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Pt Care Exam #3
| Question | Answer |
|---|---|
| Why do we need contrast media? | To image soft tissue structures |
| 3 types of contrast media | barium sulfate products, water-soluble iodine compounds, gases |
| 2 types of positive contrast agents | barium and iodinated contrasts |
| positive contrast agents do what to the radiographic beam | attenuate and leave white areas on the image |
| adverse reaction may occur if positive contrast agents are leaked into what | abdominal cavity |
| what are examples of negative contrast agents | air, gases, carbon dioxide |
| negative contrast agents leave what kind of appearance on a radiograph | dark (black) |
| are negative contrast agents used alone or in combination? | usually in combination w/ a positive contrast agent |
| what's a common complication that occurs when using negative contrast agents? | injection into bloodstream which causes an air embolus |
| what's the most common contrast media? | barium sulfate |
| you cannot use barium sulfate if what is suspected? | perforation |
| what are the ways that barium sulfate can be administered? | mouth, rectum, or colostomy site |
| barium is | hygroscopic (aborbs water) |
| what does barium sulfate looks like? | white powdery substance |
| what should you advise pts to do after a GI study using barium sulfate to avoid bowel obstructions? | increase fluids |
| complications of barium sulfate | constipation, fecal impaction, bowel obstruction, nausea, vomiting, aspiration |
| what can be used instead of barium if perforations are suspected or surgery is upcoming | iodinated contrast |
| iodinated contrast | absorbable, water-soluable medium |
| drawbacks of iodinated contrast | expensive, produces less radiographic contrast, dehydration |
| patient prep for barium enemas | 1. diet, 2. cathartics, 3. suppositories, 4. enemas |
| patient preparation diet for contrast exams | low residue diet for several days, increase fluid intake, clear liquids 24hrs prior, NPO 8-12 hrs prior |
| why is a pt prep diet important | so nothing mimics pathologies and leads to an incorrect diagnosis |
| what are cathartics | strong laxatives |
| what are the most common cathartics | saline and stimulant |
| what are suppositories | a tablet inserted into rectum to stimulate contraction of the bowel (peristalsis) |
| what are enemas | the process of filling the colon with fluid and flushing out fecal contents |
| most commonly used enemas | tap water and soap suds |
| types of enema tips | plain, inflatable cuff, double contrast tip w/ 2 lumens |
| what does a barium enema examine | the entire colon |
| what is a scout image | an image taken before the barium enema is started to ensure the pt properly prepped for the exam |
| what position is the pt placed in for enema insertion | Sim's position and then supine while waiting for the radiologist |
| definition of a stoma | a surgical opening |
| viscosity definition | thickness of the fluid |
| esophagus studies require ________ barium (thicker/thinner) | thicker |
| single contrast barium enemas require ________ barium (thicker/thinner) | thinner |
| viscous fluid = _________ tubing (larger/smaller) | larger |
| barium bag must be ________ then enema bag (higher/lower) | higher |
| upper GI exam prep | NPO day of exam, no smoking or chewing gum |
| what position is the pt placed in | upright position |
| pts have to drink ________ to coat the _________ | contrast; stomach |
| valsalva maneuver | increases intrabdominal pressure |
| SBFT | small bowel follow thru |
| ultrasound can give us information about ______ an organ ______ ______ but not the ______ | what; looks like; function |
| when scheduling GI exams, which should go first? gallbladder ultrasound, upper GI, HIDA scan | 1. gallbladder ultrasound (bc US cannot see thru contrast 2. HIDA scan (nuc med) 3. upper GI (bc barium is used) |
| what is a HIDA scan | it's a nuclear medicine exam that tell about organ function |
| PACU | post anesthesia recovery room |
| what's important to remember about pts in the ER | move pts minimally, watch for lines & tubes |
| NICU | neonatal intensive care unit |
| what's important to remember about pts in the NICU | they have a weak immune system so beware of spreading germs; scrub 3-5 mins, put on a gown, and clean equipment |
| ICU | intensive care unit |
| MICU/SICU | medical/surgical |
| STICU | surgical trauma ICU |
| STICU pts often suffer from | head and spinal trauma, orthopedic trauma |
| CCU/CVICU | coronary care unit; cardiovascular ICU |
| what are some important things to remember w/ pts in the CCU or CVICU | explain exam to pt, talk to pt even if they're unconscious, do what you can and document it, if you remove it replace it before leaving (blankets) |
| what is the actual name of an NG tube and where is it located | nasogastric tube; thru nose into stomach |
| what is the actual name of an NE tube | nasoenteric; thru nose into small bowel |
| thoracostomy tubes | used for removing fluid and air in the pleural space |
| what is the actual name of an ET tube and where is it located | endotracheal; thru mouth into trachea |
| what is an ET tube used for | an airway for pts |
| what is a central venous catheter and what's it used for | measures CVP (central venous pressure) and heart pressures; used for chemo, meds, nutrition, dialysis |
| port-a-cath | a catheter placed under the skin in the superior vena cava; used for chemotherapy; less susceptible to infection since it's under the skin |
| what is an arterial lines | inserted into vein, but the tip is in an artery; balloon-tipped |
| what's the purpose of arterial lines | detects pressure in pulmonary artery, measures cardiac output and left heart pressures, checks fluid levels, etc. |
| all pts with lines need to have a _____ after placement of lines to rule out ________ and check __________ | CXR; pneumothorax; placement |
| ICP line/tube | intercranial pressure |
| pharmacology | study of drug actions w/ living organisms |
| what is the trade name of diphenhydramine? | Benadryl |
| what is the generic name for Tylenol | acetaminophen |
| what's the trade name for ibbuprofen | Motrin or Advil |
| pharmacodynamics | the study of effects of drugs on normal body functions |
| examples of pharmacodynamics | changes in BP, changes in pulse |
| pharmacokinetics | the study of the way the body processes a drug |
| what are the 4 steps of pharmacokinetics | 1. how it is absorbed 2. distribution 3. metabolized 4. excretion |
| what is the main way of drug excretion | kidneys |
| kidneys can only excrete ___________ substances | water-soluble |
| first-pass effect | the partial metabolism of a drug before it reaches systemic circulation |
| half-line | the time it takes for a 50% decrease of a drug's presence in the body |
| clearance rate | drug's removal from the body |
| high clearance rate - needs to be administered _______ (more/less often) | more often |
| low clearance rate - needs to be administered _______ (more/less often) | less often |
| side effect definition & examples | unintended effect that is not harmful (dry mouth, upset stomach) |
| adverse reaction & examples | effect that is harmful (dizziness, allergic reaction, arrhythmia of heart) |
| idiosyncratic reaction | unusual reaction but not necessarily harmful |
| 6 rights of medication administration | right pt, right time, right medication, right route, right documentation, right dose |
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