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SJC S1 PtC Final Rev

Patient Care Final review SJC Semester 1

What the heck?Ok, that makes sense
Patients' Needs They are in an altered state of awareness. Fear of the unknown can be overwhelming. They fear loss of control. Emotions may be unnatural.
Your Personal Needs as a Technologist •Helping others •Working with people •Making a difference •Thinking critically •Demonstrating creativity •Achieving results
Maslow’s Hierarchy of 
Human Needs from bottom to top Physiologic > Safety > Belongingness and Love > Esteem > Need to know and understand > Aesthetics > Self-Actualization
Age Groups Infant:Birth to 1 year old Toddlers:1-3 years old Preschoolers:3-5 years old School-aged children:5-10 years old Adolescents:10-25 years old Young adults:25-45 years old Middle-aged adults:45-65 years old Mature adults:65 years old and older
Patients' Needs They are in an altered state of awareness. Fear of the unknown can be overwhelming. They fear loss of control. Emotions may be unnatural.
Your Personal Needs as a Technologist Helping others Working with people Making a difference Thinking critically Demonstrating creativity Achieving results
Maslow’s Hierarchy of 
Human Needs from bottom to top Physiologic > Safety > Belongingness and Love > Esteem > Need to know and understand > Aesthetics > Self-Actualization
Communication Essentials Must have emotional intelligence. Patient care communication must be patient focused, accurate and timely. Remember to consider communication and relating with patient’s family and visitors. As a technologist, communicate within your Scope of Practice
Age Groups Infant:Birth to 1 year old Toddlers:1-3 years old Preschoolers:3-5 years old School-aged children:5-10 years old Adolescents:10-25 years old Young adults:25-45 years old Middle-aged adults:45-65 years old Mature adults:65 years old and older
Physical Changes of 
Functional Aging: Nervous System Slowing psychomotor responses Slowing of information processing Decreased visual acuity Decrease in senses
Physical Changes of 
Functional Aging: Respiratory System Decreased cough reflex Shallow breathing Decreased pulmonary capacity Kyphosis
Physical Changes of 
Functional Aging: Musculoskeletal System Osteoporosis Arthritis Decreased muscle strength Atrophied muscle mass Fear of fractures
Physical Changes of 
Functional Aging: Cardiovascular System •Decreased cardiac efficiency •Orthostatic hypotension •Arteriosclerosis •DVT (Deep Vein Thrombosis) •General feeling of tiredness
Physical Changes of 
Functional Aging: Integumentary System Loss of skin elasticity Change of skin texture Loss of touch sensation Diminished sensation of heat or cold Loss of subcutaneous fatty layer
Physical Changes of 
Functional Aging: Gastrointestinal System Loss of appetite Decreased secretions Decreased GI motility Decreased sphincter muscle control
Which states allow doctor assisted suicide? Only Washington, Vermont, California, and Oregon allow doctor-assisted suicide, but Texas and many other states allow terminally ill people to have certain life-sustaining procedures withdrawn.
Five Stages of Grieving Process 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
Patient History Taking: Questioning Skills Use open-ended questions Avoid leading questions Facilitate response from the patient Remain quiet to get a response Use probing questions to focus in on detail Repeat patient response to clarify and confirm Summarize information to verify accuracy
Objective Data Perceptible to senses Able to be measured Often physiologic Signs that can be seen, heard, felt, and so on
Subjective Data Patient feelings Pain level Attitude Opinion of observer Subject to interpretation
Sacred Seven of Medical Histories Localization Chronology Quality Severity Onset Aggravating or alleviating factors Associated manifestations
Ethical analysis four basic steps 1. Identify the problem 2. Develop alternate solutions 3. Select the best solution 4. Defend your selection
Torts A civil wrong committed by one individual against the person or property of another. Two categories: Intentional misconduct Negligence
Types of Intentional Torts •Assault •Battery •False imprisonment •Defamation •Fraud •Health Information Privacy
Assault when a patient believes he or she has been threatened in such a way that reason to fear or to expect immediate bodily harm exists
Battery Any unlawful touching may constitute battery if the patient thinks that the technologist has touched him or her in an offensive way. Battery may occur even if no injury arises from unwarranted patient contact.
Defamation Slander – false spoken statement against a person’s reputation Libel –written statements, pictures, or published comments
Negligence Negligence is a failure to use such care as a reasonably prudent person would use under similar circumstances.
Negligence Proofs (four) 1. Duty 2. Breach of duty 3. Causation 4. Damage
Diagnostic Images as Records Images are legally considered to be part of the medical record Belong to the institution in which they are made Normal retention period is 5 to 7 years Patients must sign a release form to obtain images for another provider – HIPAA requirement
Seven Cs of Malpractice Prevention Competence Compliance Charting Communication Confidentiality Courtesy Caution
The annual whole-body effective dose 
limit for the occupational worker is 50 mSv or 5 rem
Reccomended maximum accumulated whole-body effective dose is calculated by: 10 mSv x Age in Years Or 1 Rem x Age in Years
Indirect hit theory Involves the irradiation of water molecules in cell cytoplasm and creation of free radicals Most prevalent and most harmful to human body
Direct hit theory Involves x-ray photon hitting an important macromolecule such as the DNA, causing genetic damage
Cellular radiosensitivity is principally a result of the rate and duration of cellular mitosis
Results of radiation to a cell Cell death Delayed mitosis Altered mitotic rate
Things that affect cell survival to radiation Cell radiosensitivity Type of damage Type of radiation Radiation exposure rate Total dose of radiation given
Acute radiation syndrome Requires large amounts of total body exposure within a few minutes
Early Effects of Acute Radiation Syndrome 1. Prodromal stage 2. Latent period 3. Manifest stage
Late Effects of Acute Radiation Syndrome 1. Somatic effects 2. Genetic effects
For a pregnant radiographer, what is the maximum monthly embryo/fetal dose allowed? 0.5 mSv (0.05 rem)
Radiation Protection: What is the most common personnel-monitoring device optically stimulated luminescence (OSL) dosimeter-typically exchanged every 2 months
Four Main Mechanisms for Homeostasis •Heartbeat •Blood pressure •Body temperature •Respiratory rate
Vital Signs •Body temperature •Pulse rate •Blood pressure •Respiratory rate •Sensorium (Mental state)
Normal Vital Signs: Temperature 97.7° to 99.5° F
Normal Vital Signs: Respirations Adult: 12 to 20 breaths per minute Child: 20 to 30 breaths per minute
Normal Vital Signs: Pulse Adult: 60 to 100 BPM Child: 70 to 120 BPM
Normal Vital Signs: Blood Pressure Systolic: <120 mm Hg Diastolic: <80 mm Hg
Routes of Body Temperature Measurement 1. Tympanic: tympanic membrane in the ear 2. Temporal Artery: infrared sensor that measures the temperature over the temporal artery (forehead) 3. Oral: Under tongue; do not bite down 4. Rectal: through the rectum 5. Axillary: Armpit
Hypothermia Temperature below normal 97.7° F
Hyperthermia Oral temperature higher than 99.5° F
Common sites of pulse measurement Radial artery Brachial artery Carotid artery
Tidal volume amount of air exchanged under normal conditions (one inspiration and expiration)
Where is proper Endotracheal tube positioning? 1-2 inches superior to the tracheal bifurcation
Common Thoracostomy 
Insertion Site Vary with the intrapleural substances to be removed Usually inserted in fifth to sixth intercostal space Laterally and midaxillary line
Central Venous Pressure Line Catheter that is inserted into a large vein to: Administer a variety of drugs Manage fluid volume Serve as a conduit for blood analysis and transfusions Monitor cardiac pressures chemotherapy and parenteral nutrition
Different types of CVP lines PORT-A-CATH (chemotherapy) PICC (peripherally inserted central catheter) Swan-Ganz catheter (pulmonary artery catheter)
Picc Line Placement Most common insertion site is subclavian vein. Position should be superior vena cava, approximately 2 to 3 cm above the opening of the right atrium
Pulmonary Arterial (PA) Catheter (Swan-Ganz) Predicts left-sided heart pressure by monitoring right-sided heart and pulmonary pressures. Passes through the right atrium, right ventricle, and main pulmonary artery into the right pulmonary artery
The U.S Department of Labor cites that ____________ are one of the leading causes of disability for people in working years. back problems
Base of Support the area between the feet, including the plantar surface area, in a standing position
Center of Gravity A hypothetical area of the body where the mass of the body is concentrated; gravity works from this area. Typically at level of second sacral segment
Orthostatic Hypotension A sudden drop in blood pressure caused by a change in a patient’s body position
Four types of wheelchair transfers:
 Standby Assist Assisted Standing Pivot Two-Person Lift Hydraulic Lift
Octostop Restraint Board use is limited to pediatric patients up to what age? 1 year old
Created by: paigeduh