Week 12- Patient Management Flashcards
What type of approach is essential during diagnostic x-ray procedures?
Holistic approach
What does holistic care begin with the patient?
Effective communication between radiographers and patients
What are the benefits of effective communication?
- Alleviate the patient’s uneasiness
- Increases the likelihood of cooperation and successful completion of the imaging procedure
How must radiographers limit patient’s exposure to ionizing radiation?
- employ appropriate radiation reduction techniques
- use protective devices that minimize exposure
What are the 9 ways patient exposure can be substantially reduced by?
- Effective communication
- Use of proper body or part immobilization
- Use of motion reduction techniques
- Use of appropriate beam limitation techniques
- Adequate filtration of the c-ray beam
- Use of specific area shielding
- Select suitable exposure factors in conjunction with computer-generated digital images
- Use of appropriate digital image processing
- Elimination of repeat radiographs
When is communication between radiographers and patient effective?
When verbal and nonverbal messages are understood as intended
What does effective communication encourage in patients?
Encourages a reduction in anxiety and emotional stress
What does effective communication enhance?
The professional image of the radiographer as a person who cares about patient well being
What does effective communication increase the chances of?
Successful completion of the the x-ray exam
What must the radiographer do if a procedure will case pain, discomfort or strange sensations?
Inform the patient of all before the procedure begins without overemphasizing them
What is a result of poor communication with a patient?
The need to do a repeat radiograph because of inadequate or misinterpreted instructions
What should patient protection begin with during a diagnostic x-ray?
Begins with clear, concise instructions
Why is there a need for immobilization in imaging?
To prevent the patient from moving during the image which will create blur
What are the consequences of blurred image?
- exams need to be repeated
- results in additional radiation exposure
How can patient motion be eliminated or minimized?
- proper body or part immobilization
- use of motion reduction techniques
What are the two types of patient motion?
Voluntary and involuntary
What type of motion does adequate immobilization during exams help reduce?
Voluntary motion
Why is shielding needed?
To prevent radiation exposure to radio sensitive body organs
Which areas of the body should be shielded whenever possible?
- lens of eye
- breasts
- reproductive organs
- thyroid glands
What is the first step in gonadal shielding?
Collimating
What types of shields are used for the eyes?
Contact type shields that are positioned directly on the patient
How much more exposure do female reproductive organs involving the pelvis receive than males?
3 times
How much exposure is reduced in females by a 1mm lead flat contact shield?
50% reduction
How much is exposure reduced in males with a 1mm lead contact shield?
90-95%
Where must gonadal shielding be placed to provide protection?
Directly over the patient’s reproductive organs
What should be used to guide placement of testicular or ovarian shields?
External landmarks
In male patients in supine position what can be used to guide shield placement over the testes?
The pubic symphysis
In female patients what should be used to guide shield placement of the ovaries?
Shield should be placed approximately 2.5medial to each ASIS
What are the types of gonadal shields?
- Flat contact shields
- shadow shields
- shaped contact shields
- clear lead shields
What are flat contact shields?
An uncontoured, flat lead shield that is placed over the patients gonads
What is a shadow shield?
A suspended shield that is placed above the beam defining system that casts a shadow on the patient directly over their gonads
What is a lead filter?
A type of shadow shield that has breast and gonadal shielding plates and casts a shadow on the patient
What are shaped contact shields?
Cuplike shields that may be held in place with a suitable carrier
What are the benefits of specific area shielding?
- minimize the number of potential deleterious c-ray induced mutations expressed in future generations
- reduces exposure to specific areas that are shielded
Why is the selection of appropriate technical factors essential in diagnostic imaging?
It ensures patients only receive a minimal dose of
What should high quality images have?
- sufficient brightness to display anatomic structures
- appropriate levels of subject contrast to differentiate anatomic structures
- maximum spatial resolution
- minimal distortion
What are the 7 considerations for technical exposure factor?
- Mass per unit volume of tissue of the area of interest
- Effective atomic number and electron density of tissues involved
- Type of image receptors
- SID
- Type and quantity of filtration
- Type of X-ray generator used
- Balance of radiographic density or brightness and contrast required
When AEC is not used what should be used to ensure uniform selection of technical exposure factors?
Technique charts
What is a radiographer responsible for checking before imaging?
The technique chart and taking the patients condition into account
What combination of kVp and mas reduces patient dose?
Use of higher kVp and lower mAs
What does the use of high kVp and low mas result in?
A high energy, penetrating beam and a small,, patient dose
What does the use of low kVp and high MAs result in?
A low energy x-ray beam in which the majority will be absorbed by the patient
What is correct image post processing essential to in imaging?
Essential to produce a high quality image in which artifacts produced by the IR, software or patient are controlled
What does a quality control program include?
Regular monitoring and maintenance of processing and imaging display equipment
What does a quality control program mandate?
Full acceptance of new equipment, regular calibration and performance evaluations of existing machines and proactive and consistent image review
What is the air gap technique?
An alternate to using a grid to reduce scatter in that the patients is placed using an OID of 4-6 inches and an SID of 10-12 feet
At what kVp levels are air gap techniques more useful?
When less than 90 kVp is used
At what kVp are air gap techniques successful in chest X-rays?
120-140 kvp
How does the air gap technique work?
Many of the scattered X-rays are so low in energy that they are absorbed by the air before they reach the IR
Why does the SID need to be increased so much in the air gap technique?
To counteract the magnification that is caused by the increased OID
How does patient dose using air gap compare to tabletop and grid?
It’s higher in air gap compared to tabletop but lower than grid
What are the consequences of repeat images?
Additionally exposure to the patient, specifically a double dose
What type of repeat images should be eliminated?
Repeats resulting from the carelessness or poor judgment of the radiographer
When is the only time an additional image is permissible?
When it’s recommended by the radiologist for the purpose of obtaining additional diagnostic info
At what rate have repeat images increased?
Approximately 5% but can be as high as 17%
What are the main reasons for repeat images?
Positioning errors and ease of repeating
What are the benefits of a repeat analysis program?
Helps identify the number of repeats and reasons for producing unacceptable images with the hopes of improving
