Patient Interaction and Management Flashcards
When is written consent needed?
For invasive procedures
Who should HIPAA violations be reported to?
ARRT ethics committee
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
Who is responsible for determining the patient’s chief complaint or single most important issue?
Physician
What is the sequence for scheduling multilpe diagnostic studies?
- Not requiring contrast
- Lab studies for iodine uptake (thyroid)
- Radiographic exams for urinary tract
- Radiographic exams for biliary tract
- Lower GI series
- Upper GI series
Who is legally responsible for the care and safety of the patient?
Medical doctor
The threat of touching in an injurious manner
Assault
An unlawful touching of a person without consent
Battery
When the confidentiality of patient information is not maintained
Invasion of privacy
An unjustifiable detention of a person against their will
False imprisonment
Is the use of restraints considered false imprisonment?
Not when there is a question about patient’s safety. Must be ordered by a physician
Neglect or omission of reasonable care and caution
Negligence
An act of negligence in providing reasonable care and caution is defined as:
Professional negligence or malpractice
Defamation by written or printed words
Libel
Defamation by spoken words
Slander
An intentional or unintentional act resulting in injury to a patient
Tort
The doing of goodness, kindness or charity, including all actions to benefit others
Beneficence
What does “Respondeat superior” mean?
“Let the master answer”
An employer can be held liable for the actions of its employees
What does “Res Ispa Loquitur” mean?
“The thing speaks for itself”
Requires the defendant to prove his/her innocence
A sensitivity to the needs of others that allows you to meet those needs in a constructive manner
Empathy
The 5-step grieving process was formulated by:
Dr. Elisabeth Kubler-Ross
What are the 5 steps of grieving:
Denial
Anger
Bargaining
Depression
Acceptance
Is it better to push or pull a heavy object?
Push
Is it better to push or pull a patient onto a table?
Pull
What type of catheter is used for the diagnosis of right and left ventricular failure and pulmonary disorders?
Pulmonary Artery Catheter (Swan-Ganz)
Where is the tip of the Swan-Ganz catheter placed?
Pulmonary artery
What % of oxygen is delivered using a nasal cannula?
21-60%
What is the flow of oxygen when using a nasal cannula?
1-6L/min
What level should the IV solution bag be placed?
18-24” above the vein
What is used to measure blood pressure
Sphygmomanometer
What is used for auscultation or listening to the heart, lungs, or abdominal sounds
Stethoscope
What is the normal pulse for adults?
60-100 beats per minute
What is the normal pulse for children?
90-100 beats per minute
What is the normal pulse for infants?
80-120 beats per minute
If a patient is conscious, what artery do you check for a pulse?
Radial
If a patient is unconscious, where do you check for a pulse?
Carotid artery
What artery is located in the skull that can be used to check for a pulse?
Temporal artery
What artery is located in the neck that can be used to check for a pulse?
Carotid artery
What artery is located in the upper extremity that can be used to check for a pulse?
Radial artery
What artery is located in the groin that can be used to check for a pulse?
Femoral artery
What artery is located in the lower extremity that can be used to check for a pulse?
Dorsal pedis artery
What is tachycardia?
Fast heart rate - higher than 100 beats per minute
What is bradycardia?
Slow heart rate - less than 60 beats per minute
Which blood pressure represents the pressure created during contraction of the left ventricle?
Systolic
Which blood pressure represents the pressure within the vascular system with the heart at rest?
Diastolic
What is hypertension?
High arterial blood pressure
Above 140 systolic
Above 90 diastolic
What is hypotension?
Low arterial blood pressure
Below 95 systolic
Below 60 diastolic
What is a normal blood pressure for adults?
110-140/60-80
What is a normal blood pressure for children?
70-112/26-70
What is normal blood pressure for infants?
60-105/22-60
What is the normal respiratory rate for adults?
12-20 per minute
What is the normal respiratory rate for children?
30-60 per minute
What is dyspnea? Apnea?
Difficult breathing
Not breathing
What is a Bennett’s fracture?
Fracture that happens at the base of the first metacarpal
What is an avulsion?
Bone is pulled away by a tendon or ligament
What is a smith’s fracture?
Fracture of distal radius - hand will be more forward than forearm
What is a colles fracture?
Fracture of the distal radius - hand will be behind the forearm
What medication is used in the case of anaphylactic shock?
Epinephrine
What type of bag is used in CPR for ventilation
Ambu bag
How far down does ET tube go?
2” above carina
Which side of the bronchus is more vertical?
Right side
What is the flow of blood through the heart?
Right atrium receives oxygen-poor blood from IVC and SVC
Flows through tricuspid valve into right ventricle
Flows through pulmonary valve into pulmonary artery to the lungs
After receiving oxygen, blood returns to left atrium via the pulmonary veins
Flows through the biscupid valve into the left ventricle and is pumped into the aorta
What is the CPR compression depth for adults?
At least 2”
What is the CPR compression depth for a child (1-8yr)
At least 1/3 of chest diameter or about 2”
What is the CPR compression depth for an infant?
At least 1/3 of chest diameter or about 1.5”
What is the compression rate for CPR?
100-120/min
What is the CPR breathing rate for an adult?
10-12 breaths/min or every 5-6 seconds
What is the CPR breathing rate for a child (1-8 yr)
Every 2-3 seconds
What is the CPR breathing rate for an infant?
Every 2-3 seconds
What is the compression to ventilation ratio for adults?
30:2
What is the compression to ventilation ratio for a child and infants?
30:2 for one rescuer
15:2 for two rescuers
Where should you check for a pulse in a child (1-8 yr)?
Cartoid or femoral
Where should you check for a pulse in an infant?
Brachial
What does RACE-PASS stand for in the event of a fire?
Rescue
Alarm
Contain
Extinguish
Pull
Aim
Squeeze
Sweep
What technique deals with reducing the probability of infectious organisms being transmitted to a susceptible individual?
Medical asepsis
What technique is the complete removal of all organisms and their spores from equipment used to perform patient care or procedures
Surgical asepsis
Technique used for procedures that involve catheterization of the bladder, tracheostomy care, dressing changes, and penetration of the skin
Sterile
Microorganism capable of producing disease
Pathogens
An inanimate object that has made contact with an infectious organism (food, water, gloves, equipment)
Fomites
Transmission of an infectious agent that is indirect by means of a fomite that touches a person’s body or is ingested
Vehicle
Typically an arthropod (mosquito, tick, flea)
Vector
Hospital inquired infection
Nosocomial infection
Physician caused the infection
Iatrogenic infection
Unknown infection cause
Idiopathic infection
What is the chain of infection?
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Aseptic technique is designed to prevent that occurance of:
Nosocomial infections
How many seconds should you wash your hands according to the CDC?
20 seconds
When scrubbing for a sterile procedure, the hand washing time requirement is
5 minutes
What is the ratio of bleach to water when mixed together as a disinfectant?
1:10
What are precautions used for contact based transmissions?
Gloves, gown, and restricted patient placement
What are precautions used for droplet based transmissions?
Particulate mask and restricated patient placement
What are precautions used for airborne transmissions?
Respiratory protection and negative ventilation
When is reverse isolation (neutropenic precautions) used?
HIV positive patients, chemotherapy and burn patients
When are strict precautions used?
When a patient has a disease that is transported through airborne or contact routes
What are the roles for clean tech/dirty tech?
Clean tech manages the equipment and IR
Dirty tech contacts the patient and the linens
How often should a patient’s blood pressure be measured when giving contrast through an IV?
Before, frequent intervals, and prior to patient leaving
What is a bolus injection (IV push)?
Large volume of contrast or drug is rapidly administered into an exisiting IV line
What is an IV drip?
Contrast administered by gravity
What is the difference between ampule and vial?
Ampule - single dose of medication
Vial - multiple doses
What is the most common contrast agent in radiology?
Air
Negative contrast results in a/an __________ in radiographic density of the image of the parts filled with negative contrast
Increase
Positive contrast results in a/an __________ in radiographic density of the image of the parts filled with negative contrast
Decrease
What is viscosity?
Related to the thickness of the contrast
What is the kVp for single contrast studies?
100-125
What is the kVp for double contrast studies?
90-100
Normal Creatinine values
.7-1.3 mg/dL
Normal BUN values
8-25 mg/dL
Normal GFR rate
90-120 mL/min
What is the estimated GFR used for?
Best test to measure kidney function and determine the stage of kidney disease
How is the estimated GFR caclulated?
Resultes from creatinine test, body size, age, and gender
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
Type of shock that results from external hemorrhage, lacerations, or plasma loss due to burns
Hypovolemic shock
Type of shock that results from massive infection
Septic
Type of shock that results from head or spinal trauma resulting in a failure of arterial resistance
Neurogenic shock
Type of shock that results from cardiac failure
Cardiogenic
Type of shock that results from being injected with a foreign protein, bee sting, or iodinated media
Anaphylaxis (allergic)
Symptoms of anaphylaxis
Increase in pulse rate
Hypotension
Itching, flushing, SOB
Hives (urticartia)
Which reactions are mild/moderate/severe?
Extravasation
Vasovagal response
Very low blood pressure
Laryngeal edema
Tachycardia
Excessive vommitting
Extravasation - mild
Vasovagal response - mild
Very low blood pressure - severse
Laryngeal edema - severe
Tachycardia - moderate
Excessive vommitting - moderate
When should Benedryl be used?
Allergic reaction
When should Decadron be used?
Allergic reaction
When should Dilantin be used?
Seizures
When should Lasix be used?
Edema
When should Epinephrine be used?
Cardiac arrest, anaphylaxis
When should Cathartics be used?
Laxatives
When should Nitroglycerine be used?
Angina (chest pain)
When should Glucagon be used?
Spasmatic colon
When should Heparin/Warfarin/Coumdin be used?
Anticoagulant
When should Insulin/Metformin/Glucophage be used?
Hyperglycemia
What position should you put a patinet in for orthostatic hypotension?
Trendelenburg
What is hyperglycemia? What are the symptoms?
High blood sugar
Flushed, dry skin, fruity smelling breath, exceccive thirst and urination
What is hypoglycemia? What are the symptoms?
Low blood sugar
Sweaty, clammy, cold skin, nervousness, blurred vision
What is the technologist’s primary resonsibility if a patient is having a seizure?
Keep the patient safe
How to determine if bleeding is from artery or vein?
Artery - strong pulsating volume of blood exisiting
Vein - Lower volume with less forcful pulsing
How to stop arterial bleeding?
Apply compression directly to the site or proximally
How to stop venous bleeding?
Apply compression directly to the site or distally
In CR, the response of the phosphor layer when interacting with x-ray photons is to release
Light photons
List 3 patient populations that should be identified as high priority patients
- Emergency
- Fasting
- Pediatric and geriatric
