Patient Care (Kettering Audio) Flashcards
(437 cards)
1
Q
“Mr. Jones do you mind if I do a portable chest x-ray on you tonight?” and the patient acknowledges that.
A
Oral/Informed Consent
2
Q
“Mr. Jones step up here on the board so I that I can do a chest x-ray on you.” and the patient follows your orders.
A
Implied Consent
3
Q
When does an examination require a written consent?
A
when the exam becomes invasive
4
Q
When you break the skin, inject iodine, and there is a chance of a reaction:
A
invasive consent
5
Q
Parental Contrast Procedures require:
A
written consent
6
Q
A technologist should prior to an exam if a patient asks a question:
A
answer all questions clearly
take time with the patient to answer questions
they can ask me 17 questions and offer up the time for 16 of them answered.
7
Q
As a technologist we NEVER:
A
give out the diagnosis
8
Q
For minors below the age of 18 or an elderly grandma who can no longer think on their own:
A
IS NOT HIPAA violation. But every single person outside of that is HIPAA
9
Q
As a technologist you should never:
A
make a patient do an exam against his or her will. They have the right to refuse an exam.
10
Q
What does HIPAA stand for?
A
Health Insurance Portability and Accountability Act
11
Q
“But its my own spouse”
A
HIPAA Violation
12
Q
“But its cousin Fred”
A
HIPAA Violation
13
Q
“But its my brother”
A
HIPAA Violation
14
Q
You overhear two coworkers discussing confidentiality in the hall, who are you going to report that violation to:
A
ARRT Ethics Committee
15
Q
Bill of Rights (AHA) American Hospital Association:
A
The patient has the right to:
considerate and respectful care
receive from his physician any information necessary to give informed consent
Refuse treatment
(look for the work NOT) it will not be correct.
16
Q
the right to refuse medical treatment including a radiographic procedure
A
Autonomy
17
Q
DNR: (extent of care)
A
Do not resuscitate
18
Q
Living will is also known as:
A
health care proxy
19
Q
we dont just say the patient hurt their hand we say.
A
the patient had trauma to the third metacarpal
20
Q
responsible for determining the patient’s chief complaint or the single most important issue
A
physician
21
Q
A patient has the following ordered, put n the number what order should be done in:
IVU
BE
KUB
UGI
A
KUB
IVU
BE
UGI
22
Q
A patient can only take off half a day and they have to have multiple exams preformed on the same day rules:
A
- non-contrast studies come first
- Iodinated contrast studies secondly
*always do the BE before the UGI first.
23
Q
Prioritizing patient waiting time. The following patients require priority scheduling:
A
- ER Patients
- Any type of NPO/Dietary Restrictions
- Routine Patients
24
Q
Who do we take orders from?
A
- Pa (who is being covered by the physician license)
- Nurse Practitioner (who is being covered by the physician license)
- Physician
25
You walk out into a busy waiting room and you say "Mr. Jones, three people stand up, the system is backed up, they are tired waiting. What do you do as the technologist?
Mr. Jones "what is your DOB, how old are you?"
*right exam right patient
26
The radiographer maintains the responsibility for proper patient identification, what is used to identify inpatients?
Wrist band
Bed name plate
27
What proper patient identification is used for outpatients?
questioning the patient, confirmation of birth date, account number or social security numbers are personal modifiers.
28
We get an order that says "leg" "arm", or a patient has pain in the left leg and the order says right leg, who do you take the exam back to?
The Ordering Physician
29
Anytime you have a question about the order what do you do?
take the order to the ordering physician
30
defamation by printed or written words inaccuracies or misstatements
Libel
31
Do not say "the patient was drunk", do not say "the patient was intoxicated", what you do say is:
the patient smelled of alcohol
the patient appeared intoxicated
32
You will never hear a radiologist say "there are no fractures", what they say is:
"no fracture identified"
33
If you say there is no fractured identified on an order and later find out there was a fracture that was missed:
Libel Statement
34
Which of the following statements are libel statements:
"the patient was drunk"
"the patient was intoxicated"
"the patient smelled of alcohol"
"the patient appeared drunk"
"there are no fractures"
"no fractures identified"
the patient was drunk, the patient was intoxicated, there are no fractures.
35
The threat of touching in an injurious manner:
Assault
36
"the patient lay still before I beat you up"
"patient lay still before I beat you with the cassette"
Assault
37
The patient feels threatened by which the tone we say it:
Assault
38
The patient feels threatened by the tone of the voice:
Assault
39
The tone of the voice, they feel threatened by the commands:
Assault
40
Unlawful Touching:
Battery
41
If you perform an exam on a patient who never was scheduled for that specific exam:
Battery
42
If you perform the wrong part on the patient, requisition for a right knee, yet you mistakenly do a left knee:
Battery
43
Make a patient get an exam against his or her will:
Battery
44
An unjustifiable detention of a person against his/her own will.
False Imprisonment
45
Who is the only person that can order a restraint device?
Physician
46
The only person that can allow restraint devices to be used are the:
Physicians (NEVER technologist)
47
The neglect or omission of reasonable care and caution:
Negligence
48
Something I failed to do:
Negligance
49
Something I actually did:
Malpractice
50
Defamation by written or printed words.
Libel
51
Defamation by spoken words
Slander
52
An intentional or unintentional act resulting in injury to a patient
Tort
53
There is an order for a 5 view lumbar spine, you roll the patient in, you preform the 5 view lumbar spine, walk out of the room to take the cassette to walk station. You walk back into the room to see that the patient was on the table and is now lying on the floor:
Intentional Tort because you never leave the patient unattended.
54
If you did the 5 view lumbar spine, transferred the patient over to the stretcher and come back in and see that you did not put the rails up and see the patient was lying on the floor:
Intentional Tort because you can not leave patient's on beds with the rails not properly secured.
55
When you transfer the patient back over the stretcher, properly secure the rails, and you come back in and the patient is on the ground (the patient decided to crawl over the rails)
Unintentional Tort
56
"Let the master answer"
Respondeat Superior
57
An employer can be held liable for the actions of an employee
Respondeat superior
58
"The thing speaks for itself"
Res ipsa loquitur
59
Requires the defendant (the individual being sued) to prove his or her innocence
Res ipsa loquitur
60
Pig-O-Stat, sand bags, sponges, tape used properly:
all immobilization devices used by the technologist 24/7 36/5
61
Devices used to reduce patient dose because of motion and repeats
Immobilization Devices
62
Tape used improperly or incorrectly:
illegal restraint
63
The patient had his or her hands taped against his or her will.
Illegal Restraint Device
64
Presentation of material is considered an example of what mode of communication?
Verbal/Written Communication
65
Attitudes are considered an example of what mode of communication?
Verbal/Written
66
Voice tone and volume are considered an example of what mode of communication?
Verbal/Written
67
Effective listening is an example of what mode of communication?
Verbal/Written
68
Eye contact is considered an example of what mode of communication
Non-verbal
69
Touching is considered an example fo what mode of communication?
Non-verbal
70
Facial Expression is considered what mode of communication?
Non-Verbal
71
the sum of verbal and non-verbal communication
Meta communication
72
A sensitivity to the needs of others that allows you to meet those needs in a constructive manner?
Empathy
73
"Patient I sure do understand"
"Patient I sure am sorry"
"Patient I understand because I understand what you are going through"
Empathy
74
The grieving process involves five steps:
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
75
use reflective answers and give support without being unrealistic
Denial
76
answers to patient questions should be of a "matter of fact" nature
Anger
77
directions given the patient should be clear and simple
Bargaining
78
responses should be quiet and supportive
Depression
79
Show a willingness to listen to the patient as they communicate the nature of their loss
Acceptance
80
Cropping of masking off anatomy
Only mask to the edge of the collimated field, DO NOT crop ANATOMY
81
What should we as technologists not manipulate?
exposure indicator
82
Processessing algorithm
Look up tables, applies the appropriate histogram to anatomy
83
Interacting with others such as the elderly (Age)
speak up with elderly patients/slow down
84
Explanation of medical terms:
we should allow patients to ask us questions prior to the examination
Pre-post examination
NEVER give out the diagnosis
85
As a male technologist, walk out into the waiting room and call the patients name, immediately I see that the patient is female and muslim, what should the technologist do?
Should not do: Get her in a private setting and ask her questions she is uncomfortable with, "can you take your top off" "is there any chance you might be pregnant"
Should do: recognize that she has values and beliefs, get a coworker/colleague because she is more comfortable with her.
86
As a technologist I do not speak spanish and that is all my patient speaks. How would you best handle this?
Get a colleague or coworker
87
What is the patient prep for an Upper GI?
NPO 8 hours prior to
NPO after midnight old school
88
What is the patient prep for an IVU, Scheduled BE?
Cleanse the bowel
Start an enema cleansing bowel prep
Fleeks kit, Easy Prep
24 hours prior to, light liquids only, NPO 8 hours prior to.
89
A patient presents and you preform a BE and you want to know if it is ok to send the patient with these post-instructions.Is is ok to tell the patient to:
a. drink plenty of fluids after they had the BE (yes)
b. tell the patient that if they haven't had a BM in 24 hours to contact the physician (yes)
c. Is is ok to tell the patient that they will see barium when they use the bathroom (yes)
d. Is is ok to tell the patient to use a laxative (NO) because you can throw off their PA balance.
KNOW, a technologist is never to prescribe anything such as a laxative.
90
Does CT use radiation?
Yes
91
Does MRI use radiaiton?
NO
92
Does ultrasound use radiation?
NO
93
Does Radiation Therapy use radiation?
YES
94
If a patient is going to be having an MRI:
Ask them if they were ever exposed to metal
95
If a patient is going to have a pelvic ultrasound it requires:
a full bladder
96
MRI patients must be questioned regarding:
1. internal metal
2. electronic or magnetically activated implants or devices
3. Only MRI sage equipment in Room.
97
PET stands for:
Positron Emission Tomography
98
Uses an x-ray beam to produce images of the breast:
Mammography
99
Patient Prep for mammography?
ensure the patient is not wearing any powders or lotions on the breasts or underarm deoderant
100
uses ultrasonic waves directed into tissues to visualize deep structures of the body
Sonography
101
uses radio-frequencies and a magnetic field to produce sectional images of the body
MRI (magnetic resonance imaging)
102
uses an x-ray beam to record predetermined planes in the body
Computed Tomography (CT)
103
introduces radioactive substances into the body for diagnostic as well as therapeutic purposes
Nuclear medicine
104
Uses dual energy x-ray absorption (DEXA or DXA) to detect osteoporosis by measuring the density of bone. Do not perform the study if the patient has had a recent barium contrast or nuclear medicine examination
Bone densitometry (BD)
105
Patient Prep for a CT exam?
based on the exam being preformed, if the exam is utilizing contrast media the patient must be NPO after midnight. Thorough patient history must be taken.
106
MRI Patient Prep:
If the exam is utilizing contrast media NPO after midnight. Thorough patient history. All metal must be removed and to make sure that there is no metal in the body.
107
Sonography Patient Prep:
drink plenty of water
108
What is the relationship between the wheelchair and x-ray table when transferring?
Parallel, 45-degrees
109
When transferring the patient from the wheelchair to the x-ray table:
place strong arm closest to the table when transferring. Do not ask the patient if they are right or left handed. Evaluate if there is a cast on the arm, CVA that caused paralysis on one side of the arm. Place strong arm closest to the table when transferring.
110
Rules of Body Mechanics:
1. provide a wide and stable base of support and maintain alignment
2. Standing with feet apart and one foot slightly in front of the other.
3. keep load well balance and close to the body when lifting.
4. keep back straight and avoid twisting the trunk
5. Work at a comfortable height
6. better to PUSH a heavy object
7. better to PULL the patient onto stretcher or table.
111
Is it better to Push/Pull a heavy object? example: wheelchair, stretcher
Push
112
Is it better to Push/Pull a patient?
Pull
113
The method of moving the patient with spinal injury, metastatic disease, fracture and subluxation:
Log Rolling
114
Which of the following pathologies could the log rolling technique be used?
subluxation fracture
subluxation
115
The log rolling technique requires:
3-5 people
Two on each side and one at the head (team leader)
Support the hips and shoulders to work in unison
116
Which person for the log rolling technique calls the shots and when to roll the patient in unison?
The person at the head of the the patient.
117
What is the Pulmonary Artery (Swan Ganz) catheter used for?
Diagnosis of the right and left ventricular failure and pulmonary disorders
Monitor effects of specific medications
118
Where can you find the tip of the Swan Ganz cathetor?
Tip of the pulmonary artery
119
Nasal Cannula
Delivers Oxygen to the Nostrils
120
Nasal Cannula flow:
low flow device
1-6 L/MINUTE (21% to 60% oxygen)
121
Used on patients that do not tolerate a nasal cannula
Oxygen mask
122
Non-rebreather mask flow:
15 L/MINUTE
60-90% oxygen to the patient
123
Oxygen Mask flow:
greater than 5 L/MINUTE
124
Oxygen Tent
Commonly used on pediatric patients
125
Oxygen is delivered at a higher concentration than room air
Oxygen Tent
126
Feeding tube is also called a:
Nasogastric Tube
127
Used for feeding or for gastric suction
Nasogastric Tube
128
When a tube is left in the tracheotomy opening:
TracheOSTOMY
129
Surgical opening cut in the trachea to create an artificial airway
TracheOTOMY
130
A urinary catheter, does it go below or above the site of insertion?
Below
131
An IV, does it go below or above the site of insertion?
Above
132
A closed chest drainage tube, does it go below or above the site of insertion?
Below
133
Used to remove free air or fluid from the pleural cavity
Closed Chest Drainage
134
Pleural Effusion:
fluid in the pleural cavity
135
Pneumotorax
air in the pleural cavity
136
Hemothorax
Blood in the pleural cavity
137
Pyothorax
pus in the pleural cavity
138
Used for the drainage and collection of urine
Urinary Catheter
139
What is the minimum height of a bag of barium when performing a BE?
45 cm (18 inches)
140
What is the minimum height of a bottle of contrast for a cystogram?
Minimum of 18 inches (45 cm)
1inch= 2.5 cm
141
What is the maximum height of a bag of barium when performing a BE?
24 inches (60 cm)
1 inch = 2.5 cm
142
What is the maximum height of a bottle of contrast for a cystogram?
24 inches (60 cm)
1 inch=2.5 cm
143
Always maintain a solution bottle/bag/IV bag:
18 inches minimum (45 cm) to 24 inches maximum (60cm) above the level of the vein
144
Device used to measure patient's blood pressure:
sphygomomanometer
145
Used for auscultation (listening) to the heart, lung, or abdominal sounds:
Stethoscope
146
Pulse rate and oxygen saturation percentage:
Pulse oximeter
147
Pulse normal value for an adult:
60-100 beats/minute
148
Pulse Normal Value for Children:
90-100 beats/minute
149
Pulse normal value for infant:
80-120 beats/minute
150
Most common for pulse palpation site for a patient in cardiac arrest:
carotid artery
151
Pulse palpation site for skull:
temporal artery
152
Pulse palpation site for neck:
carotid artery
153
Pulse palpation site for grion:
femoral artery
154
Pulse palpation site for lower extremity:
dorsal pedis artery
155
Where can you find the dorsal pedis artery?
lower extermity
156
Where can you find the femoral artery?
Groin
157
Where can you find the radial artery?
Upper Extremity
158
Where can you find the carotid artery?
NeckWhere
159
can you find the temporal artery?
Skull
160
What is the most common site to take the pulse if the patient is conscious?
Wrist (radial artery)
161
What is the most common site to take the pulse if the patient is unconscious?
Neck (carotid artery)
162
fast heart rate, greater than 100 beats per minute:
Tachycardia
163
slow heart rate, less than 60 beats per minute:
Bradycardia
164
represents the pressure created during the contraction of the left ventricle
Systolic
165
represents the pressure within the vascular system with the heart at rest:
Diastolic
166
Blood pressure equation:
Systolic/Diastolic
167
Blood pressure of 120/80, which is the diastolic?
80
168
Blood pressure of 120/80, which is the systolic?
120
169
Which one is relaxation of the heart?
Diastolic
170
What is the contraction of the heart?
Systolic
171
High arterial pressure:
Hypertension
172
Above 140 mmHg systolic:
hypertension
173
Above 90 mmHg diastolic:
Hypertension
174
low arterial blood pressure
Hypotension
175
Below 95 mmHg systolic
hypotension
176
Below 60 mmHg diastolic:
Hypotension
177
Adult normal blood pressure:
systolic:110-140 mmHg
diastolic: 60-80 mmHg
178
Children normal blood pressure:
systolic: 70-112 mmHg
diastolic: 26-70 mmHg
179
Infant normal blood pressure:
systolic: 60-105 mmHg
diastolic: 22-60 mmHg
180
Normal range for an adult respiratory rate:
12-20 breaths per minute
181
Normal range for children respiratory rate:
30-60 breaths per minute
182
Normal respirations are:
normal, quiet, effortless, and uniform
183
Apnea
cessation of breathing (no breathing)
184
Bradypnea
slow breathing
185
Tachypnea
Rapid breathing
186
When more than normal effort is required to breathe, the patient may be described as:
dyspneic or having dyspnea
187
Eupnea:
normal breathing
188
How do you remove clothes from a stroke victim/traumatic injury/shoulder dislocation/shoulder seperation. How do you properly take the shirt off and put it back on?
Take off: take good arm out first and then slide it off the stroke/injured side
Put on: put stroke/injured side first/
189
A patient presents on an immobilization device such as a spine board/c-collar:
a technologist never removes patient from the immobilization device without a physicians order to do so
190
Horizontal Lateral/cross-table lateral/c-spine:
Never move the patient on the immobilization device without the physician order
191
The patient fell under your watch who do you report that to?
immediate supervisor
192
You get a needle stick in the performance of your job report to:
immediate supervisor
193
When you overhear the coworker discussing patient confidentiality who do you report that to?
ARRT Ethics Comittee
194
The problem you are having is with the supervisor themselves who do you report that to?
directly to their supervisor
195
Results from cervical trauma and affects the body from the neck down:
Quadroplegia
196
results from trauma to lower portion of the spinal column and affect the lower half of the body
Paraplegia
197
usually results from a stroke and its effects are limited to one side of the body
Hemiplegia
198
What do you do if abnormal vital signs are recognized?
1. stop the procedure
2. stabilize
3. call for help
199
doctors can call cervical collars and what helps?
orthotics or orthoses, log roll
200
Signs of a Stroke?
1. Facial Drooping
2. Arm Weakness
3. Speech Slurring
4. Time to Call
(FAST)
201
When moving patients from one location to another, what is required?
Wheeled transport
202
Before transferring a patient:
1. check the safety of the equipment
2. provide clear instructions to the patient
3. Get help if needed
203
A technologist should always document:
factual information, not opinions
204
Incident reports should be:
completed fully and provided to the supervisor
205
When a moving a fracture of a long bone:
always support both joints (proximal and distal) and move the extremity as a complete unit
206
The height of the vertebral body has been comprimised?
Compressed Fracture
207
The best way to identify compression fractures:
any lateral view of the spine
208
Two or more pieces of bone:
Comminuted Fracture
209
Cuts 90 degrees off the long axis, is what fracture?
Transverse Fracture
210
the skin is not broken by this fracture
Closed Fracture
211
The broken bone(s) break through the skin:
Open Fracture
212
Bones are not anatomically aligned:
Displaced fracture
213
Bone is fractured but there is still normal alignment:
displaced fracture
214
What fracture breaks the skin?
compound
215
a dislocation of a joint space (any joint)
subluxation
216
a fracture that effects children
bending fracture
217
A fracture most commonly of the head of the fourth of fifth metacarpal (deviation of metacarpal):
Boxers Fracture
218
Fracture of the base of the fifth metatarsal in the foot (dancing injury)
Jones Fracture
219
Chunk of a chip of the bone that gets pulled away from the body? (island of bone)
Evulsion Fracture
220
A transverse fracture fracture of the distal radius with an dissociated ownership of the styloid and is characterized by:
Collies fracture
221
If you fall and your hand gets bent backward:
Collies fracture
222
Posterior displacement of the hand in relationship of the radius and ulna:
Collies fracture
223
Hand gets bent up under you (anterior displacement of the hand) more forward in relationship to the radius and ulna:
Smiths Fracture
224
Tangential:
To skim the surface
225
zygomatic arches are done __________:
tangentially (skim the surface)
226
Houston Settagas Sunrise is done:
tangential projection of the patella (skim the surface)
227
Popletial:
The area behind the knee
228
Retrograde:
to go against the grain/flow
229
Which of the following examinations are preformed in a retrograde manner?
BE
ERCP
230
The identification of spondylotisthesus:
PICTURE
231
The worst allergic reaction is:
Anaphylactic shock because the body releases histamines
232
Why would a patient have anaphylactic shock?
Injection of Iodinated Contrast media
Latex
233
When we inject contrast media there is always a chance of:
Anaphylactic Shock
234
Whenever you inject contrast you never:
leave the patient on the table unattended
235
The body produces:
histamines
236
What pharmacology drug do you give the patient if they are going through anaphylactic shock?
the injection of epinephrine (anti-histamine)
237
The order for CPR:
CAB (compression, airway, and breathing)
238
The rate for compression for an adult (8 year old to adult)
100/minute
239
Rate for compression for a child (1 year to 8 year):
100-120/min
240
Rate of compression for an infant: (under 1 year):
100-120/min
241
Compression to Ventilation Ratio for an adult (8 year to adult):
30:2 for both one and two rescuers
242
Compression to Ventilation Ratio for a child with one rescuer (1 to 8 year):
30:2 (1 rescuer)
243
Compression to ventilation ratio for a child for two rescuers (1 to 8 year):
15:2 two rescuers
244
Compression to ventilation ratio for an Infant under 1 year for one rescuer:
30:2
245
Compression to ventilation ratio for two rescuers for a infant (under 1 year old):
15:2
246
The key to delivering high quality CPR:
1. 100-120 compressions per minute
2. allow complete chest recoil after each compression
3. minimiz interruptions in chest compressions
4. Avoid excessive ventilation *give just enough breath to see the chest rise
5. Rotate compressors every 2 minutes
247
How do you operate an AED?
turn it on
248
In CPR the breathing rate for an adult (8 year or older):
10-12 breaths/min or every 5-6 seconds
249
In CPR the breathing rate for a child:
every 2-3 seconds
250
The CPR breathing rate for an infant (under 1 year):
every 2-3 seconds
251
When a patient presents on a spine board, as a technologist protocol is:
a horizontal beam lateral
properly cleared by the attending physician
252
When moving a fracture of a long bone:
both joint spaces
253
caused by loss of oxygen to the brain
syncope (fainting)
254
The most common medical emergency encountered by technologists:
syncope
255
High blood sugar, characterized by flushed dry skin, and mucous membranes, air hunger, and fruity smelling breath, excessive thirst and urination.
Hyperglycemia (diabetic ketoacidosis) (Kussmaul breathing)
256
Low blood sugar
Hypoglycemia
257
High blood sugar
Hyperglycemia
258
sweating, clammy, cold skin
Hyperglycemia
259
flushed, dry skin and mucous membranes, air hunger and fruity smelling breath, excessive thirst and urination
Hyperglycemia
260
sweating, clammy cold skin, nervousness and irritability blurred vision.
Hypoglycemia
261
When a patient presents and has a seizure under watch. What is the technologists primary responsibility?
1. Keep the patient safe
2. Help the patient to floor if standing
-do not pull them on the table just keep them from falling
3. Place padding under patient's head
4. Remove any hazardous objects to prevent the patient from hurting themselves
262
Petite mal (non-convulsive) seizure:
seizure may not be apparent to the radiographer
263
A sudden "horse cry" from the patient followed by forceful contractions of the abdominal and chest muscles
Grand Mal (tonic-clonic) (major motor seizure)
264
Bright red blood (oxygen in it)
Arterial blood
265
Strong pulsating volume of blood exiting a wound site
Arterial blood
266
Darker blood (oosing)
Venous
267
Arterial blood (bright red blood) apply pressure:
on the site of any open wound or between the site and the heart
268
(Darker blood) Venous blood apply pressure:
on the site of any open wound and away from the site and the heart
269
Faint or lightheaded feeling of patient's that have been recumbent for an extended period of time and are then suddenly moved into an upright position. What should you do?
Orthostatic Hypotension, Trendelenburg (elevate the feet).
270
A technologist sets the patient up on the side of the bed and the patient says "they feel faint or dizzy", what should you do?
Trendelenburg Position (the feet elevated to get the blood back up to the brain)
271
The patient feels faint or lightheaded because they have been lying down for awhile, what should you do?
Trendelenburg Position (elevate feet to get the blood back up to the brain)
272
Epitaxis or Epistaxis
bleeding from the nose/nosebleed
273
A breathing disorder characterized by wheezing and difficulty breathing (dyspnea):
Asthma
274
May be triggered by anxiety or allergies?
Asthma
275
Asthma can be controlled by:
bronchodilator (inhaler) we can assist patients with inhalers
276
How do you address or approach a fire when it presents itself?
1. evacuate the immediate area
2. report the fire and precise location
3. close all the doors
4. shut off the main oxygen valves
5. shut off all electrical equipment
6. prepare patients for further evacuation
277
RACE represents:
Rescue
Alarm
Contain
Extinguish
278
PASS represents:
Pull, aim, squeeze, sweep
279
Medical Asepsis:
clean technique, wash hands, spray the table down between patients, change the pillow case
280
complete removal of all organisms and spores
Surgical Asepsis
281
Surgical cases use:
Surgical Aseptic Technique
282
An example of sterile asepsis:
urinary catheterization
283
The soiling or making inferior by contact or mixture
Contamination
284
Microorganisms capable of producing a disease
Pathogens
285
An inanimate object that has made contact with an infectious organism (food, water, gloves, equipment, etc.)
Fomite
286
Typically an arthropod (mosquito, flea, tick, etc.)
Vectors
287
Hospital acquired infection
Nosocomial infection
288
Physician caused infection:
Iatrogenic infection
289
infection by an unknown cause
Idiopathic
290
What is the single most common nosocomial infection:
UTI from urinary catheter usage
291
What is the single most important way to break the chain/cycle of infection?
Hand washing
292
Drag and Drop in order of evens the cycle/chain of infection:
1. Infectious agent (pathogen)
2. Reservoir
3. Portal of exit
4. Mode of transmission
5. Portal of entry
6. Susceptible host
293
An organism that is capable of producing disease:
Pathogenic Organism (bacterial, viral, or fungal)
294
An environment in which pathogenic organisms can live and multiply (can be a human, plant, animal, water, food, etc):
Reservoir of Infection or Source of Infection
295
Example staphylococci and streptococcic infections:
Direct contact, airborne, inhaled
296
Examples are radiographic tables, radiographer's hands, and calipers
Indirect, fomite, vehicle borne
297
contact by means of fomites (vehicle born):
Indirect Contact
298
objects that have come in contact with pathogenic organisms
Fomites
299
Mosquito , vectors, and malaria are examples of:
Indirect Contact
300
Droplet, or dust:
airborne contaminations
301
You should wash your hands:
pre/post every exam
302
On routine hand washing should last:
15-20 seconds or 20 seconds
303
When scrubbing for sterile procedures the hand washing time requirement is:
5 minutes
304
Dirty needles should:
never be recapped by hand
305
When you are scrubbed in the cardiac cath lab:
5 minutes
Keep hands above the level of forearm
306
Never inject air from a syringe because of:
air embolism
always remove the air from a syringe before injecting
307
What do you do with a dirty needle?
NEVER recap the needle
always throw the needle away in the sharps container
308
The back of the gown is considered:
dirty
309
Operators dressed in sterile gowns pass one another:
back to back
(never front to back)
310
Sterile gloves should be kept:
above the waist
(Air below the level of the waist is considered dirty)
311
Bleach to water ratio:
1:10 ratio
312
Bleach is typically:
mixed with water in a 1:10 ratio
313
A common disinfectant used in the radiology department
Bleach
314
The most effective method of preventing the spread of infections is:
Handwashing
315
How do you properly open a sterile tray?
The first move is away from you.
316
Steam Sterilization
Autoclaving
317
can be used in commercial sterilization
ionizing radiaiton
318
Boiling water:
12 minutes
319
Disposal of Linen:
separate disposal of contaminated versus soiled items
320
Linen disposal steps:
1. Bags need to be water-proof and impermeable
2. If the bag for contaminated materials becomes contaminated, it should be placed in a second bag labeled "contaminated"
3. Make sure the containers are appropriate and clearly marked
321
Needle disposal:
1. Needles are to be disposed of intact and never recapped
2. Needle end should be placed in the sharps container first
3. Container needs to be puncture-proof
322
Disposal of Patient Supplies:
1. contents of the urinals and bedpans should be flushed away immediately unless they are being save for diagnostic specimen
2. Pour liquids to be discarded directly into drains or toilets without spilling or splashing
3. Urinals and bedpans should be rinsed out and sent to the appropriate place for re-sterilization
4. Specimens to be sent to the laboratory should be placed in a solid container with a secure cap and the appropriate patient information
323
Blood and Body Fluid disposal:
.
324
Gloves, gowns, and restricted patient placement:
contact
325
the area around the patient that is contaminated:
3 feet or 1 meter
326
Anyone who comes in contact with the patient or close to the patient needs:
mask, gown, and gloves
327
Which of the following is effective for disinfection?
Moist Heat
328
particulate mask and restricted patient placement:
Droplet
329
Used with diseases that are spread by droplet contact as the patient coughs or sneezes:
Airborne, particulate masks are required
330
Used to prevent infection transmitted by direct or indirect contact with fecal material:
Enteric Precautions
331
Gloves and gowns are required:
Enteric precautions
332
Used for tuberculosis patients with a positive sputum culture:
Acid-Fast Bacilli (AFB) N95 masks, and gloves, gowns (gross contamination)
333
When we talk about reverse (Neutropenic) isolation:
the patient is being protected by the technologist
334
For strict isolation:
the clean tech manages the equipment and the IR, dirty tech manages the patient and patient linen
335
Used for patients with diseases transported by airborne or contact route
Strict
336
Protective isolation (neutropenic) precautions clean tech/dirty tech:
clean tech handles the patient and patient linen
dirty tech handles the IR and equipment
337
Used whenever there is a chance of coming in contact with a patient's blood or body fluids
Universal Blood and Body Fluid Precautions
338
Chemical may be harmful in the body by any route such as:
1. Skin or mucous membrane absorption
2. Swallowing
3. Inhalation
339
Using Chemicals:
1. To be used only if the container is clearly labeled
2. The label should be read several times to be sure it is being handled/used appropriately
3. Use only as directed
4. Store according to directions
5. Personal protective apparel (PPE) should be worn as directed.
340
As regarding to chemicals do not:
1. Do not mix chemicals unless compatibility verification can be made
2. Do not pour chemicals down the drain
341
If chemical contact is made with the eyes:
rinse immediately for a minimum of 15 minutes
342
Chemical spills should be cleaned up:
according to proper procedure
343
If a chemical spill happens:
Notify the supervisor, may require a follow up procedure and incident report
344
The primary route of exposure for chemotherapy agents is:
through direct skin contact and inhalation of aerosolized drugs
345
Used to minimize exposure of chemotherapy agents:
PPE, gown, gloves, mask, eye, and face protection are used.
346
All needles and syringes should be discarded:
in containers (intact) that are puncture resistant, leak proof, have a lid that seals securely and must be properly labeled (cytotoxic waste)
347
MSDS (Safety Data Sheet)
.
348
The single best indication/predictor of whether or not the patient on the table will have a reaction of a contrast media?
previously documented reaction
349
Once a technologist injects iodinated contrast medium into the patient:
NEVER leave the patient unattended on the table
350
Prior to the injection of any contrast medium:
take a pulse and a pressure prior
take a pulse and a pressure during the injection and more than one time
take a pulse and a pressure before you send them to the house one last time
351
What percentage of patient's experience a severe of life-threatening reaction to contrast media?
5%
352
About what percent of patients experience some reaction to contrast media?
5%
353
Patients with known previous contrast reactions can:
be pre-medicated to prevent the impact of the contrast
354
Pressure injector in CT, fast, all at once:
Bolus
355
Injection method in which a large or concentrated volume of a contrast media or drug is rapidly administered into an existing IV line, which as a piggyback connector or heparin lock connected to the patient:
Bolus Injection
356
What is the most dangerous kind of injection?
Bolus
357
During Bolus Injection what should you do?
watch the patient carefully, signs of respiratory or cardiac arrest must be reported immediately and the administration stopped
358
IV Drip
contrast administered by gravity such as a a PC pump, cystogram
359
Contrast administered by gravity
IV drip
360
Example of infusion administration of contrast:
cystogram
IV tubing attached to a Foley Catheter
361
Ampule
holds a single dose
362
Vial
holds multiple doses
363
The antecubital vien
single most common site to inject venous catheters or needles
364
Procedural Technique of venipuncture and intravenous injection:
Insert the needle into the vein at a 15-degree angle, and gently advance the needle into the vein. When there is back flow of blood into the tubing the needle is positioned properly.
365
The second most common site to inject venous catheters or needles:
Basilic vein (back of the hand)
366
Two types of negative contrast medium:
Room Air and C02 gas crystals
367
Dark black, very little rates of attenuation, negative contrast:
radiolucent
368
The single most common contrast medium used in radiology:
Room Air (patient take a deep breath in and hold it please do not breathe)
369
White, Bright, barium, gastrografin gastroview, oil based:
Radiopaque
370
related to the concentration of an osmotic solution and has a relationship to the patient risk of reaction
Osmolarity
371
The thickness of contrast media
Viscocity
372
How do we reduce viscosity of contrast media?
warm it
373
In a single contrast study the kV range to select is:
120-125 kVp
374
dissociates into two (anion and cation) molecules in water or blood:
Ionic contrast media
375
designed to reduce the frequency of adverse reactions resulting from iodinated contrast administration
Non-ionic contrast
376
Limits the production of ions within the blood stream when the contrast is administered.
Non-ionic contrast
377
Does not disassociate into anion and cations
Non-ionic contrast
378
Will have no effect on an iodine allergy reaction
Non-ionic contrast
379
Isovue, omnipaque, optiray
Non-ionic contrast
380
Slowly absorbed within the body, not commonly used:
Oil based contrast
381
Kilovoltage used for an exam that utilizes iodinated contrast media is typically limited to a value of:
80 or less in order to prevent over penetration of the contrast
382
Why is barium combined with a molecule?
Barium sulfate reduces the toxicity
383
Non-Ionic or Ionic. Which one has Iodine?
Both
384
Used in cases in which a perforated bowel may exist:
Gastrografin (water soluble, Iodine based positive contrast)
385
May be administered orally or through a nasogastric tube:
Gastrografin
386
Be (barium enema) (single contrast study):
barium only, kV 100-125 kVp
387
kV range for a double contrast study? ACBE
90-100 kVp
388
PA and lateral chest x-ray routinely done in the department:
110-125 kVp
389
What contrast medium should be used when dealing with a preforation?
Gastrografin
Gastroview
Water-soluable
(NOT BARIUM)
390
Use of contrast agents on who can be particularly hazardous?
elderly
391
Patients with impaired ____________ must be adequately assessed before an iodinated contrast is administered because these patients are at risk for increased disease.
renal or liver function
392
Normal Creatinine:
0.7-1.3 mg/dL
393
Blood urea nitrogen (BUN) normal value:
8-25 mg/dL
394
Glomerular Filtration Rate (GFR):
90-120 mL/min/1.73 m^2
395
Estimated glomuler filtration rate (eGFR):
best test to measure kidney function and determine the stage of kidney disease.
396
It is calculated from the results of Creatinine test, body size, age, and gender.
eGFR
397
As a technologist if you inject contrast media and see extravasation by looking at the:
hematoma under the skin
398
How do you manage an extravasation?
remove the needle, apply warm compress and elevating the effecting extremity. Immediate attention is needed to prevent tissue necrosis if the extravasation involves a corrosive drug and a cold compress should be applied at the site.
399
Accidental infiltration of a vesicant- (contrast media) into the interstitial tissues at the site of injection. Pain swelling, redness.
Extravasation
400
When fluid infuses the tissue surrounding the venipuncture site.
Infiltration
401
A general term used to describe a failure of circulation in which blood pressure is inadequate to support oxygen perfusion of vital tissues and is unable to remove the by-products of metabolism.
Shock
402
Results from external hemorrhage, lacerations, or plasma loss due to burns:
Hypovolemic Shock
403
Patients that suffer head or spinal trauma resulting in a failure of arterial resistance.
Neurogenic Shock
404
Results from massive infection
Septic Shock
405
Results from cardiac failure
Cardiogenic Shock
406
Results from being injected with a foreign protein, bee stings, iodinated media:
Allergic or Anaphylaxis Shock
407
Medical term for hives:
Uticaria
408
Not life threatening but their presence may be an indicator of a more severe reaction.
Hives
409
When a patient presents on the table and inject contrast medium, what happens to the pulse when a patient presents with anaphylactic shock.
Increase in pulse rate
Drop in the blood pressure
410
Examples of mild reactions:
nausea and vomiting, hives, itching, sneezing, extravasation, vasovagal response, such as fear, exhibited by weakness, dizziness, sweating, and a feeling of passing out
411
Tech response to a mild reaction?
1. monitor and comfort the patient, provide a warm towel for extravasation
2. if vomiting occurs roll the patient on their side and provide a emesis basin.
3. Document the patient's reaction
412
Moderate reaction examples:
excessive hives, tachycardia (rapid heart rate), giant hives, excessive vomitting.
413
Tech response for a moderate reaction:
1. call for medical assistance
2. prepare for administration of antihistamine medication
3. Monitor and comfort the patient
4. Document the patient's reaction
414
Any reaction that involves a life threatening situation:
Severe reactions
415
All of the following are examples of mild reactions except:
cyanosis (blue around the lips and gums)
416
very low blood pressure, cardiac or respiratory arrest, loss of consciousness, convulsions, laryngeal edema, cyanosis, difficulty in breathing, and profound shock:
Severe reactions
417
Tech response to a severe reaction:
1. call for immediate assistance
2. remove any physical items that may be in the way of the medical staff
3. prepare for administration of antihistamine medication and if needed assist in proving cardiopulmonary resuscitation (CPR)
418
Decadron (decamethosone)
pharmacology drug given for an allergic reaction
419
What is a good antihistamine for a good contrast reaction or allergic reaction?
Decadron (dexamethosone)
420
The pharmacology drug for siezures?
Dilantin
421
Generic name for decadron?
dexamethosone
422
Generic name for benadryl?
Dyphenhydramine
423
Lasix:
drug for edema
424
Epinenphrine:
Cardiac Arrest, Anaphylaxic Shock (administered IV)
425
Nirtroglycerin:
Chest Pain (angina)
426
A patient is having a potential heart attack what do you do?
give them nitroglycerine, administered sublingal (under the tongue)
427
For someone who presents for a BE, a colonic spasm, what type of drug would you give them?
Glucagon
428
A patient who is hypoglycemic what do you do?
eat a candy bar
429
A patient who has hyperglecemia?
given insulin,metformin (generic),glucophage
430
When do you give glucogon?
before a barium enema
431
Drugs given for shock?
Levophed
Intropin
Dobutrex
432
Blood thinners, blood clots, Cumatin, heparin, warfarin, once you inject on a patient. You need look at the chart to know if they are on blood thinners becuase?
It would be harder to stop the bleed, pull the needle
433
A patient presents their known documented reactor, what type of drugs are given prior to the reaction of?
Ducadron (dexamethosone) or Benadryl (diphenhydramine)
not both or not together
some type of steroid (prednisone)
434
The technologist injected a contrast medium, they have a reaction on your table, your job is to?
document in the patient chart
435
What is checked 48 hours prior to the procedure and after contrast media?
BUN
436
Which emergency medication may not be found in the crash cart?
Glucagon
437
Arrhythmia Medications:
Pronesty
Isoptin
Corarone
Adenocard
Xylocane
