Registry Review Class - patient care extra notes

Question 1

to make an informed decision, the patient needs to have what? (5)

Answer 1

1. the nature of the trt procedure or decision
2. expectations of trt
3. expected outcome (likelihood of success)
4. other options of trt
5. risks and side effects

Question 2

Consent is a form of communication between ________ and _________

Answer 2

patient and provider

Question 3

Who needs to review and conduct the consent process with the patient? And why?

Answer 3

the rad onc/physician should conduct the consent process with the patient

If a rad t or a nurse does the consent, it can be questioned in a court of law – should be physician!
Physician or provider is the best person to do consent for it to be truly informed

Question 4

An informed consent must ideally be in ______

Answer 4

writing
– “an official agreement that has been signed on paper or digitally”

Question 5

TRUE or FALSE

In a verbal consent, the witness can be on the healthcare team, but you still want a written consent… Verbal consent can get you to next step at least… but, ideally you still want a written consent

Answer 5

TRUE

Question 6

If consent is NOT obtained, it can be considered what?

Answer 6

battery or malpractice

Question 7

TRUE OR FALSE

If a patient is NOT 18 years old or older… and or NOT fully mentally capable – a parent or guardian can sign (or health care proxy/or power of attorney) can sign the consent

Answer 7

TRUE

Question 8

when should consent be obtained?

Answer 8

PRIOR to the CT sim

Question 9

TRUE OR FALSE

risks of radiation (even radiation from CT) must be included in the consent

Answer 9

TRUE

Question 10

_____ consent is used in emergencies

Answer 10

implied

Question 11

PHI is what? and what does it do?

Answer 11

Protected Health Information

it is any info used to identify a patient

Question 12

who can we discuss patient’s info with?

Answer 12

Patient’s info (patient’s PHI, etc.) can only be discussed by those who have DIRECT care of the patient

Question 13

when performing a case study, printing, etc. what must be removed?

Answer 13

patient’s PHI
*Protected Health Information

Question 14

what is the biggest problem in the healthcare industry?

Answer 14

breach of confidentiality

Question 15

If a crime is committed, can you break HIPAA to police and associated authorities?

YES or NO

Answer 15

YES

Question 16

TRUE or FALSE

HIPAA applies to ALL healthcare workers.

-anyone who comes in contact with patients, no matter your job
-from front desk, cafeteria, to doctor

Answer 16

TRUE

Question 17

what does AHA stand for?

Answer 17

American Hospital Association

Question 18

a ___________ _________ ____ __________ outlines the expectations the patient has of the health care facility

Answer 18

Patient’s Bill of Rights

Question 19

DNI stands for what? whereas DNR stands for what?

Answer 19

DNI = Do Not Intubate –> expresses the desire to avoid intubation (tube insertion) in the event of a medical emergency

DNR = Do Not Resuscitate –> expresses the desire to not have life-saving methods/measures used if patient codes (ex. CPR)

Question 20

a living will is a type of ___________

Answer 20

Advanced Directive

Question 21

TRUE or FALSE

you HAVE to be terminally ill to have a living will

Answer 21

FALSE

you do not have to be terminally ill to have a living will

Question 22

TRUE or FALSE

a DNR is another type of Advanced Directive

Answer 22

TRUE

Question 23

_____________________ = a legal document that states/documents who Medical power of attorney is

Answer 23

Health Care Proxy

Question 24

____________________ = the person who makes the medical/healthcare decisions. And must be 18 years old or older

Answer 24

MEDICAL power of attorney

Question 25

a _____ will should be the guide for the healthcare proxy

Answer 25

living

Question 26

___________ = the person who makes legal decisions on behalf of patient

Answer 26

Power of attorney

Question 27

_____________ = the moral obligations to promote the course of action that they believe is in the best interests of the patient; act in the best interest of; to do good

Answer 27

Beneficence

Question 28

_____________ = negligence by an act, or failure to act, by healthcare provider that results in injury of death; always UNITENTIONAL

Answer 28

Malpractice

Question 29

is malpractice ALWAYS unintentional? YES or NO

Answer 29

YES

Question 30

the word "_____" means "wrong"

Answer 30

tort

Question 31

what is the word that describes an "unintentional tort"

Answer 31

negligence

Question 32

* Battery * Assault * False imprisonment * Libel * Slander * Invasion of privacy these are all words that describe _________ _________

Answer 32

Intentional torts

Question 33

what legal doctrine/jargon is being described below? doctrine that states that all persons are liable for their own negligent conduct

Answer 33

personal liability

Question 34

what legal doctrine/jargon is being described below? "let the master answer"

Answer 34

Respondeat superior

Question 35

what legal doctrine/jargon is being described below? "the thing speaks for itself"

Answer 35

Res ipsa loquitor

Question 36

what legal doctrine/jargon is being described below? principle of law that holds a person liable for all consequences of any negligent acts to another individual to whom a duty is owed & should have been reasonably foreseen under the circumstances

Answer 36

Foreseeability

Question 37

TRUE or FALSE you can be forced into a clinical trial

Answer 37

FALSE you can never be forced into a clinical trial. It is always on volunteer basis BUT once you are in a trial, they can assign you into whichever group they feel needed

Question 38

what material is typically used as patient identifiers for inpatients?

Answer 38

wristbands

Question 39

to use "restraints" correctly... what must happen beforehand?

Answer 39

a physician, PA, or Nurse practitioner must order them or order a directive

Question 40

what are the stages of grief? in order 1. 2. 3. 4. 5.

Answer 40

1. denial 2. anger 3. bargaining 4. depression 5. acceptance

Question 41

CT will still give off radiation... is the dose high or low?

Answer 41

CTs give off a low dose of radiation. Just in the diagnostic range

Question 42

MRIs DO or DO NOT use radiation?

Answer 42

they DO NOT. They're magnets, they use magnetic field

Question 43

TRUE or FALSE MRIs are always on

Answer 43

TRUE

Question 44

when transferring a patient in a wheelchair to the treatment table, where is it best to put the wheelchair?

Answer 44

parallel to the table - according to jess and WL

Question 45

for stretcher transfers, what should be the first step?

Answer 45

LOCKING THE WHEELS

Question 46

what are examples of ergonomic devices in the clinic?

Answer 46

hoyer lift and gait belts

Question 47

when is a gait belt better than a hoyer lift?

Answer 47

when the patient is weight bearing

Question 48

for a MINOR MEDICAL EMERGENCY is medical treatment needed? Observation?

Answer 48

medical trt is not needed, only observation

Question 49

the following are examples of Minor, Moderate, or Severe medical emergencies? Nausea, hives, mild vomiting, weakness, warmth, pallor (pale skin)

Answer 49

MINOR

Question 50

for a SEVERE MEDICAL EMERGENCY is medical treatment needed? Observation?

Answer 50

treatment needed immediately (like Epinephrine) and continued observation

Question 51

the following are examples of Minor, Moderate, or Severe medical emergencies? Tachycardia, bradycardia, hypotension, hypertension, dyspnea, laryngeal edema

Answer 51

MODERATE

Question 52

the following are examples of Minor, Moderate, or Severe medical emergencies? o Anaphylactic shock – experiences respiratory arrest and vascular shock o Convulsions, unresponsiveness, extreme hypotension

Answer 52

SEVERE

Question 53

for a MODERATE MEDICAL EMERGENCY is medical treatment needed? Observation?

Answer 53

medical trt is not needed, but must be under observation

Question 54

what is the ratio of compressions to breaths for an adult?

Answer 54

30:2

Question 55

what is the ratio of compressions to breaths for children?

Answer 55

15:2

Question 56

when should you administer CPR?

Answer 56

only when there is NO PULSE

Question 57

LAURA NAPPI CORRECTION - pg 19 #3 Injuries and Traumas After the incident has occurred, an incident report _____ need to be filled out according to the facility’s rules

Answer 57

WILL *it must be filled out. no option

Question 58

what is the difference between airborne and droplet transmission? *hint - comes down to size and area covered*

Answer 58

airborne = smaller particles; occurs over long distances droplet = larger particles; occurs over short distances

Question 59

where is considered NOT sterile?

Answer 59

waist level and down

Question 60

handwashing should take how long?

Answer 60

40-60 seconds

Question 61

Contrast media types & properties: the following describes Iodinated, Barium sulfate, or Water soluble media "a pharmacologic agent bound to molecules of iodine"

Answer 61

Water soluble

Question 62

Contrast media types & properties: the following describes Iodinated, Barium sulfate, or Water soluble media "positive agents; water soluble; rectal or oral to highlight GI"

Answer 62

Barium sulfate

Question 63

Contrast media types & properties: the following describes Iodinated, Barium sulfate, or Water soluble media "positive agents; used to enhance vascular organs & structures (usually IV)"

Answer 63

Iodinated

Question 64

Contrast media types & properties: the following describes Iodinated - IONIC or NON-IONIC media "High osmolality and cause more adverse reactions"

Answer 64

IONIC

Question 65

Contrast media types & properties: the following describes Iodinated - IONIC or NON-IONIC media "Low osmolality and cause fewer adverse reactions; More expensive"

Answer 65

NON-IONIC

Question 66

which type of contrast media is MOSTLY used in/as CT contrast?

Answer 66

water soluble media

Question 67

describe BUN (Blood Urea Nitrogen) levels and why it matters. Especially with regard to CT and contrast

Answer 67

waste products excreted by the kidneys -if high = impaired kidney function -a blood test that evaluates kidney function – if level is high, it indicates POOR kidney functions … contrast is hard on kidneys cause that is how it is filtered out

Question 68

what does BUN stand for?

Answer 68

Blood Urea Nitrogen

Question 69

contrast is hard on what organ(s) especially?

Answer 69

our kidneys

Question 70

if BUN levels are high in kidneys, what does it?

Answer 70

indicates POOR kidney functions and would be harder for patient to get contrast out of body/system

Question 71

what are the normal BUN values in adults?

Answer 71

7-20 mg

Question 72

severe reactions (allergic, etc) require _________________ kind of treatment

Answer 72

intensive and rapid treatment

Question 73

________ is another severe reaction which is loss of consciousness leading to convulsions

Answer 73

SYNCOPE

Question 74

every CT should have a basic ____ kit

Answer 74

allergic reaction

Question 75

at risk people for ...xyz... people should get stool tested every __ years

Answer 75

3

Question 76

at risk people for ...xyz... people should get a colonoscopy every __ years

Answer 76

10

Question 77

at risk people for ...xyz... people should get a sigmoidoscopy every __ years

Answer 77

5

Question 78

when should women start getting an annual breast cancer screen mammo?

Answer 78

40-54 years old

Question 79

TRUE or FALSE high risk smokers with risk of lung cancer should get an annual low dose CT

Answer 79

TRUE

Question 80

women aged 21-29 should get a pap smear every ____ yrs

Answer 80

3

Question 81

women aged 30-65 should get a _______ and a ____ test every 5 years!

Answer 81

pap smear and HPV test

Question 82

how often should women 30-65 yrs old get a pap smear and HPV test

Answer 82

every 5 yrs

Question 83

what does PSA stand for (2 meanings really, say both)

Answer 83

Patient Support Assembly Prostate Specific Antigen

Question 84

_____________ is the sound you hear FIRST when using a stethoscope

Answer 84

systolic

Question 85

_____________ is the sound you hear SECOND when using a stethoscope

Answer 85

diastolic

Question 86

diastolic is the relaxation OR contraction of the heart

Answer 86

relaxation

Question 87

systolic is the relaxation OR contraction of the heart

Answer 87

contraction

Question 88

TRUE or FALSE the pain scale is subjective

Answer 88

TRUE

Question 89

what is the most common PET scan tracer?

Answer 89

FDG

Question 90

like MRI, a diagnostic ultrasound does not use ________________

Answer 90

radiation

Question 91

what is the blood test for liver cancer?

Answer 91

AFP

Question 92

what is the blood test for ovarian cancer?

Answer 92

CA-125

Question 93

when does ovarian cancer typically appear/we can find it? Early or Late stage

Answer 93

Late

Question 94

who is the ONLY one who can approve prescription and treatment?

Answer 94

the rad onc

Question 95

BID means _____

Answer 95

twice a day

Question 96

if patient is getting radiation BID, how long must they wait before the second treatment? the minimum wait time between BID treatments = ______

Answer 96

minimum 6 hours **if it must happen before 6 hours, you NEED approval!

Question 97

the physician is included on a __________ charge

Answer 97

professional

Question 98

the physician is NOT included on a ____ charge

Answer 98

technical

Question 99

consults and follow-ups are a technical and professional charge, OR only professional, OR only technical?

Answer 99

only Professional makes sense - the patient is only seeing the physician

Question 100

a vsim is a technical and professional charge, OR only professional, OR only technical?

Answer 100

technical and professional charge

Question 101

a complex charge means what devices were used?

Answer 101

personalized/custom created devices ex. aquaplast masks, vac-locks, custom bolus, etc

Question 102

when it comes to devices, what charge trumps the others?

Answer 102

complex (complex over simple and intermediate)

Question 103

if the patient uses an indexed device (ex. WB, breast board, belly board) but it is not personalized, what is the charge?

Answer 103

intermediate

Question 104

if a patient uses a pillow or knee wedge, what is the charge?

Answer 104

simple