Exam 2 Flashcards
(176 cards)
1
Q
Sterilization
A
complete destruction or elimination of all living microorganisms.
2
Q
Medical asepsis
A
reduction in numbers of infectious agents, which, in turn, decreases the probability of infection but does not necessarily reduce it to zero.
3
Q
Surgical asepsis
A
procedure used to prevent contamination by microbes and endospores before, during, or after surgery using sterile technique.
4
Q
Chemical asepsis
A
The use of disinfectants or antiseptics to alter the environment available to the microbe.
5
Q
Exogenous transmitted diseases
A
result from an encounter with a microbe in the environment.
6
Q
Endogenous transmitted diseases
A
result of encounters with organisms already present in or on the body.
7
Q
Nosocomial infection
A
hospital acquired condition. Generally occurring 72 hours after admittance.
8
Q
iatrogenic infection
A
an infection that is the result of intervention with a physician.
9
Q
Transmission based precautions:
A
Designed to place a barrier to the spread of highly infectious diseases between persons with such diseases ask the persons caring for them. Three routes: Air, Droplet, contact
10
Q
Transmission based precautions: Airborne
A
Examples: tuberculosis, chicken pox and measles. Precautions: private room, standard precautions, mask for patient.
11
Q
Transmission based precautions: Droplet
A
Spread by sneezing, coughing, talking, etc. Examples: influenza, rebel, pneumonias, meningococcal meningitis. Precautions: Private room, mask, standard precautions.
12
Q
Transmission bases precautions: Contact
A
Direct contact: person actually touches an infected or colonized body surface. Indirect contact: person comes in contact with an object that has been contaminated. Precautions: private room, gloves, wear gown, standard precautions.
13
Q
Standard precautions:
A
precautions used to prevent the transmission of disease by body fluids and substances.
14
Q
Sterile field
A
the work area where sterile supplies are placed for procedures. It is considered free of microorganisms.
15
Q
Exams using sterile technique:
A
Angiography Atrhrography Myelography Hysterosalpingography Exams in the operating room
16
Q
Only ____ items are used in sterile fields.
A
sterile
17
Q
If in doubt about the sterility of an object:
A
Consider it unsterile
18
Q
Sterile field must be ______ to be considered sterile.
A
continually monitored
19
Q
T/F: Create sterile fields as close to time of use as possible
A
True
20
Q
Sterile persons should avoid:
A
unsterile areas
21
Q
Anything below level of table or level of waist is considered:
A
unsterile
22
Q
The undersurface of the drape is considered:
A
unsterile
23
Q
Sleeves on gowns are considered:
A
sterile
24
Q
Front of waist is considered:
A
sterile
25
Back of gown and below waist is considered:
unsterile
26
Persons in sterile gown and gloves must pass each other:
back to back
27
A sterile person may touch only:
what is sterile
28
Unsterile persons ________ reach above or over a sterile field.
cannot
29
T/F: Sterile materials are still considered sterile when wet.
False
30
If solution soaks through a sterile field to non sterile, then:
wet area may be redraped.
31
Sterile gloves must be kept _____ and ______ waist level.
in sight/above.
32
Sterile field is established using:
a sterile drape
33
How to confirm that the package containing the drape is sterile
Must be clean and dry
Check expiration date
Not opened
34
Opening a sterile package:
Place package on center of surface.
Open package away from you.
Do not let any unsterile object touch insides of package.
Drop sterile towels on sterile field while wrapping away from sterile field.
Drop approximately 6 inches above the field at a slight angle.
Use free hand to hold back wrapping from touching sterile field.
35
Neonatal Contact shielding:
placing lead directly on infant's gonad
36
Neonatal shadow shielding
hanging a piece of lead in the beam to cast a shadow in the collimator light
37
Shadow shielding requires:
low levels of ambient light
38
Contact shielding has a greater potential for
cross-infection
39
What two things are major threats resulting significant morbidity and mortality each year in neonatal unit?
Sepsis and nosocomial infections
40
Nonaseptic
the use of equipment and exams where it is unnecessary to maintain a sterile environment.
41
NG tubes
plastic or rubber tubes inserted through the nasopharynx into stomach. Primarily used for decompression or removal of flatus (gas) and fluid from stomach.
42
When NG tubes are used for feeding, they are connected to:
an electronic pump that controls and measures intake as well as signals any interruption in feeding.
43
RT's perform abdominal films on patients with NG tubes to:
confirm placement of these tubes
44
Be careful when moving patients with NG tubes….why?
Because you may dislodge the tube.
45
NG tubes are generally hooked to:
low pressure suction.
46
If patient is continually being suctioned then:
Dr's orders are needed to stop in order to remove pt from room.
47
Removal of NG tube is usually performed by
a nurse
48
_____ are typically all that is needed to handle the end of an NG tube.
Gloves
49
During occasions when RT is assisting patient using urinal:
Provide privacy
Offer a washcloth
Do not discard urine if being monitored.
50
Describe process of emptying urinal when urine is not being monitored.
```
Wear gloves
empty contents
rinse with cold water
place with soiled supplies
remove gloves
wash hands
```
51
Things to remember when using bedpans
Used for dedication and for urination for female
If necessary to move patient, use two people.
Fracture pan is lower to accommodate trauma patient.
Wear gloves/wash.
52
Hypotonic enema
uses tap water to cleanse colon.
53
Hypertonic enema
used when patient can t tolerate large amounts of fluid.
54
Barium enema is used for:
to diagnose pathology and conditions of colon or lower GI tract.
55
The most common complication of a barium enema is
damage to the rectal wall due to overinflation of the balloon catheter.
56
Double-contrast barium enema indicated for:
```
diarrhea
high risk-cases
polyps
family history
personal history of cancer
rectal bleeding
```
57
Single-contrast barium enema indicated for:
```
gross pathology
fistulas
acute appendicitis or diverticulitis
intussusception
obstruction
```
58
What kinds of drugs are used with barium enema?
Glucagon is administered immediately before exam to relieve bowel spasm.
59
Post barium enema instructions
Lack of bowel movement 24 hours post procedure should prompt patient to contact physician.
Symptoms such as bleeding, weakness, constipation & abdominal pain should be brought to physicians's attention.
60
What is a colostomy?
surgical creation of an opening between the colon and surface of the body, due to trauma, cancer, diverticulitis, colitis, etc. May be permanent or temporary.
61
Emergency
a situation in which the condition of a patient or a sudden change in medical status requires immediate action
62
General priorities during an emergency situation
```
Ensure open airway
Control bleeding
Prevent or treat shock
Attend to wounds or fractures
Provide emotional support
Continually reevaluate and follow up appropriately.
```
63
Emergency cart
Emergency cart contains drugs and equipment needed to respond to life threatening situations
64
AED
Automatic External Defibrillator. Application of external electrical shock to restore normal cardiac rhythm and rate
65
PAD
Public Access Defibrillation. Can be fully automatic or semi-automatic.
66
Ventricular fibrillation
is a fluttering or ineffective cardiac rhythm that results in heart’s inability to pump blood. AED helps restore ventricular rhythm.
67
The simplest way to classify head injuries is
level of consciousness
68
Level of consciousness are
```
Alert & conscious
Drowsy but responds
Alert someone
Unconscious
Get help
Comatose & unresponsive
Call a code
```
69
Signs of Deteriorating Situations
Irritability
Lethargy
Slowing pulse rate
Slowing respiratory rate
70
Response by RT during medical emergency
Maintain open airway
Move pt as little as possible
Procedure stopped
Medical assistance obtained ASAP
71
Shock:
general term indicating a failure of the circulatory system to support vital body functions.
72
Types of shock
Hypovolemic
Cardiogenic
Neurogenic
Vasogenic
73
Hypovolemic
caused by loss of blood or tissue fluid
74
Cardiogenic
caused by variety of cardiac disorders
75
Neurogenic
caused by spinal anesthesia or damage to upper spinal cord
76
Vasogenic
caused by sepsis, deep anesthesia or anaphylaxis
77
What are the two types of shock that are most likely to be encountered in the x-ray department?
Hypovolemic or Anaphylactic. This is contributed to a result of reaction to contrast media.
78
What are the causes of shock?
Sudden change in body temp, pain, stress and anxiety.
79
Signs and symptoms of shock are:
```
Restlessness
Apprehension/general anxiety
Decreasing blood pressure
Tachycardia
Pallor
Cold & clammy skin
```
80
RT's reaction to shock:
Stop the procedure
Ensure maintenance of the patient’s body temperature
Call for medical assistance
Measure patient’s vital signs while waiting for assistance
81
Anaphylactic shock is a type of:
vasogenic shock
82
Re: Anaphylactic shock due to contrast media….Because the most severe reaction can result in death (due to cardiac arrest)….
contrast media should never be administered without first taking an adequate history
83
Regarding anaphylactic shock, the most severe reactions happen (how fast?)
quickly.
84
Mild reactions to contrast media:
Uticaria (hives)
Sneezing
Itching
85
Monitoring of the patient after the exam can identify
any unlikely delayed reaction
86
Although reactions to contrast media may be mild:
they may be an indication of the beginning of a more serious reaction
87
How is a reaction to contrast media treated?
Antihistamine is administered to counter the allergic reaction
88
Serious reactions to contrast media:
Laryngeal edema
Shock
Cardiac arrest
89
RT's reaction to serious reaction to contrast media:
Physician notified ASAP & vital signs taken
90
What are some examples of radiological procedures that require that the patient be fasting and places diabetic patients in a compromised situation?
Upper GI, Sm Bowel studies, Barium Enema, etc.
91
Hypoglycemia
Condition where excessive insulin is present.
| If patient has an insufficient amount of glucose they will go into insulin shock or insulin reaction.
92
Symptoms of hypoglycemia
Intensely hungry, weak, shaky, sweat excessively, confused, irritable, possibly aggressive and mildly hostile
93
Treatment of hypoglycemia
Glucose tablets
Orange juice
Sugared soft drink
Candy bar,any form of carbohydrate
Pt should sit quietly until food has taken effect (10-15 min.)
No food should be administered to an unconscious patient
94
Hyperglycemia
A condition where excess sugar is in the blood
| Condition may develop gradually so may not be noticed by a technologist
95
Symptoms of hyperglycemia
rapid thirst & urination, dry mucosa, rapid and deep breathing, drowsiness and confusion
96
How to treat hyperglycemia
Patient needs to be treated with insulin
Seek medical help ASAP
If left untreated condition will lead to diabetic coma
97
Other terms associated with hyperglycemia are
hyperosmolar coma and ketoacidosis
98
Asthma or respiratory distress occurs in the radiology department since it seems to be brought on by
stressful situations
99
Symptoms of asthma
wheezing
100
Reaction of the RT to asthma attack:
Stop the procedure
Assist pt to sitting position
Maintain calm demeanor
101
If the patient cannot speak due to an airway obstruction:
the Heimlich maneuver would be appropriate.
102
RT's reaction to choking:
Ascertain that the patient is choking
“Can you speak?”
Encourage patient to cough
Abdominal thrust (Heimlich maneuver)
103
How to perform the Heimlich on an unconscious patient:
Patient placed in supine position
Heel of hand on victim’s abd above navel, below sternum
Pressure applied in quick upward thrust
104
Heimlich maneuver for a pregnant patient:
Chest thrust used in place of abdominal thrust
105
Heimlich on infants
combination of back blows and chest thrusts
106
Cardiac arrest
Sudden stopage of cardiac output
| If not treated leads to permanent organ damage or death
107
Symptoms of cardiac arrest
crushing chest pain, may also be readiating down left arm
108
RT reaction to cardiac arrest
CALL FOR HELP IMMEDIATELY
| BEGIN CPR
109
Why must CPR be administered immediately for cardiac arrest?
Cerebral functions are generally impaired if brain is deprived of oxygen for 4 – 6 minutes.
110
What are the ABC's of CPR?
Airway
Breathing
Circulation
111
Possible complications of CPR
```
Rib fractures
Fractured sternum
Pneumothorax
Lacerated liver and spleen
Fat emboli
```
112
What is a CVA?
Cerbrovascular Accident (stroke or brain attack.)
113
What are symptoms of a stroke?
```
paralysis on one or both sides
Slurred speech
Complete loss of speech
Extreme dizziness
Loss of vision
Complete loss of consciousness
```
114
Does a stroke come on quickly, or over a number of hours.
Can be either.
115
What is a TIA?
transient ischemic attack (mini-stroke)
116
What are the symptoms of a TIA?
```
Same symptoms as a stroke, however they last less than 24 hours.
paralysis on one or both sides
Slurred speech
Complete loss of speech
Extreme dizziness
Loss of vision
Complete loss of consciousness
```
117
Some examples of minor medical emergencies are:
Nausea, epitaxis, vertigo, syncope, seizures, falls, wounds, burns.
118
RT's reaction to nausea
Provide emesis basin and a cold wash cloth. Encourage patient to breathe slowly and deeply through mouth. Allow patient time to relax, position them upright or semi upright, and if that's not possible, turn their head to the side.
119
Epitaxis
nosebleed.
120
RT reaction to nosebleed
Have patient lean forward and pinch nostril. If pressure fails, use moist compress. If bleeding does not stop within 15 minutes, medical assistance should be obtained.
121
What is vertigo?
Diziness
122
What is syncope?
Fainting. Temporary state of shock as result of lack of blood flow to brain
123
Vertigo and syncope are experienced by patients who have been:
bedridden or had limited mobility for an extended amount of time. Vertigo patients should be assisted to seated or recumbent position.
124
Patients arising from radiographic table will experience vertigo as a result of
orthostatic hypotension
125
Steps to increase blood flow to head following syncope:
Patient assisted to recumbent position with feet elevated
Tight clothing loosened
Most cloth applied to forehead
126
Characteristics of seizures
Caused by variety of factors
Range from mild to severe
Characterized by involuntary contraction of muscles
Last for a minute to several minutes
127
RT reaction to patient seizure
```
Prevent pt from injuring themselves
Do not attempt to restrain patient
Never place hand in mouth
Move pt to floor, away from objects
Place pillow under head
Assure open airway
Note where seizure began
One-sided or two-sided
Length of seizure
```
128
RT reaction to falls
RT should attempt to minimize physical impact of fall so as to minimize injury for both technologist and patient
129
Hemorrhage
bleed outside a vessel
130
RT reaction to hemorrhage
Apply pressure
May take 10 min. to clot
Dressing should not be removed
If necessary apply clean dressing
If extremity is bleeding, place above level of heart unless contraindicated
This will slow blood flow and result in less blood loss
131
How to handle a patient with burns
Care must be taken by RT to maintain proper infection control and minimize pain while positioning image receptors under patient during an exam
Burns are extremely painful injuries – extra gentle care is required when handling burn victim
132
Wound Dehiscence
Reopening of a wound/incision. Patient’s sutures separate
| Abdominal contents come out of peritoneal cavity
133
RT reaction to wound dehiscence
Do not attempt to replace tissue into Abd
Cover area with sterile dressing
Seek medical attention ASAP
134
Beginning 20th century, what were the major causes of death in US due to infectious diseases
Pneumonia
TB
Diptheria
135
Infection
the establishment & growth of a microorganism on or in a host.
136
Pathogenic microorganisms cause
infectious diseases
137
Pathogens have ability to:
Multiply in large numbers
Cause tissue damage
Secrete exotoxins
138
Pathogens are divided into what 4 infectious agents?
```
Bacteria-
can remain viable for many years & then germinate
Viruses –
needs a host/unresponsive to antibiotics
Fungi-
ex. Athlete’s foot
Protozoan parasites
ex. malaria
```
139
Six steps of Establishment of Infectious Disease
1. Encounter
2. Entry
3. Spread
4. Multiplication
5. Damage
6. Outcome
Encounters are numerous and span a lifetime.
140
Encounter
involves the infectious organism coming in contact with the host.
141
Congenital
microorganisms able to pass through placenta to create infection
ex: rubella and syphillis
142
Entry
```
Ingression: microorganisms adhere to the surface of the cell and excrete toxins
Example:
Digestive system
Diarrhea
Respiratory system
pneumonia
```
143
Entry
Penetration involves microorganisms invading past the epithelial barrier
Example:
Cuts & Wounds
Mosquito bites
144
Spread
the propagation of infectious organisms
| Spread of infection depends on the site of infection and type
145
Most important barrier of spreading disease is:
the immune system
146
Most important means of controlling spread of microorganisms is through
hand washing
147
Multiplication
Number of infectious agents need to multiply before impact is noticed
148
Incubation period
time frame in which the infection has set in until the time a substantial number of microbes has multiplied or increased
149
Direct damage
Cells are destroyed in the host by poisons secreted by the infectious agent
In a matter of hours enough organisms may be present to cause a complete obstruction in a major organ system
Ex: snake bite
Effects usually immediate
150
Indirect damage
The host is infected in such a way that their metabolism can be altered and it is just a matter of time before serious results take effect.
Ex. Botulism
Usually delayed effect
151
Three possible outcomes of infection:
The host gains control and eliminates the infection
The infection overcomes the host's immune system.
There is a compromise and a coexistence.
152
Four factors are involved in the spread of diseases
1. host
2. infectious microorganism
3. mode of transmission
4. reservoir
153
Vector
carrier that transfers an infective agent from one host to another
154
Fomite
inanimate object able to harbor pathogenic microorganisms, serving as an agent of transmission
155
Reservior
The site where an infectious organism can remain alive
| Transmission can continue to occur
156
Compromised patient
Patients who have weakened resistance to infectious organisms because of their admitting illness
Hospital patients have a greater sensitivity to infection
157
Sources of infection
```
Medical Personnel
Patient Flora
Contaminated hospital environment
Blood-borne pathogens
Invasive procedures
```
158
Infection from medical personel
Can be Direct or indirect, through Ingestion or inhalation from food handlers or surgeons.
159
Examples of patient flora
Skin
Gastrointestinal system
Genitourinay system
Respiratory system
160
Examples of contaminated hospital environment
Mildew
Improperly sterilized surgical equipment
Contaminated IV solution
Fomites
161
Blood-borne pathogens
Disease-causing microorganisms that may be present in human blood
Considered nosocomial infections
162
Invasive procedures
Any surgery & insertion of devices as needles, vascular catheters, endotracheal tubes & endoscopes
163
Defenses of the body
Mechanical, chemical, cellular
164
Mechanical defenses of the body
skin, handwashing
165
chemical defenses of the body
Sebaceous/sweat glands
| Mucous membranes
166
Cellular defenses of the body
Acidity of the stomach
167
Chemotherapy
Treatment of a disease by chemical agents
168
Static chemotherapy
chemo drugs that inhibit growth but do not kill them off
169
Bacteriocidal chemotherapy
ability to kill susceptible microbes
170
Immunization
security against a particular disease
171
Vaccine
any preparation used as a preventive inoculation to confer immunity against a specific disease
172
Environmental control agencies
Department of Health and Human Services (DHHS), Center for Disease Control and prevention (CDC), US Dept of Labor’s Occupational Safety & Health Administration (OSHA), World Health Organization (WHO)
173
Responsibilities of Dept. of Health & Human Services (HHS) & Centers for Disease Control & Prevention (CDC)
make the recommendations and guidelines for environmental control of infectious disease in U.S.
174
Responsibilities of US Dept of Labor’s Occupational Safety & Health Administration (OSHA)
enforces policies.
175
Responsibilities of World Health Organization (WHO)
issues recommendations for infection control
176
Extravasation
Fluid leaking into the surrounding tissue.
