
Q

How to put on and take off a gown

A

Putting on: injured side first

Taking off: uninjured side first

133
Q

Ways to prevent ulcers…

A
  • Keep pressure off of knees, hips, and heels
  • Change patient if damp
  • Reposition patient every 10 mins
134
Q

Order for diagnostic studies

A
  1. Radiographic exams not requiring contrast media and any lab studies for iodine uptake
  2. Radiographic exams of urinary tract
  3. Radiographic exams of biliary system
  4. Lower GI
  5. Upper GI

MRT Year 1 Semester 1 (9 decks)

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