Chapter 15 Intro to Radiologic & Imaging Sciences & Patient Care

Cessation of spontaneous ventilation

apnea

Absence of gas from part or the whole of the lungs as a result of failure of expansion or reabsorption of gas from the alveoli

atelectasis

listening to sounds of the body, typically through the use of a stethoscope

auscultation

Measurement of the degree of heat of the deep tissues of the human body

Body Temperature

Slowness of the heartbeat as evidenced by slowing of the pulse rate to less than 60 beats per minute

bradycardia

abnormal slowness of breathing

bradypnea

profuse sweating

diaphoresis

Pertaining to dilation, or a period of relaxation of the heart, especially of the ventricles

diastolic

difficult or labored breathing

dyspnea

pertaining to or characterized by fever

febrile

Constancy in the internal environment of the body, naturally maintained by adaptive responses that promote healthy survival

homeostasis

persistently high arterial blood pressure

hypertension

abnormally high body temperature, especially that induced for therapeutic purposes

hyperthermia

abnormally low blood pressure, seen in shock but not necessarily indicative of shock

hypotension

low body temperature

hypothermia

decreased oxygen tension (concentration) in the blood

hypoxemia

reduction of oxygen supply to the tissue

hypoxia

Insertion of a tubular device into a canal, hollow organ, or cavity

intubation

difficulty breathing except when sitting up or standing erect

orthopnea

increased amounts of fluid within the pleural cavity, usually the result of inflammation

pleural effusion

presence of air or gas in the pleural cavity

pneumothorax

Photoelectric device used for determining the oxygen saturation of the blood

pulse oximeter

action of inhaling oxygen and exhaling carbon dioxide during breathing

respiration

instrument for measuring blood pressure

sphygmomanometer

Pertaining to tightening, or a period of contraction of the heart (myocardium), especially that of the ventricles

systolic

Rapidity of the heart action, usually defined as a heart rate greater than 100 beats per minute

tachycardia

abnormal rapidity of breathing

tachypnea

volume of air inhaled and exhaled during one respiratory cycle

tidal volume

Mechanical movement of air into and out of the lungs

ventilation

Your role as an RT is to accurately assess a patient. You can do this by:

1. Schedule patients in correct rooms

2. Determine the sequence patients should be done

3. Relay information to Radiologist

4. Changes in patient conditions- this can avoid life-threatening emergencies

If you build a rapport with your patient, you build trust and in return they are more likely to

cooperate

If you have to stop/leave during an exam, __________________ with your patient that you are doing so. Keep checking up on your patient. Also, if your shift is over introduce who is going to take over for you.

communicate

Key aspects to comfort your patient:

1. Introduce yourself

2. Your Presence is comforting

3. Touch

4. Reassure your patient- explain the procedure

5. Don't leave in the middle of the exam if possible

Physical discomfort can add tension in turn this can (state problems and solutions):

1. Make it hard for them to be still - (use sponges and pillows)

2. Trouble breathing - typically in obese pts (prop up)

3. Cold - (get warm blankets, tuck in)

4. Crying or running nose - (get tissue)

5. Dentures, glasses, hearing aids, jewerly etc- (give them a plastic bag or falcon tube)

If patient is thirsty and asks you for some water. What should you do?

Check chart first! Record amount. Patient may be NPO

What does NPO stand for ?

Nothing by mouth

We need to asses current physical status of the patient. During the physical evaluation we need to check for:

1. Change in skin color (Pale -Physical change)

2. Anxious or Apprehensive (Sweaty palms or shaking hands)

3. Diaphoretic - (Sweating)

4. Fever- Hot Dry Skin

5. Cyanosis- Fingertips/lips are blue and indicates that they need oxygen

Vital signs include

body temperature, pulse, blood pressure, respiratory rate, and electrolyte balance

`What are the instruments you use to measure vital signs?

Watch, stethoscope, sphygmomanometer, and thermometer

Vital signs can be

1. assessed quickly

2. objective - non invasive

3. measure physiologic indicators of response to therapy

Normal temperature

98.6 F or 37 C

The _____________ plays an important role in the preservation of heat by initiating shivering (to generate heat) and vasoconstriction (to conserve heat)

hypothalamus

The _____________ system plays an important role by removing excess heat through ventilation

respiratory

Thermoregulation is the term use to describe the body's maintenance of heat production and heat loss. The ______________ plays an important role in regulating heat loss and can initiate peripheral vasodilation and seating (diaphoresis) to dissipate body heat.

hypothalamus

What is the average oral temperature?

98.6 O

What is the average tympanic temperature?

97.6 T

What is the average temporal artery temperature?

100.0 TA

What is the average rectal temperature?

99.6 R

What is the average axillary temperature?

97.6 A

Fever with temperature higher than 99.5, orally (38

Pyrexia or Hyperthermia

temperature below normal range

hypothermia

_____________ ___________ in the body may occur if body temperature fluctuates more than 2.0-3.0 F

physiologic changes

The body exchanges oxygen and carbon dioxide. Both events must take place or ________ will occur

death

The muscle of ventilation is the ___________

diaphragm

Diaphragm contracts and moves downward.

-Pushes abdominal content outward

-Expands the chest cavity

Inspiration

relaxation of diaphragm

-returns to the floor of the chest cavity

expiration

A single __________ consists of an inspiratory phase and expiratory phase

respiration

Normal respiratory rate for an adult is

16-20 breaths/min

Normal respiratory rate for children under age 10 is

20-30 breaths/min

Normal respiratory rate for newborns is

30-60 breaths/min

The number of respirations may be influenced by:

1. Emotions

2. Pain

3. Activity and age

4. Drug and disease

5. Temperature

The ratio or respiration to heartbeats is approximately

1 to 4

Respirations should be observed for differences in:

1. Depth (shallow, normal, deep)

2. Pattern (regular or irregular)

3. Degree of effort

4. Rate

respirations greater than 20/min

tachypnea

decrease in respirations -less than 12/min

bradypnea

decreased oxygen in the blood or tissues -blood pressure increases

hypoxia

carbon dioxide levels are low respirations increase in rate and depth

hyperventilation

number of heartbeats per minute (contraction of the walls of the heart push blood into the arteries)

measurement of pulse

The pulse can be palpated at superficial arteries:

-Temporal

-Radial (Most Common)

-Brachial (antecubital fossa of adults) also common

-Carotid (neck) also common

-Femoral

-Popliteal

-Pedal

Most accurate way to listen to heartbeat?

Apical - listening with a stethoscope

What is the normal adult heart rate?

60-100 bpm

What is the normal child under 10 heart rate?

70-120 bpm

Pulse oximeter is placed on finger, toe or earlobe. Finger or toe ______ _________ must be removed for accurate reading

nail polish

Normal range for O2 is

95-100%

used to provide continuous observation of the heart rate and blood pressure

arterial catheters

If pulse irregularities are accompanied by complaints of palpitations, dizziness, or feeling faint they can be ____________ ____________

life threatening

Characteristics to note when calculating pulse

Rate, rhythm, volume

Use 2nd and 3rd finger over artery do no not use _________ - compress gently

thumb

_______ _________ is a measure of the force exerted by blood on the arterial walls during contraction and relaxation of the heart

blood pressure

Blood pressure is the product of:

1. intensity of the contraction of the heart ventricle

2. amount of blood being pumped out of the heart

3. resistance of blood vessels to blood flow

Blood pressure is measured with

stethoscope and sphygmomanometer

Blood pressure are recorded in

millimeters of mercury (mm Hg)

Normal systolic pressure

110-120 mm Hg

Normal diastolic pressure

60-80 mm Hg

________ measurement over the _________ measurement

systolic; diastolic

_____________ pressure measures the pumping action of the heart muscle, or the force of ventricular contraction (the peak pressure present during left ventricular contraction)

systolic

_____________ pressure measures maximum cardiac relaxation, or the lowest pressure of the ventricle between heartbeats

diastolic

persistent elevation above 140/90 mm Hg

hypertension

blood pressure of less than 95/60 mm Hg

hypotension

Having hypertension causes damage to

heart, brain, kidneys, lungs, other organ systems

provides the specific information regarding types and number of cells that make up the blood

Complete blood count

red blood cell count (RBC), hemoglobin(Hgb), and hematocrit(Hct) all relate to the ______ ______ component of blood

red cell

Low RBC , Hgb, and Hct are associated with

anemia, blood loss, and fluid retention

Elevated RBD, Hgb, and Hct are associated with

polycythemia and dehydration

When you are injecting contrast your patient needs to be

hydrated

_______ _________ ________ counts and differential counts are done to detect infection

white blood cell (WBC)

Depression of WBC can indicate

immunosuppression, excessive radiation exposure, or chemotherapy

__________ are the mechanism for forming clots

platelets

Normal Activated Partial Thromboplastin (APTT) is :

-Patients receiving heparin

25-35 seconds

Blood urea nitrogen (BUN) normal range ?

7-18 mg/dl