Radiation Safety Flashcards
Cycle of infection broken by:
destruction, removal, prevention
Approx platelet count range:
140,000-400,000/cc
Normal adult respiration
20-30 breaths/min
Practice that helps prevent spread of micro-organisms
Medical asepsis
Most common route of infection spread
Direct contact
Loss of hair after radiation
Epilation
A,B,C’s of CPR
Airway, breathing, circulating
Artery where pulse is measured
Brachial
Normal adult pulse
60-80 beats/min
Iodinated contrast
Risk of anaphylaxis
radiation recall
recurrence of radt skin rxns during chemo
SVC syndrome symptoms
Facial/arm edema, cough, neck distention
SVC Syndrome
Narrowing of the superior vena cava restricting blood flow to the heart
Most common manifestation of infection in neutropenic patients
Fever
Parenteral drug administration uses _____ technique
Surgical asepsis technique
Parenteral drug administration is:
Providing drugs through the blood stream (ie: IV, IC, IM, SQ, ID, IP)
Nosocomial infection
hospital acquired infection
3 routes of drug administration
enteral, parenteral, percutaneous
5 rights of drug safety
- Right patient
- Right time
- Right dose
- Right route
- Right drug
Manifestation of infection
- Germ must be present
- Germ must have place to live
- Germ must have susceptible host (not immune)
- Way for germ to enter host
CPR Compression Ratio
30:2 ratio of compression to ventilations
Cerebral Vascular Accident (CVA) (Stroke)
sudden interruption of the blood supply to the brain
Asepsis
absence of pathogenic microorganisms
Medical asepsis
practices designed to reduce the number and transfer of pathogens; synonym for clean technique
Surgical asepsis
techniques used to destroy all pathogenic organisms, also called sterile technique
Contamination
Process by which something is rendered unclean/unsterile
Disinfection
Pathogenic spores (bacteria) are destroyed
Antiseptic
Inhibits growth of bacteria
Sterilization
Process by which all micro-organisms are destroyed
Neutropenia
Low WBC count
Anemia
Low RBC count
Thrombocytopenia
Low platelet count
RBC count range
4.2-5.7 mill/cc3
WBC count range
3,900-10,000/cc3
HGB count range
13.2-16.9/cc3
HCT count range
38.5%-44.9%
Platelet count range
150,000-400,000/cc3
Karnofsky Performance Scale
0-100 Scale
Based on ability for patient to perform daily activities and care for themselves
Eastern Cooperative Oncology Group (ECOG)
0-5 scale (0 = fully active, 5 = dead)
Progression of disease and how it affects daily living
Glasgow Coma Scale
3-15 scale
Assesses cognitive function
Informed Consent
- Nature of disease, procedure, tx
- Expected outcomes/likelihood of success
- Reasonable alternatives
- Known risks
Physiologic concerns for patient
Maslows Hierarchy of Needs + Pain Relief
Maslows Hierarchy of needs
physiological, security, social, esteem, and self-actualization
Psychological concerns for patients
Five stages of grief + anxiety
Five stages of grief
denial, anger, bargaining, depression, acceptance
Social concerns for patients
-support from family/friends
-participation in normal life activities
-intimacy
Mores
fixed customs or manners; moral attitudes
Values
Regarded as good + desirable, can be learned
7 ethical principles
- beneficence
- nonmaleficence
- autonomy
- justice
- veracity
- role fidelity
- confidentiality
Beneficence
Act for good of another
Nonmaleficence
duty to do no harm
Autonomy
Ability to make independent decisions
Justice
What’s considered fair
Veracity
truthfulness
Role fidelity
Operation within scope of practice
Confidentiality
Protection of privacy
Tort
A civil wrong
Unintentional tort
negligence and malpractice
Intentional tort
A wrongful act knowingly committed
Quasi-intentional tort
invasion of privacy, defamation of character
Autonomy supported by:
Patients bill of rights act (1998)
DNR:
Request for no resuscitation
Living will
Healthcare wishes for end of life care if patient cannot make decisions on their own
POA/healthcare proxy
Active whenever patient is unable to make decisions on their own/states whom they want to make these decisions
Advance directive
Tells provider what kind of care is preferred in the case of patient being unable to make decisions
Linear Attenuation Coefficient
The linear attenuation coefficient is dependent on the density of absorbing material and is the fraction of photons attenuated per unit thickness. It has a dimensionless unit of 1/cm.
If the intended dose for treatment is 180 cGy, and a shadow tray with a factor of 0.97 is accidentally inserted, what actual dose is received by the patient?
The shadow tray factor of 0.97 indicates that about 3% of the dose is absorbed by the tray and/or 97% of the dose is transmitted. 180 x 97% = 175.
In which of the following diseases is it important to include regional lymphatics?
A. T1 glottic larynx carcinoma
B. glioblastoma multiforme
C. nasopharynx carcinoma
D. osteosarcoma of the femur
nasopharynx carcinoma (has lymphatic drainage)
One disadvantage of using a vertex field to treat primary brain malignancies is that the field exits through the:
When treating the vertex with the patient in neutral position, the vertex field would exit through the pharynx. If the patient is treated with chin flexed, the vertex field exits through the pharynx and spinal cord.
For breast irradiation, internal mammary lymphatics would be best treated using:
an anterior electron field
When extremities are irradiated for the management of primary bone malignancy, it is important to spare a portion of:
tissue along the extremity to prevent obstruction of lymphatic flow
A patient is receiving 3000 cGy total dose to a spine port using the SSD technique. The total given dose is 3636 cGy. What is the percent depth dose?
82.5 % — Use the applied dose formula. Given dose = TD/%DD. 3636 = 3000/x; 3000/3636 = 0.825.
The volume of lung within an anterior supraclavicular field can be reduced when treating breast carcinoma by:
moving the breast down on the chest wall and making the match line as superior as possible
The normal limits for PSA in the patient under 60 years old is less than or equal to:
4 ng/mL
While moving a patient with a chest tube, the tube becomes dislodged. The therapist should:
apply an airtight dressing over the opening
A necessary instrument for examination of the inner ear would be the:
otoscope
Hair loss (epilation) is usually permanent when the scalp is exposed to radiation doses exceeding:
60 Gy
The lumen size for a urinary catheter is expressed in:
The lumen size of the urinary catheter is expressed in French. The lower the French size, the smaller the lumen.
The process of modifying the beam profile to optimize the dose distribution throughout the treatment volume is called:
intensity modulation
The average rate for respiration in the adult, in breaths/minute is:
10 - 20
For a clinical whole brain without the use of a face mask, the inferior border will be at the mastoid process and (select two):
supraorbital ridge
external auditory meatus
Which of the following sites is most likely to show bone metastasis?
thoracic spine
Adults undergoing total body irradiation may be treated at an extended distance while assuming the position of:
semirecumbent, with the knees bent on a gurney
The type of nutrition that bypasses the gastrointestinal tract and introduces nutrients into the veins is called:
parenteral
increasing the dose rate on a linear accelerator will _______the percent depth dose.
not change
Blood Urea Nitrogen (BUN) test measures the function of the
kidneys
The tolerance dose (TD 5/5) for the whole lung in the adult is:
1800 cGy in 10 fractions
Treatment machine accessories composed of dense metal should be kept at least_______cm away from the patient’s skin surface.
15 cm
