Quiz 1 Flashcards
When caring for the elderly, it is important to remember that, as one ages, there is often a decrease in
Reaction time and strength (not long term memory)
Which is the preferred scheduling sequence?
Abdomen ultrasound, lower GI series, upper GI series
Note: retained barium sulfate contrast can obscure necessary anatomic details. Barium from lower GI will not obscure upper GI
Ipecac is medication used to induce vomiting and is classified as
Emetic. (Just remember emesis basin is for)
Diuretic is medication to stimulate production of urine
Antipyretic is used to reduce fever
Antihistamine is to relieve allergic effects
Drugs used to prolong blood clotting time include
Heparin
Lidocaine is used to treat ventricular arrhythmias
Medical abbreviation meaning “every hour” is
qh
tid means three times a day
qid means four times a day
pc means after meals
All drug packages must provide
Generic name, contraindication, usual dose, chemical composition & strength, side effects
What order should the examinations be scheduled?
- Upper GI
- Intravenous pyelogram
- Barium enema
Intravenous pyelogram (IVP)
BE
Upper GI
IVP done first b/c contrast medium used is excreted rapidly
BE should be next b/c any barium remaining from previous BE shouldn’t interfere with stomach or duodenum
Small container holding several doses of medication is termed
A vial
Quantity of medication introduced intravenously over a period of time is termed
An infusion
IV push is
Rapid injection
Bolus: quantity of material being injected
Hypodermic: administration of med by any route other than oral
Cathartics
Used to stimulate defecation
Emetics function to induce vomiting
Antitussives are used to inhibit coughing
When caring for a patient with an IV line, radiographer should keep the medication
18 to 20 in above level of the vein
If container is too high, pressure of IV fluid can cause it to pass through the vein into surrounding tissues. If IV too low, blood may return through needle into the tubing form a clot and obstruct flow of IV fluid
Chest drainage systems should always be kept
Below the level of patient’s chest
Chest drainage system has several components: 1. chamber that collects the draining fluid, 2. Suction control chamber. 3. Water-seal chamber which prevents air from atmosphere from entering the system. 4. Water-seal venting chamber which allows air to leave the system, thus preventing pressure buildup
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
Ethical principle that aspires never to, above all, do harm describes
Nonmaleficence (refers to prevention of harm)
Beneficence (refers to bringing about good)
Fidelity (refers to faithfulness)
Veracity (refers to truthfulness)
Radiographer who tells the patient that he or she will have to repeat this uncomfortable examination if the patient does not try harder to cooperate can be accused of
Assault (threat of touching of laying hands on someone)
Battery (refers to unlawful laying of hands on a patient; i.e touch inappropriately; perform wrong exams)
False imprisonment (patient is ignored after stating he or she no longer wishes to continue with procedure or if restraining devices are used improperly)
Defamation (patient confidentiality is not respected, suffers embarrassment or mockery)
Honor Code violations that can prevent a radiography student from meeting ARRT certification requirements include
Being suspended from radiography program
Being dismissed/expelled from a radiography program
A radiographer who discloses confidential patient info to unauthorized individuals can be found guilty of
Invasion of privacy
Spoken defamation is slander. Written defamation is libel
All of the following are part of the Patient’s Bill of Rights except
The right to review any institutional records
Radiographs are the property of the
Health care institution
In blood pressure reading 145/75 mmHg, what does 145 represent?
Phase of contraction of cardiac muscle tissue
145 is systolic (contraction)
75 is diastolic (relaxation)
Blood pressure is 120/95. What does 95 represent?
Phase of relaxation of cardiac muscle tissue & higher than average diastolic pressure
Physical changes characteristics of gerontological patients usually include
Loss of bone calcium (don’t assume loss of hearing & loss of mental alertness)
When radiographing the elderly, it is helpful to
Address them by their full name & give straightforward instructions
Rules for good body mechanics
Keep back straight, avoid twisting, keep load close to body, push don’t pull
Patient w/ injury needs to undress, radiographer should
Remove clothing from uninjured arm first
Symptoms of shock include
Pallor, weakness, increased pulse
Blood pressure is measured in (mm Hg)
Normal vital signs are….
Blood pressure: 110-140 mm Hg/ 60-80 mm Hg
Pulse rate: 60-100 beats/min
Temp: 97.7 F- 99.5 F
Respiration rate: 12-20 breaths/min
Symptoms of impending diabetic coma include
Increased urination, sweet smelling breath, extreme thirst
First stage of grieving process (according to Elizabeth Kubler Ross) Also name all the grieving process
1st Denial 2nd Anger 3rd Bargaining 4th Depression 5th Acceptance
MRI is contraindicated for patient who has
Aneurysm clips
Maslow’s hierarchy of basic human needs includes which of the following?
- Self actualization
- Esteem
- Love/Belonging
- Safety
- Physiological (food, water, air, etc)
When radiographing young children,
Let them bring a toy & be cheerful + unhurried
Types of inflammatory bowel disease are:
Ulcerative colitis & Crohn’s disease. Ulcerative colitis only attacks the large bowel & mucosal layer of intestinal wall. Crohn’s disease attacks any part of GI tract & extends through all the laters of intestinal wall
The practice used to retard the growth of pathogenic bacteria
Antisepsis: retard growth of pathogenic bacteria Medical asepsis: destruction of pathogenic microorganism so through process of disinfection Surgical asepsis (i.e sterilization) refers to the removal of all microorganisms and their spores
Subjective data example
Patient states that she experiences extreme pain in upright position
- Objective data includes signs and symptoms that can be observed
- Subjective data relate to what patient feels & to what extent.
How can you tell the RPO position in the series of IVU images?
In RPO position, the right ilium is more “open” than the left. RPO position places the left kidney and right ureter parallel to IR. The urinary bladder contains considerable contrast, indicating that it is most likely a prevoid image.
When erect position is requested as part of an IVU, it is used to demonstrate
Kidney mobility
Erect position is requested as supplemental view to rule out nephroptosis. With patient erect, kidneys drop no more than 2 in. More marked dropping of kidney is termed nephroptosis, a condition that is due to loss of surrounding perinephric fat.
How can you tell whether the abdomen is taking PA or AP?
In PA, the ilia is more foreshortened, giving the pelvis a “closed” appearance, whereas AP the ilia and bladder area appears more “open”.
Linear tomography (remember the image that shows the kidneys with the blurring effect)
Body section tomography functions to provide an image of a particular plane of tissues within the body, blurring out everything above and below the plane of interest.
Linear tomography is when X-ray tube moves in one direction while the xray IR moves in the opposite direction.
How does RPO position of IVU present?
Oblique IVU projections should be approx 30 degrees. When abdomen is obliques, kidney of the “down” side is perpendicular to the IR and its ureter is parallel to the IR. The kidney of the “up” side is parallel to the IR
Review the image of kidney
what are renal pelvis, minor and major calyces, etc.
The renal pelvis is the proximal expanded end of the ureter lying within the renal sinus. The minor calyces receive urine from collecting tubules of renal pyramids and convey it to major calyces which empty into renal pelvis
What is Wilm’s tumor? What examination would be appropriate for this?
Tumor of kidney. It’s most common childhood renal tumor, usually affecting only one kidney.
IVU would be appropriate
Routine excretory urography usually includes a postmicturition (post voiding) radiograph of the bladder. This is done to demonstrate
Tumor masses
Residual urine
Prostatic enlargement
(The presence of residual urine may be an indication of small tumor masses or in male patients, enlargement of prostate gland)
What should you do if you discover while taking patient history that the patient scheduled for an IVU takes meteor in hydrochloride daily?
Proceed with examination if kidney function is normal
Instruct patient to withhold metformin for 48 hrs after examination
Why do people use glucophage (metformin hydrochloride)?
To lower blood glucose level in patients who have type 2 diabetes. Patients on metformin may have intravascular iodinated contrast studies if their renal function is within normal limits.
(Iodinated media together with metformin could induce renal failure)
During IV urography, the prone position generally is recommended to demonstrate
The filling of ureters and the renal pelvis
How do the kidneys lie in posterior portion?
Kidneys lie obliquely in posterior portion of trunk with their superior portion angled posteriorly and their inferior portion and ureters angled anteriorly. To facilitate filing of most anteriorly placed structures, patient is examined in prone position
The procedures used to demonstrate renal function include
IVP, descending urography, infusion nephrotomography are functional urinary studies because the contrast medium is introduced intravenously and excreted by the kidneys
Retrograde urography isn’t considered a functional study of urinary system. It involves introduction of contrast medium into kidneys via catheter, demonstrating structure not function
During IVU, the RPO position is used to demonstrate
Left kidney parallel to IR
Right kidney perpendicular to IR
What radiographic examination can demonstrate urethral reflux?
Voiding cystourethrogram
What position is most likely to place the right kidney parallel to the IR?
LPO
Which of the following involve(s) intentional misconduct?
- Invasion of privacy
- False imprisonment
- Patient sustaining injury from a fall while left unattended
Invasion of privacy and false imprisonment
Unintentional misconduct would be #3 from above
To “excuse” suboptimal images, a radiographer makes a note on exam requisition claiming that patient “was uncooperative” radiographer can legally be found guilty of
Libel (written defamation)
(Malpractice refers to action that results in patient injury; Communicating false information to third party is found guilty of defamation. Spoken defamation is called slander)
Intentional misconduct include
Slander and invasion of privacy
Negligence is unintentional
What are ARRT rule of ethics?
Mandatory minimum professional standards for all RTs.
Dysplasia
Abnormal development of tissue
Dysphasia
Difficulty in speaking
Malposition
Anatomic structure located in a place other than the norm
Dyspnea
Difficulty breathing
Which of the following can a radiographer be found liable for a negligent tort?
- Radiographer images the wrong forearm
- Patient is injured while being positioned on xray table
- Radiographer fails to question patient about possible pregnancy before exam
All of them
What are the four elements of negligent tort liability?
Duty (what should’ve been done),
breach (deviation from duty),
injury sustained and
cause (result of breach)
Exposure factors of 100 kVp and 6 mAs are used with a 6:1 grid for a particular exposure. What should be the new milliamperes-seconds value if a 12:1 grid is substituted?
10 mAs Factor for grid ratio: No grid = 1 x original mAs 5:1 grid = 2 x orig mAs 6:1 grid = 3 x orig mAs 8:1 grid= 4 x orig mAs 12:1 grid = 5 x original mAs 16:1 grid = 6 x orig mAs Grid conversion formula is mAs1/mAs2 = grid factor 1/grid factor 2 Substituting the unknown for the problem above: 6/x=3/5 -> 3x= 30 so x =10 mAs
What does a tort include?
Tort is an intentional or unintentional act that involves personal injury or damage to a patient.
The legal document or individual authorized to make an individual’s health care decisions, should the individual be unable to make them for himself or herself, is the
- Advance health care directive
- Living will
- Health care proxy
You have encountered a person who is apparently unconscious. Although you open his airway, there is no rise and fall of the chest, and you can hear no breath sounds. You should
Begin external chest compressions at a rate of at least 100 compressions/min
[the tradition of ABC’s (airway, breathing, chest compressions) has been changed to CAB (chest compression, airway, breathing). If victim isn’t able to be roused, rescuer should start with 30 compressions at a rate of 100 compressions/min.
- if patient has spine injury, use the jaw thrust method instead of lifting the head to prevent further spine injury
A vasodilator would most likely be used for
Angina (constriction of blood vessels)
What is bradycardia?
Abnormally slow heartbeat
Symptoms of inadequate oxygen supply include
Dyspnea Cyanosis Retraction of intercostal spaces Diaphoresis Dilated nostrils Distend ion of veins of the neck
Heimlich maneuver is used if a patient is
Choking
Rapid onset of severe respiratory or cardiovascular symptoms after ingestion or injection of a drug, vaccine, contrast agent, or food or after an insect bite best describes
Anaphylaxis
What type of shock results from loss of blood?
Hypovolemic
Septic shock is when body is invaded by bacteria
Sternal compressions during CPR are made with the heels of the hands located about
1 1/2 in. superior to the xiphoid tip
Moderate hypertension can produce damage to which of the following organ(s)
Lungs, kidneys and brain
Skin discoloration owing to cyanosis may be observed in the
Gums and earlobes
Difficulty in breathing precipitated by stress and causing bronchospasm best describes
Asthma
The medical term used to describe the vomiting of blood is
Hematemesis
Hemoptysis
Coughing or spitting up blood
Hematuria
Blood in urine
Epistaxis
Nosebleed
The condition that allows blood to shunt between the right and left ventricles is called
Ventricular septal defect
Coarctation of the aorta is
A narrowing or constriction of the aorta.
Atrial septal defect is
A small hole in the interatrial septum.
Swan-Ganz catheter is
IV catheter
A patient experiencing an episode of syncope should be placed in what position?
Dorsal recumbent with feet elevated
Anaphylactic shock manifests early symptoms that include
Dysphasia
Itching of palms and soles
Constriction of throat
Name some of the central venous lines
Port-a-Cath, PICC, Swan-Ganz catheter
What is central venous line? What do you use it for?
A catheter placed in a large vein. You use it to deliver frequent medications or nutrition or to monitor cardiac pressures.
What is the Port-a-Cath?
It is a totally implanted access port. It permits long term intravenous treatment.
What is the PICC line?
Is a peripherally inserted central catheter. It permits long-term intravenous treatment.
What is Swan-Ganz catheter?
This catheter is advanced to the pulmonary artery and is used to measure the pumping ability of the heart, to obtain pressure readings, and to introduce medications and IV fluids.
What is the Levin and Salem-sump tubes? What is special about the Salem-sump?
They are NG tubes used for gastric decompression. Salem-sump tube is radiopaque and has a double lumen. One lumen is for gastric air compression, and the other is for removal of fluids.
What blood pressure measurements indicate shock?
Why is such blood pressure indicate shock?
Systolic pressure less than 60 mm Hg
Shock is indicated by extremely low blood pressure, that is, a systolic blood pressure reading lower than 60 mm Hg
During a grand mail seizure, patient should be…
What do you have to do to patient following the seizure?
Protected from injury.
Following the seizure, place patient on his or her side to prevent aspiration of any oral secretions
Extravasation occurs when…
contrast medium is injected into surrounding tissue
A cathartic is used to
Stimulate defecation
You treat bradycardia and cardiac arrest with dopamine or epinephrine to increase what? And what are the overall term used for dopamine and epinephrine?
To increase blood pressure. The overall term is vasoconstrictors.
What is base of support? (According to proper body mechanics)
Base of support is the portion of body that’s in contact with the floor or some horizontal plane.
What is center of gravity?
Midpoint of the pelvis or lower abdomen
What is line of gravity?
Abstract line passing vertically through the center of gravity
What is IV infusion?
Quantities of medication dispensed intravenously over a period of time
What is IV push?
Refers to rapid injection
What is bolus?
Quantity of material being injected
What does the term hypodermic mean?
Administration of medication by any route other than oral.
What is Ipecac?
Medication used to induce vomiting
What four medications are generally found on typical crash cart?
Heparin, norepinephrine, nitroglycerin, and licocaine
What does heparin used for? What is another name for it?
Decrease coagulation
Anticoagulant
What does norepinephrine used for?
Raise blood pressure
What does nitroglycerin used for?
Functions as vasodilator, relaxing the walls of blood vessels and increasing circulation.
Lidocaine is for?
Used as local anesthetic or antidysrhythmic
What is the function of analgesic?
Relieve pain. Ex: aspirin
What venous device can be used for a patient requiring IV injections at frequent or regular intervals?
Heparin lock
What do you use heparin lock for?
Used for patients who will require frequent or regular injections.
What is contributory negligence?
Both the health care provider’s and the patient actions contribute to an injurious outcome. Ex: patient who fails to follow physician’s orders
What is comparative negligence?
Percentage of the injury owing to patient’s actions is compared with the total amount of injury
What is gross negligence?
When there is willful or deliberate neglect of the patient.
Corporate negligence occurs…
When a corporation fails to meet its legal obligations to its clients
The risk of inoculation with HIV is considered high for which of the following entry sites?
Broken skin and perinatal exposure
Overall chance that a person will become infected with HIV is high with entry sites such as anus, broken skin, shared needles, infected blood products, and perinatal exposure. Low risk entry methods include oral, nasal, conjunctiva, and accidental needle stick
OSHA (occupational safety and health administration) make which of the following requirements?
- Hepatitis B immunization so must be made available to all hospital employees
- Puncture proof containers for all used needles
- Follow up care must be provided to any staff accidentally exposed to blood splash/needle stick
2 and 3 only.
Hepatitis B immunization is provided for all staff who “might be” exposed to blood/body substances.
Guidelines for cleaning contaminated objects or surfaces include which of the following?
Clean from the least to the most contaminated areas
Clean from the top down.
In what manner do you clean the patient for skin prep?
Clean in circular motion starting from center and working outward.
All of the following rules regarding proper hand washing technique are correct except:
- Keep hands and forearms lower than elbows
- Use paper towel to turn water on
- Avoid using hand lotions whenever possible
- Carefully wash all surfaces and between fingers
Avoid using hand lotions.
Indirect modes of disease transmission include
Airborne, fomite and vector
What is fomite?
Inanimate object that has been in contact with an infectious microorganism. Ex: door knob, xray table
What is a vector?
Animal host of an infectious organism that transmits the infection via a bite or sting.
If 2 radiographers perform a portable xray on a patient with MRSA precaution, what is the proper technique?
One radiographer remains clean and the one who positions the mobile unit also makes the exposure
Diseases whose mode of transmission is through the air include
TB, mumps and rubella
Rubella, mumps and influenza are spread by droplet contact
What are the four stages of infection? And which is the most communicable?
1st: Latent period (the infection is introduced and lies dormant)
2nd: Incubation (microbes reproduce)
3rd: Disease phase (signs and symptoms occur; infection is most active and communicable at this point)
4th: Convalescent [recovery] phase
What are the require contact precautions?
Gloves, masks and gowns
When do we need negative-pressure room?
We need it when dealing with patient who has airborne precaution
What does MRSA stand for?
Methicillin-resistant staphylococcus aureus
What is a reservoir?
A site where an infectious organism can remain alive and from which transmission can occur.
An illness of unknown or obscure cause is said to be
Idiopathic
What does systemic mean?
What does epidemic mean?
What does pathogenic mean?
Refers to or concerns a (body) system
Epidemic: describes a disease that swiftly affects a large number of people in a particular region
Pathogenic: anything that is or can be disease-producing
What are Hemovac or Penrose used for?
For tissue drainage of wounds or in postoperative drainage.
When disposing of contaminated needles, they are placed in a special container using what procedure?
Do not recap the needle and dispose of the entire syringe.
Cycle of infection includes which of the following components?
- Reservoir of infection
- Susceptible host
- Means of transmission
All of the above plus pathogenic organisms.
In which stage of infection do the infective microbes begin to multiply?
Incubation period
Body substances and fluids that are considered infectious or potentially infectious include?
Feces, breast milk, wound drainage.
[body substances include pleural, pericardial, peritoneal, and amniotic fluids, synovial fluid, CSF, breast milk and vaginal secretions as well as nasal secretions, tears, saliva.
Complete killing of all microorganism is called?
Sterilization
Which of the following can be transmitted via infected blood?
- HBV
- AIDS
- TB
HBV & AIDS
Sterile technique is required when contrast agents are administered
Intrathecally
What is the first treatment of extravasation of contrast media during an IV injection?
1st Apply pressure to the vein until bleeding stops
2nd apply moist heat
A patient suffering from orthopnea would experience the least discomfort in which body position?
Erect
Orthopnea is a respiratory condition in which patient has difficulty breathing in any position other than erect.
Recumbent position mean?
Lying down
The most common used method of low-flow oxygen delivery is the
Nasal cannula
As diaphragm relaxes and moves up, the sternum and ribs move..
Inferiority
Conditions in which there is lack of normal bone calcification include
Rickets and osteomalacia
A patient who has been recumbent for some time and gets up quickly may suffer from light-headed east or feel faint. This is referred to as
Orthostatic hypotension
What is the normal BUN level? Creatinine?
BUN: 8-25MG/100mL
Creatinine: 0.6-1.5mg/100mL
