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Review Patient Care

What is the ethical principle that never to, above all, do harm? Nonmalficence.
When medications are given any way other than orally, what is it called? Paranterally.
What is it called when medications are given orally? Enterally
What is a lesion with a stalk projecting inward from the intestinal mucosal wall? Polyp.
What is an outpouching from the wall of an organ such as the colon? Diverticulum
What is an abnormal tubelike passageway between organs, or between the organ & the surface? Fistula
What type of shock results from a sever allergic reaction to foreign proteins after an injection? Anaphylactic shock
What type of shock results from a loss of a lot of blood or plasma? Hypovolemic shock
What type of shock results when toxins produced during a massive infection cause a dramatic drop in blood pressure? Septic shock
What type of shock occurs 2ndry to cardiac failure or other interference with heart function? Cardiogenic shock
What type of shock occurs from the pooling of blood in the peripheral vessels? Neurogenic shock
Hypotension, tachycardia & cardiac arrest are symptoms of what type of reaction to iodinated contrast media? Cardiovascular reaction
Between which vertebrae is the most likely space for a lumbar puncture? Between L2 & L3
Which portion of the femur is the intertrochanteric crest located? On the proximal posterior portion. The trochanteric crest runs obliquely between the greater & lesser trochanter's posteriorly.
What type of reaction to IV contrast would a few hives, flushed face & nausea signal? A minor reaction
What is anemia characterized by? Decreased hemogolobin & circulating red blood cells.
Can the radiographer be found liable of a negligent tort to for failing to ask a patient of their pregnancy status? Yes.
What 4 elements must be present for a negligent tort? Duty (what should have been done), Breach (Deviation from duty), Injury sustained & Cause (as a result from breach).
Where are the heels of the hands positioned for sternal compression for CPR? 1 1/2" superior to the xiphoid tip.
Are fluids & medications administered intravenously for a local effect? No. Medications are generally administered topically for a local effect.
What reasons are medications administered intravenously for? To promote a rapid response & to administer parenteral nutrition.
What are the symptoms of hypoglycemia? Fatigue, irritability, restlessness & weakness.
What are Maslow's heirarchy of needs, from bottom to top? 1.) Physiologic needs (food, water, air, rest...) 2.)Safety & security 3.)Love & Belongingness 4.)Self-Esteem & Esteem of others 5.)Self Actualization.
What is it referred to when a patient who has been recumbent for some time gets up quickly & suffers from light headedness & feels faint? Orthostatic hypotension
What is the ethical principle bring about good (being kind), or benefiting others called? Beneficience
What is the ethical principle that refers to faithfulness? Fidelity
What is the ethical principle that refers to sincerity & truthfulness (telling the truth)? Veracity
What type of transmission based precaution are patient's with Rubella (German Measels), Mumps & Influenza? What type of room do these patients have? How would the RT be prepared for these patient's? Droplet precautions. The droplet precautions patient's are in a private isolation room. A regular string mask (an N95 mask for influenza), sometimes with gown & gloves.
What type of transmission based precaution are patients with Tubercle Bacillus (TB), Varicella (Chickenpox) & Rubeola (Measels)? What is required to avoid spread for patients on these precautions? How would the RT prepare? What type of room? Airborne precautions. The patients are required to wear a mask when being transported to the X-Ray dept. If patient does not have a mask, RT must wear N95 mask. Patients are in a negative pressure room.
What type of transmission based precautions are patients with MRSA, C-Diff (Clostridium Difficile) & some wounds? What type of room for these patients? What is required of the RT for these patients? Contact precautions. Patients have a private room. Gloves & gown for anyone coming into contact with the patient.
What physical sign(s) may indicate weakness when the patient appears in the radiology department? Diaphoretic patient? Patient with fever? Anxious (anxiety) patient? A patient who needs oxygen? Paleness frequently indicates weakness. Pale, cool skin for the diaphoretic patient. Hot dry skin for fever patient. Sweaty palms for the anxiety patient. bluish lips, mucous membranes & nail beds for the cyanotic patient needs oxygen & medical attention.
A radiographer who discloses confidential patient information to an unauthorized party can be found guilty of what? If the disclosure is in someway harmful, or detrimental to the patient, what else may the RT be guilty of? What are the 2 types? An invasion of privacy. Defamation. Slander (spoken defamation) & Lible (written defamation).
Which of the following drugs is used to treat disrhytmias...Epinephrine, Lidocaine (Xilocaine), Nitroglycerin, Verapamil? Lidocaine (Xilocaine) is used to treat cardiac arryhythmias.
Which of the following is a bronchodilator? A Vasodlator?...Epinephrine, Nitroglycerin, Verapamil. What does a bronchodalitor do? A vasodilator? Epinephrine is a bronchodilator, it relieves bronchospasm. Nitroglycerin & Verapamil are vasodilators. Vasodilators relax the walls of blood vessels permitting increased blood flow.
Which of the following are examples of COPD, Bronchitis, Asthma, Pulmonary Emphysema? All of them.
What is the term for a quantity of medication introduced intravenously over time? What is the term that refers to the quantity of material being injected? What is the term for a rapid injection? An IV infusion. A bolus. A push.
What are some of the minor adverse reactions to IV contrast? Anaphylactic shock manifests early symptoms that include what? A flushed appearance, nausea (occasional vomiting), a few hives. Constriction of the throat (laryngeal edema), dysphagia (difficulty swallowing), itching of the palms & toes.
For CPR, what is the rate of chest compression's for infants? 5 compression's/breath = 100 compression's/minute.
Which of the following are forms of intentional misconduct, slander, invasion of privacy, negligence? Slander & invasion of privacy.
What would it be considered if an RT left a weak patient standing & the patient fell & hurt themselves? Unintentional misconduct, or negligence.
What is the recommended needle angle for intramuscular injections? For subcutaneous injections? For intravenous injections? 90 degrees. 45 degrees. 15 degree angle with the arm.
To reduce back strain from moving heavy objects, should the RT push, or pull the object? Whenever possible, push (or roll) an object.
What type of transmission based precautions for MRSA patients? Are masks indicated for patients on MRSA precautions? Do they require a negative pressure room? Contact precautions. Gloves, gown & mask for anyone coming into contact with MRSA patient. Just gloves & gown for contact precautions. MRSA patients do require a private room, but without negative pressure.
For a patient with a tracheostomy, which is true of the following? Should sterile technique be employed if touching the tracheostomy for any reason? Should the patient be well aerated prior to suction? How many seconds should I never suction longer than? Both of them. A sterile technique should be used if I touch the tracheostomy for any reason. The patient should be well aerated prior to suctioning a tracheostomy. I should never suction longer than 15 seconds, permitting the patient to rest in between.
What is the normal BUN ranges for blood chemistry? Normal BUN range is 8-25 mg/100 mL.
What is the normal creatinine range for blood chemistry? Normal creatinine range is 0.6-1.5 mg/100 mL.
Which one of the following is not a mechanical obstruction seen in infants? Paralytic (adynamic) ileus, meconium ileus, volvulus, intussusception. What is a meconium ileus? Paralytic (adynamic) ileus is an obstruction caused by loss of peristaltic movement. Volvulus, intussusception & meconium ileus are mechanical obstructions. meconium ileus is obstruction of the intestines by the meconium (1st feces) of a newborn.
Bluish skin discoloration owing to cyanosis may be observed in what areas of the body? gums, area around the mouth, nailbeds & earlobes.
What ethical principle is related to the theory that patients have the right to decide what will, or will not be done to them? Autonomy
What is the term for congenital clubfoot? Talipes.
What is a congenital disorder characterized by wasting of the skeletal muscles? Muscular dystrophy
What is the disorder characterized by an incomplete separation of the tibial tuberostiy (often seen in active adolescent boys)? Osgood-Schlatter disease (Osteochondritis).
What is the medical abbreviation for "after meal"? What is the medical abbreviation meaning "4 times a day"? 3 times a day? What is the medical abbreviation meaning "every hour"? pc (after meal). qid (4x a day). tid (3x a day). qh (every hour).
What are symptoms of an inadequate oxygen supply? Dyspnea, cyanosis, diaphoresis, retraction of intercostal spaces, dilated nostrils, distention of the veins.
What type of conditions would benefit from a double contrast BE? What type of conditions would benefit from a single contrast? Double contrast studies are useful for demonstration of the bowel wall (colitis) & anything projecting into it (polyps). Single contrast demonstrate outpouchings (diverticulitis).
The practice that is used to retard the growth of pathogenic bacteria is termed what? Antisepsis.
What is the term that refers to the destruction of pathogenic microorganisms through the process of disinfection? What are some examples of disinfectants? Medical asepsis. Hydrogen peroxide, chlorine, boric acid.
When assisting the patient to undress, which side (strong/weak) of the patient should be started with? Assist the patient with undressing by starting with the strong side.
When assisting the patient to redress, which side (strong/weak) of the patient should be started with? Assist the patient with redressing by starting with the weak side.
When is it okay to restart suctioning post contrast insertion through an NG tube? Why is this the only time? If the patient is at risk for vomiting. Want to be sure the contrast gets to where it needs to be. So it should only be suctioned if the patient is at risk to vomit, not just because they are uncomfortable.
What is the max suction for adults? 25 mm Hg
Why is an x-ray taken post NG tube insertion? To verify the tube is ont in the bronchus.
What is the normal adult BP range? What is the pre-hypertension range? What is the hypertension range? What is the hypotension range? Normal adult BP is 100-140 mm Hg systolic & 60-90 mm Hg diastolic. Pre-hypertension is 120-140 mm Hg systolic & 80-90 mm Hg diastolic. BP consistently more than 140/90. Hypotension is charcterized by systolic pressure less than 90 mm Hg
What measurements are taken when obtaining vital signs? Measurement of body temp, pulse rate, respiratory rate & arterial blood pressure.
What is the normal respiratory rate for adults? For young children? For infants? 12-18 breaths/minute for adults. Up to 30 breaths/minute for young children. 30-60 breaths/minute.
What is the normal adult pulse rate? for children (4-10 years)? For infants? 60-90 beats/minute for adults. 90-100 breaths/minute for children. 120 beats/minute for infants.
What is normal adult body temperature orally? Rectally? Axillary? 98.6F orally. Rectal temp generally 0.5-1.0 degrees higher than oral (99.1-99.6F rectally). Axillary 0.5-1.0 lower than oral (97.6-98.1F axillary).
What is the normal range of body temp for children 5-13 years? For infant to 4 years? 97.8-98.6F for children aged 5-13. 97.9-100.4F for infants to 4 years.
What are the 5 most easily palpable superficial arteries best suited for determination of pulse rate? Which one is most frequently used? Radial, Carotid, Temporal, Femoral & POpliteal. The radial pulse is most frequently used.
What are the low flow devices used to deliver oxygen? Which one is most frequently used? Which one is best suited for short term oxygen therapy? Which oxygen delivery system is high flow? Nasal cannula, simple face masl, partial rebreathing & non rebreathing mask are low flow. The nasal cannula. The simple face mask. Mechanical ventilators are high flow.
What is the term used to identify the diameter of the needle? How does the needle bore relate to the gauge? The gauge. As the gauge increases, the needle bore becomes smaller.
Wher should the IV bottle, or bag be hung? 18-24 inches above the level of the vein.
What is an extravasation? Extravasation refers to medication/contrast leaked to the tissue outside the vein.
In regards to BP, what happens with a loss of blood? What happens with anything clogging tubes? Loss of blood will decrease BP. Anything clogging tubes will increases BP.
What are the signs vs. symptoms? Which is subjective vs. objective? The signs are objective & can be seen, felt, heard, or measured. Such as, high BP, cough, raspy breathing. The symptoms are subjective, such as pain.
What is the difference between Type I Diabetes Myelitis & Type II? Type I the body does not produce insulin which can result in excess glucose. Type II the body produces insulin (either not enough, or not used sufficiently).
What is medication reconciliation? A process to be sure that patients & their healthcare workers have the most current medication list possible. A physical list that travels with the patient.
What do contrast pre-medications do for patients who have had a previous history of allergic response? What type of medications are they? They suppress the allergic response. combo of corticosterioids (prednisone) & antihistamines (benadryl).
What is Metformin? What must a patient taking Metformin do prior to receiving contrast media? What must the patient taking Metformin/Glucophage do after the exam? AKA: Glucophag; a drug used for non insulin dependent dianetes. A patient using Glucophage/Metformin needs to withhold use for 48 hours prior to recieving contrast. The patient must withhold use of Metformin/Glucophage for 48 hours after the exam.
What are the 4 H's? HISTORY (patient's history), HYDRATION (elderly, newborns), HAVE (have equipment & personnel ready), HEADS UP (know patient's condition, note changes).
What is an air embolism? What can happen? What amount may cause an air embolism? What is the treatment for an air embolism? Air that is entered into the venous system causing a blockage with cardiopulmonary arrest. 3-8 ml of air. Call code, administration of 100% O2 (hyperbaric recommended) with the patient in a LLD position.
What are Ethics? What are Biomedical Ethics? Ethics is a system, or code of conducts & morals advocated by a particular individual or a group. Biomedical Ethics is a branch of ethics that deal with the medical profession.
What are the 5 R's (Right's) of drug administration? The right Patient (2 forms of ID), right Drug (check 3 times), right Amount , right Route(oral/rectal/IV), right Time (time of day).
What is Pharmacokinetics? What are the processes of pharmacokinetics? The energy process that controls absorption, distribution, metabolism & excretion? Absorption, Distribution, Metabolism & Excretion.
What is Pharmacodynamics? The study of how the effects of a drug are administered. The response of tissues to chemical agents at various sites on the body.
What is the Half Life of drugs? The time required for the drug to decline by 50%.
What is a Side Effect? What is an Adverse effect? Any predictable pharmacologic action on the body other than the intended action. Any unwanted effect is an adverse effect.
What is the Lethal Dose? What is the Effective Dose? What is the Therapeutic Index? How's the Therapeutic Index calculated? Lethal dose is the amount that's lethal to 50% of the population. The effective dose is dose amount that gives therapeutic effect to 50% of the population. TI is a measure of safety of drug. As LD/ED with calculations closer to 1 being more dangerous.
What is toxicity? Is the toxicity directly related to the dose? The degree to which something is poisonous. Yes, the greater the dose, the greater the toxic effects.
What is Creatinine? Where does it get excreted? What is BUN? What is it a measurement of? Where does it com from? How is it excreted? What happens to BUN levels with liver damage. Creatinine is formed when food is changed into energy. It is excreted via the kidneys in the urine. Blood Urea Nitrogen. The amount of nitrogen in the blood. It comes from the liver & is excreted via the kidney. BUN levels decrease with liver damage.
What is conscious sedation? Why is it used? What is the difference between general anesthesia & conscious sedation? What are the 3 barbituate conscious sedation drugs commonly used? A drug induced relaxation. So the patient is able to tolerate an unpleasant procedure. The only difference is the dose, with general anesthesia having a larger dose of the same medication. Thiopental, Methohexital, Penobarbital.
What is the first line of treatment for cardiorespiratory arrest? Epinephrine
What are the 3 common opiate analgesics? Morphine, Meperidine & Fentanyl
What is an allergy? What are the types of different reactions to latex? An abnormal acquired immune response to a substance (allergen) that would not usually trigger a reaction. Irritant contact dermatitis, Allergic contact dermatitis (delayed hypersensitivity), Latex allergy (immediate hypersensitivity).
What is the purpose of contrast medium? To increase subject contrast in body tissues & areas where there is little natural subject contrast.
Why may active Hepatitis B patients not receive contrast? Because the liver metabolizes the contrast.
What is the scale of I to V for in regards to minimally controlled to the possibility of dependency? On a scale of I-V, schedule I has the high potential for dependence & Schedule V is minimally controlled.
What are contraindications for contrast media that would require further precautions prior to administering contrast? A previous allergic response, Liver disease, Renal disease, Diabetes, Sickle Cell anemia, Pheochromocytoma & Multiple Myeloma.
What is positive contrast media & negative contrast media? Which one has a higher atomic #? What does this result in? Positive contrast media has a higher atomic # resulting in greater attenuation (absorption) of x-ray photons, shich makes + contrast radiopaque (appear white). Negative contrast media are radiolucent (appear black).
For a double contrast study, what is the purpose of the negative contrast? The positive contrast? The positive contrast coats the various parts under study while the air fills the space.
Which type of contrast media will not significantly increase the osmolarity of the blood? Non Ionic contrast media
What may make an iodinated contrast media more viscous? What does this result in regarding the injection? What should be done with iodinated contrast media prior to using? Being at room temperature makes iodinated contrast media more viscous which makes the injection more difficult. iodinated contrast media should be warmed resulting in a reduced viscosity.
If there is a contrast media reaction, when do they generally occur? Within 2-10 minutes.
When the patient who is feeling dizzy, or faint cannot be assisted to chair (with head between knees) which position should they be helped to? Into the Trendelenburg position, or recumbent position with elevation of the legs if the table cannot be tipped that way.
What is a medical emergency? A sudden change in the patients condition requiring immediate medical intervention.
For the patient who has an unsplinted fracture what needs to be done in regards to moving the patient? What can a muscle spasm result in for the patient? The areas proximal & distal to the fracture site need to be adequately supported. Muscle spasm can cause additional pain & interfere with proper reduction of the fracture.
The risk of inoculation with HIV is considered high for which of the following entry sites......broken skin, perinatal exposure, accidental needle stick? Which is considered a low risk entry site? Through broken skin & perinatal exposure are considered high risk. Through accidental needle stick is considered low risk entry method.
Which of the following is there a lack of normal bone calcification......Rickets, Osteoarthritis, Osteomalacia? Rickets & Osteomalacia
Characteristics of a patient with pulmonary emphysema include which....shoulder girdle elevation, increased AP diameter of the chest, hyperventilation? Shoulder girdle elevation & an increased diameter of the AP chest.
In which stage of infection do the infective microbes begin to multiply? The Latent period
When performing cardiopulmonary resuscitation (CPR) on an infant, it is required that the number of compressions per minute, compared to that for an adult...remain the same, double, decrease, increase? The # of compression's remains the same at 100 compressions/minute.
Dorsal decubitus projections of the chest are used to evaluate small amounts of....fluid in the posterior chest, air in the posterior chest, air in the anterior chest? Fluid in the posterior chest
Which of the following would be true regarding tracheostomy patients....they have difficulty speaking, routine CXR requires the tracheostomy tubing to be rotated out of view, audible rattling sounds indicate a need for suction? They have difficulty speaking & gurgling rattling sounds may indicate the need of suction. The tube should not be rotated so it will not become dislodged & possibly cause an airway obstruction.
An inanimate object that has been in contact with an infectious microorganism is which of the following......vector, fomite, protozoa, host? Fomite
Reaction at the site of an IV injection of iodinated contrast media may be cause by which of the following.....extravasation of the contrast agent, allergy to seafood, anaphylaxis, allergy to certain medications? Extravasation of the contrast agent
Which of the following is NOT true regarding informed consent....patient must understand all aspects of the procedure, patient must be of legal age, consent must be given voluntarily, patient must be mentally competent? That the patient must understand ALL aspects of the procedure
The airborne route of microorganism transmission is by which....fomite, sneeze or cough of infected person, suspension of particles in the air? Which is by droplet? Airborne transmission is by suspension of particles in the air. Droplet is by sneeze or cough of infected person.
Is it true that non ionic contrast agents contain iodine? Can iodinated contrast media be ionic & non ionic? Yes & Yes
Created by: jamestkelley