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Intro to Radiography > Chapter 18 > Flashcards

Chapter 18 Flashcards

1
Q

Define Aseptic

A

Product or method free of microbiological organisms

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2
Q

What is Surgial Asepsis?

A

Protection from infection using sterile technique before, during and after surgery

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3
Q

What radiography exams is sterile technique required for ?

A

Angiography
Arthrography
Hysterosalpingogram
Opearting room
Myelogram

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4
Q

What is angiography used for?

A

Stints, clear out blood vessels

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5
Q

What is Arthrography?

A

Inject the joint with gadolinium and lidocane

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6
Q

What is a Hysterosalpingogram?

A

Exam fallopian tubes

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7
Q

What is a Myelogram?

A

Used to exam the spine by putting a spinal needle into lower back

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8
Q

What is Medical Asepsis? What technique is used?

A

Reduction of infection agents - decrease probability of infection but not to zero.

Uses clean technique.

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9
Q

Is barium enema a sterile technique?

A

No, don’t want to eliminate the good bacteria

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10
Q

Goal of sterile technique?

A

Protect patient from infection and eliminate ALL harmful microorganisms

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11
Q

What is the number one priority for sterile technique?

A

Hand washing

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12
Q

What is the first step to making sure a packing is sterile?

A

Check expiration date and check to see if it is clean and dry

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13
Q

When opening a sterile packing, which way do you place package on the surface?

A

Top flap opens away from you

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14
Q

Can you reach over the sterile package to open flaps?

A

No, you must reach around

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15
Q

What hand should you use on each side when opening sterile package?

A

Right hand on right side, left hand on left side

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16
Q

Do you have to wear gloves when opening the sterile package?

A

No

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17
Q

Can sterile items be added to sterile tray after it has been opened? How?

A

Yes, drop contents on the field about 6 inches and at an angle

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18
Q

Where are sterile solution bottles considered sterile?

A

Inside the bottle only

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19
Q

Once the sterile solution bottle is set down, is it considered sterile?

A

No

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20
Q

What should you check on a soltuion bottle?

A

Name, concentration, and expiration date

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21
Q

How many times should you check a solution bottle?

A

3 times

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22
Q

Who should you show the solution bottle to?

A

Physician or radiologist performing the exam

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23
Q

How should you place the top of the sterile solution bottle?

A

Top side down

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24
Q

How high above the bowl should you hold the solution bottle?

A

1-2 inches

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25
Q

What happens if the sterile field gets wet?

A

Allows microorganisms can move from unsterile field

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26
Q

What are other procedures we might use sterile technique on?

A

Biopsies, hip injections

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27
Q

If in doubt about the sterility of an object, consider it:

A

unsterile

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28
Q

Purpose of surgical scrubbing

A

Removes debris and transient microorganisms from hands and nails

Reduce resident microbial count to a minimum

Inhibit rapid rebound growth of microorganisms

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29
Q

What are the two methods of surgical scrubbing?

A

Numbered stroke - certain number of brush strokes used

Timed scrub - certain amount of time

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30
Q

How long should you scrub fingers and hands?

A

3 minutes

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31
Q

How far above the elbow should you scrub?

A

3 inches

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32
Q

How should you dry your hands and elbows?

A

Wrist to elbow, using blotting-rotating motion, don’t revist an area

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33
Q

How far should you be from the sterile area when picking up the sterile gown?

A

12 inches

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34
Q

Difference between open and closed gowns?

A

Closed - hands don’t go all the way through

Open - hands come out (more in radiology dept)

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35
Q

Who is the person who ties the gown?

A

Circular

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36
Q

When do you put on sterile gloves?

A

After gowning

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37
Q

What is the closed method of gloving?

A

Fingers covered by gown, and pick up gloves

Use non-dominant hand to pick up opposite glove (left hand to pick up right glove)

Place glove on hand with palm down and fingers facing toward you

Fingers grasp the bottom of the cuff and assistant hand pulls glove over hand to be gloved

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38
Q

What is the open method of gloving?

A

Opposite hand picks up glove - do not touch outside surface of glove

Dominant hand gets gloved first

Sterile glove hand picks up the other glove by reaching under the cuff

Sterile glove on first must touch only the outer surface

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39
Q

How to gown another:

A

Sterile picks up at neckband, arms length away holding gown, allows unfold.

Holds at shoulder seams w outside facing sterile person

Circular (not person who started the gowning process) adjusts gown in back and ties.

Sterile person pulls cuffs over person’s sleeves, not touch person being gowned hands.

40
Q

Gloving another

A

Sterile person opens the package and picks up the right glove

Sterile person slides fingers under cuffs and spreads cuffs. Good grip.
Person to be gloved thrusts hand in.

Sterile person releases cuff gently and rolls cuff over wrist area.

41
Q

How often must the sterile field be watched?

A

Continuously

42
Q

What is the time factor when setting up sterile technique?

A

The longer the pack is open, the more likely it is to be come unsterile

43
Q

Anything below the waist is sterile/unsterile?

A

Unsterile

44
Q

What portions of the gown are sterile?

A

Arms and front

45
Q

How must sterile peope pass each other?

A

Butt to butt

46
Q

Can you redrape an unsterile field?

A

Yes

47
Q

Where must gloves be kept?

A

In sight and above waist

48
Q

What is the best way to communicate with a trach patient?

A

Yes/no questions, hand signals, simple sign language

49
Q

What is a tracheostomy done for?

A

Upper airway obstructions

50
Q

What level of Maslow’s Hierarchy is a Trach patient?

A

Physiological

51
Q

Who does the suctioning for trach?

A

Nurse or respiratory therapist

52
Q

What needs to happen before suctioning a trach pateint?

A

Aerate with 5-10 breaths of oxygen using an Ambu bag

Patency of the catheter must be tested

53
Q

How to test the patency of catheter?

A

Saline

54
Q

How do you insert catheter for trach patient?

A

Insert until resistance met, then withdraw 1 cm

Apply suction immediately while withdrawing in rotating motion

55
Q

Never suction a trach patient more than:

A

15 seconds

56
Q

After inserting a catheter into a trach, how do you assess the airway?

A

Auscultation - using the stethoscope to listen to internal sounds

57
Q

What are chest tubes used for?

A

Atelectasis, pneumothorax, thoracotomy, and open heart surgery

58
Q

What is a chest tube?

A

Tube inserted into pleural cavity to remove fluid, blood, air

59
Q

What does the chest drainage system include?

A

Collection chamber
Water seal chamber - prevents air from entering chest
2nd water chamber - controls amount of suction

60
Q

Where must chest tubes be located?

A

Be at or below level of the chest

61
Q

If a patient has a chest tube and you are with them for more than an hour, what must be reported?

A

Drainage of excess of 100mL per hour

Change of fluid from a serous fluid to a dark red color

62
Q

Type of urinary catheters:

A

Foley and straight

63
Q

What is a Foley catheter?

A

Has a balloon and must fill it with sterile water

64
Q

What is a catheter called that remains in place/stays in the body?

A

Indwelling catheter

65
Q

What are urinary catheters used for?

A

Emptying bladder
Relieve retention of urine
Irrigate the bladder or put in drugs
Permit accurate measurement of urine output
Relieve incontinence

66
Q

What unit are catheters measured in?

A

French unit

67
Q

What is the diameter range of catheters?

A

8-18 french units

68
Q

What are the different type of catheters based on duration used?

A

Plastic - short term
Latex - 2-3 weeks
Polyvinyl - 4-6 weeks
Silicone - 2-3 months

69
Q

Things to watch for with urinary catheters?

A

Keep collection bag below the bladder (prevent reflux and infection)
Never drag bag on the floor
Be sure to cut opening to drain sterile water before trying to remove
If you empty or give fluids- be sure to document

70
Q

What are foley catheters used for frequently?

A

Voiding cystograms

71
Q

Urinary catheter kit includes:

A

Sterile gloves
Antiseptic solution
Cotton balls and forceps
Lubricant
Container to receive urine
Sterile drape

72
Q

What is the lithotomy position?

A

Supine, knees bent, genitalia exposed

73
Q

Where does the sterile drape go for catheter insertion?

A

Men - under the penis
Women - under the buttocks

74
Q

How to test the balloon in a Foley?

A

Inject sterile water

75
Q

What hand do you use to expose the urinary meatus?

A

Non-dominat hand

76
Q

What hand do you use to insert catheter?

A

Dominant hand

77
Q

How far do you insert urinary catheter?

A

Until urine flow
Women - .5 inches
Men - 6-8 inches

78
Q

What should you do if you meet resistance when removing the catheter?

A

Notify nurse or physician

79
Q

What is a voiding cystourethrogram?

A

Radiography of urethra and bladder before, during, and after voiding

80
Q

What is a Suprapubic catheter?

A

Closed drainage system above pubic symphysis; used for gynecology surgeries and urethral injuries

81
Q

What is a condom catheter?

A

Used for males for incontinence

82
Q

Central venous lines require what technique?

A

Sterile technique

83
Q

Technique required for tracheostomies?

A

Sterile technique

84
Q

What technique is used for catheter insertion?

A

Aseptic technique

85
Q

Where are pacemakers placed?

A

Underneath the skin on the chest (pectoral fascia)

Apex of right ventricle

86
Q

What does a pacemaker do?

A

Regulates heart reat - prevents brachycardia

87
Q

What senses the heartbeat on a pacemaker? And what does it do?

A

Electrode - sends impusles to make the heart contract

88
Q

What vein is used to access where the electrode will go?

A

Subclavian vein

89
Q

What does a radiographer do for insertion of pacemaker?

A

Run fluoroscopy while physician positions guidewire

90
Q

What kind of technique is used to insert a pacemaker?

A

Sterile technique

91
Q

How is a pacemaker inserted?

A

Guidewire is inserted to provide pathway

Introducer sheath is used to place the pacing lead into subclavian vein

Under fluoro, the lead is advanced to the right atrium

Sheath withdrawn and lead placed at apex of right ventricle

92
Q

What is the one constant in the operating room?

A

Sterile corridor between patient drape and instrument table

93
Q

What is used to keep C-arm sterile?

A

Snap cover - most common - image intesifier and C-arm covered and tension bands hold in place

Shower curtain approach - sterile plastic wall with hole; hip pinnings, fermur rod

Stop gap approach - drape site with additional sterile cloth and C-arm brought over area of interest. Used only when physician doesn’t manipulate C-arm

94
Q

How to reduce contaminants in neonatal unit?

A

Hand washing
Keep multiple peices of lead in unit and sterilize after use
Cover lead with pillow case
Assign a piece of lead to each crib

95
Q

Types of neonatal shielding and the advantages/disadvantages

A

Shadow - lay on top of bassinet - less cross of infection/ambient lighting

Contact - lay directly on baby - regular lighting/more chance of infection

Intro to Radiography (15 decks)

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