Patient Care Exam Review #3

What is the most common nosocomial infection?

UTI’s (urinary tract infection)

Why are UTI’s the most common nosocomial infection?

due to poor infection control practices by the HCW during placement of catheters

2 types of catheters and their function

Straight Catheter: used to obtain a specimen or to empty the bladder and then removed

Indwelling Catheter (Foley): Inserted and left in place to allow for continuous drainage of urine

Do you have to worry about sterile technique when inserting urinary catheters?

YESSSSSSS

You do not need a physician’s order to place a urinary catheter?

T/F

FALSE

Why must a urinary catheter drainage bag be kept below the level of the bladder?

maintains gravity flow and prevent contamination from back flow of urine

If a drainage bag has to be lifted above the level of the bladder what should we do, and why?

clamp tubing

prevent back flow

If a pt has any type of cystography done, what type of contrast is used?

cystografin

Meatus

opening of the urethra

Retrograde

moving in a direction opposite from normal

Cystography

imaging of the bladder

Voiding

emptying urine from the bladder

Voiding Cystography

imaging of the pts ability to empty the bladder

Cystourethrography

imaging of the bladder and urethra

Voiding Cystourethrography

urethra is studied as the pts voids upon removal of the catheter

Retrograde Pyelography

imaging done to visualize the proximal ureters and the kidneys after injection of contrast

What is the reason that a pt might have a ureteral stent placed?

if a pt has an obstructed ureter due to stricture, edema, or malignant tumor, a stent may be placed to relieve the problem

NICU

Neonatal Intensive Care Unit

What are 3 ways to prevent the spread of infection in the NICU

hand hygiene

clean and disinfect equipment before entering NICU

If RT has any forms of respiratory illness or even a cut on their skin, they must stay away from the NICU

What are 2 types of immobilizers used for children

PAPOOSE

PIGG-O-STAT

Why is radiation safety important for peds pts

radiosensitivity of their rapid and changing cell growth

a geriatric pt is considered ____ and older

65

Polypharmacy

multiple medication consumption

It is the responsibility of the RT to be able to differentiate between normal changes of aging and the deficits from a disease process

T/F

TRUE

Depression is common and debilitating in an aging person

TRUE

Arthroplasty

repair of joint

2 most common types of arthroplasty

knee and hip

The most common post op complication is

dislocation of the hips

What is drug addiction

overwhelming feeling of physical need for a particular drug that must be met at all costs; uncontrolled cravings

Give 3 withdrawal symptoms from drug addiction

depression

headache

N/V/D

Contrast media is considered a drug

T/F

TRUEEEE

Adverse Reaction

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

Extravasation

To move or pass through a vessel into the tissues

The process that controls absorption, distribution, metabolism, and excretion of drugs by the body

Pharmacokinetics

The method or mechanism of drug action on living tissues

Pharmacodynamics

Side Effect

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

The study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs

Pharmacogenetics

Adverse reactions to contrast typically occur with:

ionic, high osmolarity, iodinated contrast, administered IV or arterially

Give an example of a parenteral route of drug administration

Intravenous (IV)

Give an example of a enteral route of drug administration

Oral or rectal

A _________ reaction to iodinated contrast media occurs within ____ minutes of administration

SEVERE; 20 MINUTES

List 4 symptoms of a severe reaction to iodinated contrast

dyspnea

diffuse edema

wheezing

anaphylactic shock

List 4 symptoms of a mild reaction to iodinated contrast

edema

scratching throat

nasal congestion

sneezing

List 4 symptoms of a moderate reaction to iodinated contrast

facial edema

wheezing

diffuse urticaria

diffuse erythema

Osmolarity

measure of solution concentration

mixability

how the contrast mixes with bodily fluids

viscosity

thickness of the contrast

toxicity

contrast media’s potential to be toxic

bolus

large amount injected at one time

vial

small container holding several doses of medication

ampoule

small container; holds a single dose

Normal lab values for Creatinine

0.6 - 1.5 mg/dL

Normal lab values for BUN

6 - 20 mg/dL

4 side effects of iodinated contrast agents

Pain at the injection site

headache

altered taste

N/V

List 4 symptoms of a vasovagal reaction to iodinated contrast

Pallor

cold sweats

rapid pulse

syncope

What are 2 functions of the Large Intestine

absorption of water and vitamins

elimination of waste products

What is the most common type of contrast and why

Barium sulfate

little toxicity and inexpensive

Peritonitis

inflammation of the serous membrane lining the abdominal cavity

Colostomy

artificial opening created in the large intestine to evacuate the bowels

ILEOSTOMY

artificial opening created in the small intestine to evacuate feces

NG tube

tube inserted through the nose into the stomach

Ostomy

general term for an operation in which an artificial opening is formed

Stoma

opening in the body created by bringing a loop of bowel to the skin surface

Cathartic

substance that accelerates defecation

NEGATIVE contrast agents _________ organ density to produce contrast

DECREASE

What are 2 examples of negative contrasts

air

CO₂

POSTIVE contrast agents ___________ organ density to improve radiographic visualization

INCREASE

2 examples of positive contracts agents

barium sulfate

iodinated contrast

if there is a contradiction of barium to be used during a GI exam, what type of water soluble contrast would be used instead

GASTROGRAFIN

5 contraindications of barium usage

1. perforation of gastric mucosa

2. disease or injury that may cause perforation

3. esophageal varices

4. toxic mega colon

5. Prior to surgery

When scheduling GI exams what are the 4 rules that must be considered

fasting exams must be done in the morning

all non contrast exams must be done first

iodine before barium

lower GI before UGI or SBFT

What is the correct order in which you would schedule GI exams

1. Iodine

2. BE

3. UGI

4. SBFT

What is the most important information to tell a pt after a barium contrast exam?

Increase fluid intake and eat high fiber diet

What is the reason to tell pts what to do after a barium contrast exam

avoid barium being retained or fecal impaction

avoid dehydration

How can we prevent hip dislocation post op

CORRECT POSITIONING

sitting- uncross legs and hips not should not be flexed more than 90 degrees

weight bearing restrictions may apply

NEVER ADDUCT LEGS