Rad Tech & Patient Care MIDTERM

Chapters 8, 12, 13

What is a NPO?

nothing by mouth

1. What is orthostatic hypertension?

2. How can you prevent this?

1. a mild reduction in the oxygen supply to the brain that occurs with changes in body position

-may cause patient to feel light headed/faint when rising suddenly

2. allow the patient to pause and regain a sense of balance before moving immediately

For patient who have had a stroke, which side do you assist from? What other help do you give them?

1. position yourself on the weak side

2. brace the patients weak leg

3. position patient with strong side adjacent to bed/table and tell them to lead with their strong leg

What are the steps to transfer a patient from a bed to their wheelchair?

1. lower bed to lowest position

2. lower side rails

3. position wheelchair parallel to bed with wheels locked & footrests out of the way

4. lift patient to sitting position, pivot while lifting, allowing patient’s legs to clean edge of table/bed

5. allow patient to rest briefly before standing

6. use face-to-face assist to raise weak patient to standing position

7. help patient pivot back to wheelchair

8. ease patient to sitting position

9. adjust legs and footrests

10. cover patient’s lap and legs for comfort

What are the movements ALLOWED for patient transfer if they just had hip surgery via the anterior approach? Which are NOT ALLOWED?

1. allowed:

   1. may sit upright

   2. weight bearing usually tolerated (check chart)

2. not allowed:

   1. abduction

   2. adduction

   3. internal & external rotation

   4. hyperextension

What are the steps to assist a patient from the wheelchair to the table?

1. lock wheelchair brakes & move footrests out of the way

2. assist patient to stand

3. assist patient with step stool if necessary

4. assist patient to pivot and sit on table

5. support patient’s shoulders while raising their legs onto table; ease patient to supine position

What are the movements ALLOWED for patient transfer if they just had hip surgery via the posterior approach? Which are NOT ALLOWED?

1. allowed

   1. weight bearing usually tolerated (check chart)

   2. abduction

2. not allowed

   1. adduction

   2. internal rotation

When should you use side rails?

1. during patient transport

2. leaving patient unattended

3. for elderly, weak, disoriented patients

4. during radiographic exams

   1. if turning/rotating patient, use side rail to prevent patient from rolling off table

What are the types of elder abuse? What are the signs of elder abuse?

physical abuse, neglect, mistreatment

1. bruises

2. pressure marks

3. broken bones

4. abrasions

5. burns

6. decubitus ulcers

7. unattended medical needs

8. poor hygiene

9. unusual weight loss

emotional/verbal abuse

1. unexplained withdrawal from normal activites

2. sudden change in alertness

3. unusual depression

4. belittling, threats, uses of power/control by spouses

5. strained/tense relationships between caregiver & elderly

6. frequent argument between caregiver & elderly

sexual abuse

1. bruises around breasts

2. bruises around genital area

finacial abuse

1. sudden changes in financial situation: exploitation

Define exploitation

illegal misuse/concealment of funds, property, assets for another’s benefit

When a patient needs to void (urinate) in the department, what is the best course of action?

1. ask nurse

2. check chart

When a patient asks for something to drink in the department, what is the best course of action?

1. ask nurse

2. check chart

What is the best method to transfer an obese patient from a wheelchair to the x-ray table?

1. ASK FOR HELP 

2. Gait belt 

3. Hoyer lift

4. hydraulic lift

Which way is better for a hip surgery anterior or posterior

posterior

If you detect an irregular pulse, what pulse site should you check to verify?

apical pulse using a stethoscope

Why shouldn’t you use the thumb to check a pulse?

It has a pulse

Which 2 laboratory value is the best indicator of kidney function?

1. BUN

2. creatinine

3. GFR

Define:

1. recumbent

2. supine

3. prone

4. lateral recumbent

5. SIMS position

6. Fowler

7. Trendelenburg

1. lying down in any position

2. lying down on back

3. lying face down

4. lying on one side

5. leg up, knee flexed and leg back (sleeping position)

6. upper body elevated above feet

7. head lower than feet

What is SIMS position used for?

1. rectal temperature

2. rectal examinations

Define orthopnea

difficulty breathing when lying down

Define tachycardia

rapid heart rate

greater than 100 bpm

Define diaphoresis

excessive sweating

How should patients who experience difficulty breathing, nausea, abdominal pain need to be positioned?

Need to have their head elevated

Define emesis?

vomiting

How do we avoid bedsores (decubitus ulcers)?

1. move patient every 1-2 hours

2. use radioluscent pad if a patient is in position on table for longer than 10 minutes

What are some signs of child abuse?

1. multiple injuries

2. evidence of chronic or repeated injury with no other explanation

3. injuries that are not consistent with the parents’ report of the trauma

4. failure to seek prompt treatment for serious injury

5. bruise marks in shape of hand, finger, objects (belt)

6. specific patterns of scalding (child immersed in hot water)

7. burns from stove, radiator, heater, hot objects on hands/butt

8. cigarette burns on exposed areas/genitals

9. bite marks

10. lash marks

11. choke marks around neck

12. circular marks around wrist/ankles

13. seperated skull sutures or bulging fontanel in infant

14. unexplained unconsciousness in infant

1. What is cyanosis

2. How do you check for it?

1. blue coloration of the skin: blood flow is not adequate to body

2. look at their skin, usually fingers, nails, nailbeds

What are characteristics of physical abuse referred to as?

NAT: non-accidental trauma

1. What does BUN test for?

2. What are the normal ranges for BUN (blood urea nitrogen)

1. how much urea is in the blood, how well kidneys are removing waste

2. 7-21 mg/dL

   1. high BUN= dehydrated, kidneys not function properly, renal failure

   2. low BUN= overyhydration, liver diease, malnutrition

1. What is creatinine?

2. What are the normal ranges?

1. waste product from muscle metabolism

2. 0.7-1.5 mg/dL

   1. high creatinine= kidneys not functioning well, NOT fit for IV contrast

What does creatinine and GFR levels fluctuate with?

1. age

2. gender

3. muscle masss

4. hydration levels

1. What is GFR?

2. What does it test for?

3. What are the normal ranges?

1. Glomerular Filtration Rate

2. tests how much blood kidneys filter per minute (mL/min)

3. 90-120 mL/min

   1. <90= kidneys not functioning properly to filter out IV contrast

a _____ BUN level & ____ creatinine level indicates decreased kidney function.

high; high

a _____ GFR level indicates decreased kidney function.

low

What temperature is the most accurate?

rectal temperature

What is the average adult temperature for:

1. oral

2. tympanic (ear)

3. axillary (armpit)

4. rectal

1. 98.6

2. 99.6 (1 degree more)

3. 97.6 (1 degree less)

4. 99.6 (1 degree more)

What two temperature average are the same for adults?

tympanic & rectal (99.6)

1. Define pulse rate

2. what is the average pulse rate?

1. # of pulses per minute

2. 60-100 bpm

1. Define blood pressure

2. what is the average for systolic and diastolic?

1. lateral force exerted on the arterial walls

2. 119/79 : average

   1. systolic: 100-119

   2. diastolic: 60-79

Define systolic and diastolic

1. systolic: ventricles contracting (1st sound)

2. diastolic: ventricles relaxing (last sound)

What are the tests for blood clotting?

1. PT

2. PTT

3. INR

4. Platelet

Define PT test for blood clotting

1. what does it stand for?

2. what does it measure?

3. what are the normal ranges?

1. prothrombin time

2. measures time it takes for liquid portion of blood to clot

3. 11-13.5 s

   1. >13.5 s: blood not clotting adequately

Define PTT test for blood clotting

1. what does it stand for?

2. what does it measure?

3. what are the normal ranges?

1. partial thromboplastin time

2. measures blood coagulation time (same as PT)

3. 25-35s

   1. >35 contraindication for IV (uncontrollable bleeding may occur)

Define INR test for blood clotting

1. what does it stand for?

2. what does it measure?

3. what are the normal ranges?

1. international normalized rate

2. blood coagulation (same as PT and PTT)

3. 0.8-1.2

   1. >1.2: contraindication for IV

Define platelet test for blood clotting

1. what does it measure?

2. what are the normal ranges?

3. what does low count and high count mean?

1. # of platelets in blood & blood clotting activity

2. 150-400k

   1. low count= potential for bleeding disorders (contradiction for IV)

   2. high count= clotting disorders

1. what is respiratory rate?

2. what are the normal ranges?

1. # of cycles (inspiration & expiration) per minute

2. 12-20 breaths/min

Define dyspnea

difficulty in breathing

1. what does pulse oximetry measure?

2. what are the normal rates?

3. what is considered hypoxic?

1. measures oxygen saturation in blood

2. 90-100%

3. below 90%

Define bradypnea and what is the number?

slow breathing

fewer than 12 breaths per minute

Define tachypnea and what are the numbers?

rapid breathing

more than 20 breaths per minute

Define pleurisy

inflammation of the pleura causing adhesions between the lungs & the chest wall

Define hypertension

abnormally high blood pressure

Define hypotension

abnormally low blood pressure

hypotension can result in a potentially life-threatening condition called ____.

shock

What are the symptoms of shock?

• increase in pulse rate & respiratory rate

Define diaphoresis and what causes this?

secretion of sweat

elevated body temperature, physical exertion, heat exposure, mental/emotional stress

Explain how to take a patient’s history

A: acknowledge- warmly greet patient by name

I: introduce- tell the patient who you are (name, title, length of time in profession) and what you will be doing

D: duration- explain how long exam will take & update of delays

E: explanation- describe exam patient will undergo & collect pertinent history

T: thanks- express gratitude to patient choosing facility, exhibiting patience, being positive

Why would the use of a rectal thermometer be contraindicated?

it can stimulate the vagus nerve which has connections to the sympathetic nervous system throughout the thoracic, abdominal, and pelvic cavities

What type of questions would you ask a patient when obtaining their history?

• open ended questions

• facilitation

• silence

• reflection or reiteration

• clarification or probing

• summarization

What is the standard format that is used to determine and describe the chief complaint in the event that a detailed history is required?

• onset: how did it start? what happened? when did it first trouble you? Was it sudden or a complaint that gradually got worse?

• duration/chronology: have you had it before? has it been continuous? does it bother you all the time? how long has this attack been bothering you?

• specific location: where does it hurt or where is the problem? can you put your finger on where it hurts the most? does it hurt anywhere else?

• quality of symptoms: what does it feel like? sharp or stabbing pain? dull ache? throbbing pain?

• severity of pain: how severe is it? mild, moderate or severe (pain scale)?

• what aggravates/alleviates: what seems to make it worse? when is it worse? is it worse after meals? at night? walking? what has helped?

• associated manifestations: are there any other symptoms that you are experiencing?

Define emphysema

enlargement of air spaces in lungs (Type of COPD)

What is the range for stage 1 hypertension?

systolic: 140-159 mm Hg

diastolic: 90-99 mm Hg

What is the range for stage 2 hypertension?

systolic: 160 mm Hg or greater

diastolic: 100 mm Hg or greater

Define embolus

free-floating clot, air bubble, or other substance in bloodstream

Define thrombus

blood clot attached to interior wall of vein or artery

When do we use a pig-o-stat?

for chest exams of infants and toddlers

What is the difference between restraints and immobilization?

restraints are used to restrict movement for safety, where immobilization restricts undesired motion during imaging procedures

What are the steps to empty a urinary bag?

1. hold bag below bladder to prevent back up

2. if bag has rigid measuring container within reservoir, tilt the bag to empty the measured unit in the reservoir

3. wearing non-sterile gloves, open clamp and allow bag to empty into waster container

4. reclose clamp

5. record amount