RAD 117 FINAL

Explain NG Tube placement?

Explain NG Tube placement?

• Inserted through the nasopharynx into the stomach, duodenum, or jejunum

• Most common NG tubes: Levin and sump tube

Explain NE Tube placement?

• Move into the duodenum and small intestines with peristalsis

What are tubes with a hollow lumen through which secretions and air can be evacuated or through which medications, nourishment, or contrast can be instilled?

• Nasogastric (NG) and nasoenteric (NE) tubes

• Technologists are not responsible for inserting or removing NG or NE tubes

What position is the patient placed in during an NG or NE tube placement?

• Fowler’s position

Explain ET Tube placement?

• Correct placement of the tube is approximately 5 to 7 cm above the carina

• A chest radiograph is always obtained to ensure proper placement

Explain G-Tube placement?

• Placed from the inside of the stomach to the external abdominal wall for the the purpose of feeding a patient who cannot tolerate oral food intake

What are signs that patients would need to be suctioned?

• Profuse vomiting in a patient that can’t change position

• Audible rattling or gurgling

• Signs of respiratory distress

What are the precautions and scope of practice for suctioning?

• Emergency suctioning is not within the scope of practice of a radiographer

• Radiographers are only responsible for checking the emergency suctioning equipment

Explain lithotripsy?

• Tube that carried urine from the kidneys to the bladder

• Use of shock waves to break up stones in the kidney and parts of the ureter

Explain arthrography?

• X-ray imaging of joints (shoulder, knee, hip, etc.)

• Contrast media is injected into the joints

Explain myelography?

• X-ray of the spinal cord

• Contrast media is injected into the subarachnoid or epidural spaces of the spinal cord

Define: Lavage

• The process of washing out an organ, usually the stomach, bladder, or bowel

Define: Suctioning

• An emergency procedure done when a patient may be unable to clear emesis, sputum, or other drainage from the nose, mouth, nasopharynx, oropharynx by coughing or swallowing

What are the precautions when caring for a patient with an ET tube?

• The radiographer must insure that the tube placement has not shifted

What are the precautions when caring for a patient with tissue drains?

• Place at or near wound sites or operative sites when a large amount of drainage is expected

• Infection control

What are the precautions when caring for a patient with a chest tube?

• May require the placement of one or more chest tubes inserted into the pleural cavity

• Water-sealed drainage system is established by connecting the chest tube to a clear tube that ends in a chamber containing a sterile solution

Category: Diuretics

Brand name: Lasix (found on emergency drug carts)

Generic name: Furosemide

• Used to treat hypertension, acute pulmonary edema, and congestive heart failure

• Reduces blood volume through urinary excretion to water to treat hypertension

Category: Antianxiety drugs (Benzodiazepines)

Brand name: Ativan

Generic name: Lorazepam

• Used for treatment of anxiety, and in some cases, to treat behavior disorders

Category: Drugs affecting the blood

Brand name: Heparin

Generic name: Heparin sodium

• Inhibits formation or fibrin clots, used to maintain potency of venous catheters

• Used to prevent thrombus formations and extension of thrombi (blood clot)

Category: Opioid analgesics (narcotic)

Brand name: Morphine

Generic name: Morphine sulfate

• Used to control intense pain and the anxiety that results (may create dependence)

Category: Antianxiety drugs (Benzodiazepines)

Brand name: Valium (found on emergency drug carts)

Generic name: Diazepam

• Used for treatment of anxiety, and in some cases, to treat behavior disorders

Category: Antihistamines

Brand name: Benadryl (found on emergency drug carts)

Generic name: Diphenhydramine

• Used to prevent anaphylaxis (allergic reactions)

Explain biotransformation?

• Metabolism of drugs in the body

Explain first-pass effect?

• Partial metabolism of a drug by the gastric and hepatic circulation before it reaches the systemic circulation

Explain pharmacodynamics?

• The study of the method or mechanism of drug action on living issues or the response of tissues to chemical agents at various sites in the body

Explain pharmacokinetics?

• The process that control absorption, distribution, metabolism, and excretion of a drug

Explain the metabolism of a drug, and why an oral drug is given in higher doses?

• Drugs are processed differently (age, ethnicity, health status, gender, weight, time of day, etc.)

• Larger doses taken orally compensate for first-pass effect

Explain half-life?

• The time it takes for a drug’s presence in the body to be decreased by 50%

Explain clearance rate?

• The drug’s removal from the body (including contrast media)

What are the three methods of drug administration?

• Enteral

• Topical

• Parenteral

Explain enteral drug administration?

• Oral, sublingual (PO), buccal, and rectal

Explain topical drug administration?

• Application of drug on skin, eyes, nose, throat, vagina, or rectum

• Respiratory mucosa by inhalation

Explain parenteral drug administration?

• Non-oral means of administration

• Drug is injected directly into the body

What are the types of parenteral drug administrations?

• Subcutaneous

• Intramuscular

• Intradermal

• Intravenous

Explain needle length?

• Range from 3/8 to 2 inches long

• The smaller the lumen the larger the gauge

• Range from 1-50 mL

Define: Gauge

• The size of the hole in the needle

Define: Barrel

• The body of the syringe

Define: Tip

• The end of the syringe to which the needle is fastened

Define: Hub

• The part that attaches to the syringe (the actual needle)

Explain IV injection steps?

1. Tourniquet placement: between the heart and inches away from the injury

2. Site selection: find the best vein suitable for venipuncture

3. Clean up: needles and syringes should be disposed of in the sharps container; recapping should never occur

Explain negative and positive contrast media?

• Negative: carbon dioxide and air

• Positive: barium and iodine

What is the purpose of contrast media?

• Contrast media is considered a drug

• Highlights the differences between body tissues in a radiograph

How to reduce patient anxiety?

• Observe the patient and inform them carefully regarding the benefits of the IV procedure

What is the correct order of scheduling multiple contrast exams?

• Starting from high to low (chest, abdomen, etc.)

• The least amount of contrast needed may be done first

Explain the medical short hand for drug administration?

• PO - by mouth

• IM - intramuscular

• IV - intravenous

• STAT - at once

• VO - verbal order

• SC or SQ - subcutaneous

• ID - intradermal

• bid - twice a day

• gtt - drop

• cc - cubic cm

• ac - before meals

• pc - after meals

• hs - at bedtime

• PRN - as necessary

• q - every

• qd - every day

• tid - three times a day

• q2h - every 2 hrs

What are the five rights of drug administration?

Right . . .

• Drug

• Dose

• Route

• Time

• Patient

Define: Side effect

• When a drug produces an effect that is mild, common, unintended, and nontoxic

Define: Adverse reactions

• When a drug produces an effect that is more severe or life threatening

Define: Toxic reactions

• An unwanted effect that is an extension of the therapeutic effect

Explain infusion vs. bolus?

• Infusion - the introduction of a drug slowly through the blood stream

• Bolus - a single, large quantity dose of drug intended for therapeutic use

Explain extravasation vs. infiltration?

• Extravasation - the escape of IV fluid from a vessel into tissue due to irritation

• Infiltration - IV does not irritate tissue

What to do when extravasation occurs?

• STOP the IV if the patient has itching or a feeling of congestion or fullness in the the chest or throat

• Notify the physician or RN

• Some drugs are very irritating to tissues and cause necrosis and sloughing

What types of drugs need to be labelled as not being able to dispense without a prescription?

• Opioids, methadone, morphine, and others; Demerol, OxyContin, Morphine

• Codeine, hydrocodone with aspirin or Tylenol, nonamphetamine stimulants, Vicoden

Explain sterile technique and infection reduction for IV/injections?

• Surgical asepsis: referred to as “sterile technique”; the complete removal of microorganisms and their spores from the surface of an object

• Medical asepsis: any practice that helps reduce the number of spread of microorganism

• Aseptic technique: any medical procedure that involves penetration of body tissues

Explain iodine IV/injection?

• Some patients can be allergic to iodine; iodine particles influences a severity of adverse reactions

• Used mostly in CT

• Increase patient’s hydration because contrast media can dehydrate patients (elderly)

Explain Barium IV/injection?

• Side effects: constipation

• Adverse reactions: may pass into the respiratory tract, peritoneal cavity, or the bloodstream

• Used commonly in GI studies

• Check the physician’s order before administering barium mixtures

Define: Osmolarity

• Concentration of particles dissolved in a fluid

What are the types of modalities in CMI?

• CT - computed tomography

• MRI - magnetic resonance imaging (no ionizing radiation)

• Mammography - X-ray of the breast

• Ultrasound - non-ionizing frequency sound waves

• PET - position emission tomography; uses gamma rays (for cancer)

• DEXA - dual-energy X-ray absorptiometry (diagnose osteoporosis)

• Cardiac interventional - cath-lab (OR radiography; angioplasty)

• Vascular interventional - special procedures (OR radiography; angioplasty)

• Radiation therapy - treats cancer

Define: Myelography

• Radiographic examination of the spinal cord

• Contrast media is injected into the subarachnoid or epidural space

Define: Lithotripsy

• Surgical crushing of stone(s)

Define: Angioplasty

• Surgical repair or unblocking of a blood vessel (usually coronary)

Define: Arthrography

• Diagnostic imaging examination of a joint

• Injected with contrast media and followed with fluoroscopy and/or CT