Week 12- Patient Management

Question 1

What type of approach is essential during diagnostic x-ray procedures?

Answer 1

Holistic approach

Question 2

What does holistic care begin with the patient?

Answer 2

Effective communication between radiographers and patients

Question 3

What are the benefits of effective communication?

Answer 3

• Alleviate the patient’s uneasiness
• Increases the likelihood of cooperation and successful completion of the imaging procedure

Question 4

How must radiographers limit patient’s exposure to ionizing radiation?

Answer 4

• employ appropriate radiation reduction techniques
• use protective devices that minimize exposure

Question 5

What are the 9 ways patient exposure can be substantially reduced by?

Answer 5

1. Effective communication
2. Use of proper body or part immobilization
3. Use of motion reduction techniques
4. Use of appropriate beam limitation techniques
5. Adequate filtration of the c-ray beam
6. Use of specific area shielding
7. Select suitable exposure factors in conjunction with computer-generated digital images
8. Use of appropriate digital image processing
9. Elimination of repeat radiographs

Question 6

When is communication between radiographers and patient effective?

Answer 6

When verbal and nonverbal messages are understood as intended

Question 7

What does effective communication encourage in patients?

Answer 7

Encourages a reduction in anxiety and emotional stress

Question 8

What does effective communication enhance?

Answer 8

The professional image of the radiographer as a person who cares about patient well being

Question 9

What does effective communication increase the chances of?

Answer 9

Successful completion of the the x-ray exam

Question 10

What must the radiographer do if a procedure will case pain, discomfort or strange sensations?

Answer 10

Inform the patient of all before the procedure begins without overemphasizing them

Question 11

What is a result of poor communication with a patient?

Answer 11

The need to do a repeat radiograph because of inadequate or misinterpreted instructions

Question 12

What should patient protection begin with during a diagnostic x-ray?

Answer 12

Begins with clear, concise instructions

Question 13

Why is there a need for immobilization in imaging?

Answer 13

To prevent the patient from moving during the image which will create blur

Question 14

What are the consequences of blurred image?

Answer 14

• exams need to be repeated
• results in additional radiation exposure

Question 15

How can patient motion be eliminated or minimized?

Answer 15

• proper body or part immobilization
• use of motion reduction techniques

Question 16

What are the two types of patient motion?

Answer 16

Voluntary and involuntary

Question 17

What type of motion does adequate immobilization during exams help reduce?

Answer 17

Voluntary motion

Question 18

Why is shielding needed?

Answer 18

To prevent radiation exposure to radio sensitive body organs

Question 19

Which areas of the body should be shielded whenever possible?

Answer 19

• lens of eye
• breasts
• reproductive organs
• thyroid glands

Question 20

What is the first step in gonadal shielding?

Answer 20

Collimating

Question 21

What types of shields are used for the eyes?

Answer 21

Contact type shields that are positioned directly on the patient

Question 22

How much more exposure do female reproductive organs involving the pelvis receive than males?

Answer 22

3 times

Question 23

How much exposure is reduced in females by a 1mm lead flat contact shield?

Answer 23

50% reduction

Question 24

How much is exposure reduced in males with a 1mm lead contact shield?

Answer 24

90-95%

Question 25

Where must gonadal shielding be placed to provide protection?

Answer 25

Directly over the patient’s reproductive organs

Question 26

What should be used to guide placement of testicular or ovarian shields?

Answer 26

External landmarks

Question 27

In male patients in supine position what can be used to guide shield placement over the testes?

Answer 27

The pubic symphysis

Question 28

In female patients what should be used to guide shield placement of the ovaries?

Answer 28

Shield should be placed approximately 2.5medial to each ASIS

Question 29

What are the types of gonadal shields?

Answer 29

- Flat contact shields - shadow shields - shaped contact shields - clear lead shields

Question 30

What are flat contact shields?

Answer 30

An uncontoured, flat lead shield that is placed over the patients gonads

Question 31

What is a shadow shield?

Answer 31

A suspended shield that is placed above the beam defining system that casts a shadow on the patient directly over their gonads

Question 32

What is a lead filter?

Answer 32

A type of shadow shield that has breast and gonadal shielding plates and casts a shadow on the patient

Question 33

What are shaped contact shields?

Answer 33

Cuplike shields that may be held in place with a suitable carrier

Question 34

What are the benefits of specific area shielding?

Answer 34

- minimize the number of potential deleterious c-ray induced mutations expressed in future generations - reduces exposure to specific areas that are shielded

Question 35

Why is the selection of appropriate technical factors essential in diagnostic imaging?

Answer 35

It ensures patients only receive a minimal dose of

Question 36

What should high quality images have?

Answer 36

- sufficient brightness to display anatomic structures - appropriate levels of subject contrast to differentiate anatomic structures - maximum spatial resolution - minimal distortion

Question 37

What are the 7 considerations for technical exposure factor?

Answer 37

1. Mass per unit volume of tissue of the area of interest 2. Effective atomic number and electron density of tissues involved 3. Type of image receptors 4. SID 5. Type and quantity of filtration 6. Type of X-ray generator used 7. Balance of radiographic density or brightness and contrast required

Question 38

When AEC is not used what should be used to ensure uniform selection of technical exposure factors?

Answer 38

Technique charts

Question 39

What is a radiographer responsible for checking before imaging?

Answer 39

The technique chart and taking the patients condition into account

Question 40

What combination of kVp and mas reduces patient dose?

Answer 40

Use of higher kVp and lower mAs

Question 41

What does the use of high kVp and low mas result in?

Answer 41

A high energy, penetrating beam and a small,, patient dose

Question 42

What does the use of low kVp and high MAs result in?

Answer 42

A low energy x-ray beam in which the majority will be absorbed by the patient

Question 43

What is correct image post processing essential to in imaging?

Answer 43

Essential to produce a high quality image in which artifacts produced by the IR, software or patient are controlled

Question 44

What does a quality control program include?

Answer 44

Regular monitoring and maintenance of processing and imaging display equipment

Question 45

What does a quality control program mandate?

Answer 45

Full acceptance of new equipment, regular calibration and performance evaluations of existing machines and proactive and consistent image review

Question 46

What is the air gap technique?

Answer 46

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

Question 47

At what kVp levels are air gap techniques more useful?

Answer 47

When less than 90 kVp is used

Question 48

At what kVp are air gap techniques successful in chest X-rays?

Answer 48

120-140 kvp

Question 49

How does the air gap technique work?

Answer 49

Many of the scattered X-rays are so low in energy that they are absorbed by the air before they reach the IR

Question 50

Why does the SID need to be increased so much in the air gap technique?

Answer 50

To counteract the magnification that is caused by the increased OID

Question 51

How does patient dose using air gap compare to tabletop and grid?

Answer 51

It’s higher in air gap compared to tabletop but lower than grid

Question 52

What are the consequences of repeat images?

Answer 52

Additionally exposure to the patient, specifically a double dose

Question 53

What type of repeat images should be eliminated?

Answer 53

Repeats resulting from the carelessness or poor judgment of the radiographer

Question 54

When is the only time an additional image is permissible?

Answer 54

When it’s recommended by the radiologist for the purpose of obtaining additional diagnostic info

Question 55

At what rate have repeat images increased?

Answer 55

Approximately 5% but can be as high as 17%

Question 56

What are the main reasons for repeat images?

Answer 56

Positioning errors and ease of repeating

Question 57

What are the benefits of a repeat analysis program?

Answer 57

Helps identify the number of repeats and reasons for producing unacceptable images with the hopes of improving