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Patient Care in Radi
Patient Care Ch 9-10-11
| Question | Answer |
|---|---|
| Guidlines for trauma patients that differ from inpatients. | Trauma may have single injury or multiple injury. Each situation must be analyzed accordingly. |
| What precautions are used in trauma? | Universal precautions for whatever the situation calls for. |
| Patience and skill is required by the technologist, how do we proceed with trauma? | To accomplish the procedure without extending present injuries or increasing patients discomfort. |
| Does the RT have to assess the patient before starting the procedure? | Rt should assess pts. neurologic status and level of consciousness before starting & reassess every 5-10 minutes. |
| Can you remove any bandages or splints to do the procedure? | No, do not remove any dressings or splints and especially any impaled objects. |
| Is a trauma a routine procedure? | Two 90 degree laterals to each other, to the degree the patients condition permits,approach routine positioning with the cassette as close to the body part as possible. |
| Dealing with spinal injuries? | Using the log roll,transfer patient with as much help as possible to the table. |
| In case of skull and cervical spine injuries, what do we do first? | A crosstable lateral cervical spine must be obtained first and approved by the Dr. before moving the patient in any way. |
| What is standard procedures on trauma patients? | Each body part requirres at least two radiographs taken at 90 degree angles to one another. |
| True or False? Central ray entrance and exit points should be as close to routine as possible. | True |
| For long bone radiography in the trauma patient? | Always include the joint nearest thr trauma and the joint farthest from trauma should be included, if possible, otherwise separate views should be taken of that joint. |
| Do you need to modify technique for splints and bandages? | Wet casts need to increase mAs not kVp to avoid scatter. |
| Do you need to explain to patient if he is "out of it"? | Explain your movements clearly in order to gain whatever cooperation is possible, allow pt. as much control over movement as possible. |
| How do you take several exams at once? | Take all AP's at once in an uninterrupted sequence, then lateral positions, etc. |
| How does it help to take x-rays in sequence of all AP's then Laterals etc.? | It reduces the number of times you have to move the tube, allows overall procedure to be completed more quickly. |
| What are some of the necessary equipment needed for safety and precaution to health workers? | Provide lead aprons for anyone who may need to be in the room caring for the critically injured patient. |
| Is it OK to submit a poor radiograph because the patient was difficult to get? | No, inability of the patient to move or get in position should never be an excuse for a poor radiograph. |
| How to approach the pediatric patient? | Sensitive approach, positive manner,keep distance, explain procedure, eye level |
| NICU Neonatal Intensive Care Unit-procedure? | 2 min. hand scrub for medical asepsis.Special clothing, disinfect portable machine,prevent chilling of infant, careful not to dislodge catheters and drains. Prevent intoduction of infectious microorganisms. |
| Older Children approach? | Respect privacy, be direct and honest, child may return to role of young child, be more comfortable with parent. |
| How to transport infants? | It is safe to carry infants and small children a short distance. Long distance use crib, or gurney for older children with rails and sides up. Never leave alone. |
| Restraints and Immobilizers for the anxious child? | Folding a sheet, commercial restraints, held in position by assistants(protective gear) |
| Special care with retraints and immobilizers? | Be careful not to pinch or bruise skin or interfere in circulation. Explain that it is not for punishment and be safe and quick as possible. |
| Members of the elderly population may be classified into two groups? | The healthy elderly and the frail. |
| Is the number of elderly people on the rise or decline? | On the rise. |
| What is gerontology? | The study of all aspects of aging. |
| What are some of the common changes due to aging? | Decreased in the following, swallowing, bladder control, circulation,vision & hearing, sense of smell, muscle mass & osteoporaosis. |
| In the elderly patient what can mimic senility? | Dehydration can cause dizziness and other conditions that look like senility. |
| What are some adaptations in the radiology dept. to aid the elderly? | Remove rollers from chairs and stools, providing blankets, placing radiolucent pads on the table for comfort and handles on step stools for ease of use. |
| In elderly patients, they often have less lean body mass, would you increase or decrease kVp? | decrease kVp for the leaner patient. |
| In elderly patients, poor expansion of the lungs during CXR's may be due to what? | A decrease in alveolar elasticity. |
| Name some of the geriatric patient breakdown? | Less swallowing reflux, decrease in bladder control, lung capcity and coronary blood flow. Inability to lie flat for long periods. |
| How to treat an elderly patient? | Address them by their title and full name., give simple and direct instructions. Treat with full respect as any other patient. |
| AAD (Acute Abdominal Distress)causes: | Injuries that hemmorrhage,appendicitis, bleeding ulcers, ectopic pregnancy,cholecystitis,pancreatitis,bowel obstr. |
| On pt. w AAD, 3 reasons for a scout film? | 1. pathology(stones etc),Check technique, anatomy positioning |
| AAD Clinical manifestations: | Poss. abrasions laceration from seatbelt or entry/exit would from bullet, Rigid abdomen, severe abd. pain, N/V, extreme thirst, poss. hypovolemic shock. |
| Facial injuries usualy include? | Blow-out fracture - Malar bone (cheekbone) and the maxillary sinus. |
| How should a facial trauma be treated? | As a basal and spinal cord injury, because it is close to the base of the skull and spinal cord. |
| AAD (Acute Abdominal Distress)causes: | Injuries that hemmorrhage,appendicitis, bleeding ulcers ,ectopic pregnancy,cholecystitis,pancreatitis,bowel obstr. |
| 1. pathology(stones etc),Chk technique, anatomy positioning | |
| AAD Clinical manifestations: | Poss. abrasions laceration from seatbelt or entry/exit would from bullet, Rigid abdomen, severe abd. pain, N/V, extreme thirst, poss. hypovolemic shock. |
| Facial injuries usualy include? | Blow-out fracture - Malar bone (cheekbone) and the maxillary sinus. |
| How should a facial trauma be treated? | As a basal and spinal cord injury, because it is close to the base of the skull and spinal cord. |
| What are some results of a spinal cord injury? | Cessation of motor function/partial or complete cess. of phys. function due to level of damage:loss of bladdwr control, bowel control, loss of feeling, paralysis. |
| Most spinal cord injuries occur where? | Cervical or lumbar areas because these are the most mobile parts of the spine. |
| Two types of head injuries? | 1.Open injury:to skull or meninges, brain is susceptible to damage or infection. 2.Closed (blunt injury); brain tissue may swell; resulting in pressure to brain. |
| Why must brain and spinal cord injuries require special care? | These tissues have very little healing power. |
| Fractures at the base of the skull are called what and may result in what? | Basal skull fracture may result in tear of the dura mater, that may cause leakage of the cerebral spinal fluid (CSF). |
| Layers beneath the skull? | Skull, dura mater, arachnoid, subarachnoid(space w/CSF), Pia mater and brain. |
| What is a subdural hematoma? | An accumulation of blood between the arachnoid and dura mater resulting from a contusion or laceration of the subdural blood vessels. |
| What does an isolette do for the infant patient in the NICU? | They are environmentally and thermal controlled, and the practice of meticulous infection control measures.For infants w/ low birth weights or immature immune system which makes them more susceptible to infection. |
| Angulated Fractures: | The bone fragments & fractures at an angle to each other. Caused be direct or lateral force. |
| Avulsion Fx | Pulling away of bone and tissue from ordinary connections. Caused from direct energy and resisted extension of area affected. |
| Bucket handle Fx | Common in spine and involve condensing of the bone on one side, Cases: axial force applied from above |
| Comminuted Fx | Breaking of bones in many pieces. Crushing injuries usually produce them |
| Greenstick Fx | A break on only one side of the cortex- usually in children. Causes: minor direct or indirect force. |
| Closed Fx | Skin is unbroken. Causes: by lesser force than other type fx. |
| Impacted Fx | Wedging of bones against each other. Causes: axial force distal to fracture site. |
| Oblique Fx | Angled across the cortex of the entire bone. Causes: compression w/direct or indirect force. |
| Open or Compound FX | Breaking of the skin above fracture site. Causes; Moderate or extreme force causes the tissue tolerance to be surpassed. |
| Pathologic Fx | May be transverse, oblique or spiral. Caused be force imposed on weakened bone by tumor. |
| Spiral Fx | Curve around the cortex of the bone. Causes: twisting when the distal end is unable to move. |
| Straddle Fx | Involve the pubic rami and are bilateral. Causes; Falling w/ great force directly on an object. |
| Transverse Fx | Crosswise breaks through the bone. Causes: direct or indirect force in the direction of the site. |
| Symptoms and complications of Fx. | Swelling, edema, bleeding, bruising and shock. Complications: malunion, nonunion, thrombophlebitis, fat embolism, infection, laceration of an artery & nerve damage. |
| Types of Child retraining devices? | Sheet, Mummy, Pigg-o-stat (chest, and abd. uprights, plastic mold (IVP, abdomens) not extremities. |
Created by:
sewwhat4
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