RAD 117 FINAL

%%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


1. __**Site selection**__: find the best vein suitable for venipuncture
2. __**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
* Positiv**e**: 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?**%%

* I**nfusion** - 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