RADT153 - Unit 4 - Drug Administration & Life-Sustaining Accessories

drug

substances capable of producing physical and/or psychological responses in the body

medication

are drugs, after administered, are used to cure, prevent, or treat illness or discomfort

- therapeutic (desirable)

- adverse (undesirable)

5 RIGHTS of drug administration

1. right patient

2. right drug

3. right amount/dose

4. right route

5. right time

percentage of radiographic procedures that requires contrast media

30%

radiopaque

anatomy is filled or outlined by POSITIVE contrast agent; appears WHITE on the radiograph

- is like bone, very solid and dense; appears white

- when we give contrast media, we are giving it that opaque look

radiolucent

anatomy is filled or outlined by NEGATIVE contrast agent; appears DARK on the radiography

atomic number for iodine

53

atomic number for barium

56

- is radiopaque

- absorbs xrays

bolus in contrast media

large dose/amount in a short period of time; one time

infusion in contrast media

a dose over a long period of time

2 classifications of iodinated contrast based on its molecular structure

1. ionic

2. non-ionic

ionic contrast media

- thicker, viscous, syrupy

- contains more iodine

- more iodine = greater chance the PT has an allergic reaction and goes through physiological changes

PRO = structures are better visualized under x-ray

non-ionic contrast media

- safer, less toxic for the PT, not as thick

CON = harder to see structures under x-ray

how many times should you verify the label before administering drug/contrast?

what 3-4 things do you verify?

3 times

- name

- strength

- dose

- expiration date

any PT given contrast media needs to be observed for a minimum of ___ before going home

1 hour

- PO

- IM

- IV

- STAT

- VO

- SC OR SQ

- ID

- BID

- GTT

- CC

- by mouth

- intramuscular

- intravenous

- at once, immediately

- verbal order

- subcutaneous

- intradermal

- twice a day

- drop

- cubic centimeter

- ac

- pc

- hs

- PRN

- q

- qd

- tid

- q2hrs

- mL

- before meals

- after meals

- at bedtime

- as necessary

- every

- every day

- three times a day

- every 2 hours

- milliliter

3 different routes of drug administration

1. enteral - GI tract. ORAL is the most efficient and cost effective way

2. parenteral - involves some break in the skin; injection; IV needle; intramuscular

3. topical

6 complications of intramuscular injections

- abscess

- nercrosis

- skin slough

- nerve damage

- prolonged pain

- periostitis

do you ever recap a needle?

NEVER; CHOOSE NO

most common site for venipuncture

median cubital vein; area around the elbow

where can a radtech start the IV

anywhere in upper extremity; fingers to shoulders or arm

is oxygen a drug?

yes, must be prescribed by physician

PaO2

- partial pressure of O2

- measures amount of actual O2 in arterial blood

HCO3

- amount of bicarbonate in arterial blood

- controls the pH

SaO2

saturation / percentage of hemoglobin with oxygen in arterial blood; want to be 97% and above

hypoxemia

- low levels of O2 in blood

- decreased PaO2 (partial pressure)

- anything less than 90% saturation (SaO2) is hypoxemia

finger probe measuring O2 levels fluctuates because....?

we are breathing in how much pure O2?

- fluctuates b/c the air we breathe is not 100% O2

- only breathe in 25% of pure O2

how to place an O2 tank?

in a holder/stand; lay on its side; NEVER leave standing

non-rebreather mask

- constant 100% concentration

- has VALVE to prevent CO2

- HIGHER level of O2 to PT

partial rebreather mask

- constant, but variable 60-90%

- NO VALVE

3 types of urinary procedures we do in radiology

1. cystography

2. ureteral stent placement (OR/IR)

3. retrograde pyelography (OR)

which procedure does PT have to be knocked out in?

stent placement

what is a pigtail catheter

- runs through the bladder, into the ureter, and into the kidney

- done under anesthesia and under surgery

why is a cystogram done in radiology?

- b/c you're only looking at the bladder

- it's uncomfortable but not as painful as a stent or retrograde

4 different catheters for urinary system

- Straight catheter

- Indwelling urinary catheter

- Suprapubic catheter

- Condom catheter

foley catheter and what type of lumen does it have

- inserted and left in place to allow for continuous drainage or urine

- inflate the balloon

- double lumen

alcock catheter has what lumen type

- deliver meds or irrigate

triple lumen

double lumen catheter

- inflatable balloon

- continuous drainage of urine into a receptacle or drainage bag

triple lumen

provides a passage for continuous irrigation of the bladder

a urine drainage bag has to be ____ than the bladder for the bladder to drain

lower

NG tubes

- polyurethane, silicone, or rubber

- inserted through the nasopharynx into the stomach, duodenum, or jejunum

= in addition for its use in diagnosis of:

1. gastric decompression

2. drainage and secretions

3. feedings (nutrition & meds)

4. control bleeding

- levin, sump, nutriflex, moss, and sengstaken-blakemore

NE tubes

- polyurethane, silicone, or rubber

- inserted through the nasopharynx into the duodenum and small intestines by means of peristalsis

- in addition for its use in diagnosis of:

1. feeding

2. gastric and intestinal decompression

3. relieves obstructions in the small intestine

- cantor, harris, and miller-abbott

how are tube positions verified?

the correct tube placement position requires verification by calling x-ray, fluoroscopy, or sending to labs using pH balance sample

tracheostomy

- create a hole in the upper airway

- can be connected to a ventilator

- CON = PT fearful of choking

positive pressure ventilation

- O2 being pumped into the lungs

- increases the PT's airway pressure through an endotracheal or tracheostomy tube

- positive pressure allows air to flow INTO the airway until the ventilator breath is terminated

- the airway pressure drops to 0, and the elastic recoil of the chest wall and lungs push the tidal volume - the breath - out through passive exhalation

negative pressure ventilation

- pulls O2 out of the lung

- AKA iron lungs

- most common in homes and polio wings of hospitals

- the vacuum (negative pressure) action replicates the human breathing causing the chest wall to inflate and deflate

- does not require an artificial airway

chest tube and drainage-- pressure in the pleural cavity is normally ____ than ____ ____, but disease or injury can alter this

lower; atmospheric pressure

pneumothorax

air in the pleural cavity causing 1 or both lungs to collapse

hemothorax

blood in the pleural cavity preventing lungs to expand normally

pleural effusion

fluid in the pleural cavity

most common places for drainage tubes to be placed are

wounds and operative sites